diff --git a/40-data/_verification_log_2026-05-15.json b/40-data/_verification_log_2026-05-15.json new file mode 100644 index 0000000000000000000000000000000000000000..cf83cf29c34c695b764e585b59ef6447aba2c7d7 --- /dev/null +++ b/40-data/_verification_log_2026-05-15.json @@ -0,0 +1,251 @@ +{ + "verified_at": "2026-05-15", + "sample_size": 20, + "verified": 4, + "stale_url": 6, + "broken_url": 4, + "no_url": 0, + "ambiguous": 6, + "items": [ + { + "policy_id": "hdfc-ergo__group-health-insurance__wordings", + "bucket": "policy_facts", + "file": "hdfc-ergo__group-health-insurance__wordings.json", + "field": "day_care_treatments_count", + "claimed_value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "confidence": "medium", + "verification_status": "stale_url", + "evidence_snippet": "Page describes day care broadly (eye surgery, dialysis, chemotherapy) but states no specific count. Our claimed value 144 not on page." + }, + { + "policy_id": "icici-lombard__arogya-sanjeevani", + "bucket": "policy_facts", + "file": "icici-lombard__arogya-sanjeevani.json", + "field": "day_care_treatments_count", + "claimed_value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "confidence": "medium", + "verification_status": "broken_url", + "evidence_snippet": "HTTP 403 Forbidden on PDF URL." + }, + { + "policy_id": "icici-lombard__arogya-sanjeevani__wordings", + "bucket": "policy_facts", + "file": "icici-lombard__arogya-sanjeevani__wordings.json", + "field": "day_care_treatments_count", + "claimed_value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "confidence": "medium", + "verification_status": "broken_url", + "evidence_snippet": "HTTP 403 Forbidden on PDF URL (same as #2)." + }, + { + "policy_id": "hdfc-ergo__my-health-women-suraksha__brochure", + "bucket": "policy_facts", + "file": "hdfc-ergo__my-health-women-suraksha__brochure.json", + "field": "day_care_treatments_count", + "claimed_value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "confidence": "medium", + "verification_status": "stale_url", + "evidence_snippet": "Same HDFC ERGO day-care URL; page does not state a count. Claimed 144 not verifiable." + }, + { + "policy_id": "national-insurance__new-national-parivar__wordings", + "bucket": "policy_facts", + "file": "national-insurance__new-national-parivar__wordings.json", + "field": "network_hospital_count", + "claimed_value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "confidence": "high", + "verification_status": "verified", + "evidence_snippet": "Page states '5,322 network hospitals' in Why Choose NICL section. Exact match." + }, + { + "policy_id": "tata-aig__medicare-premier__cis", + "bucket": "policy_facts", + "file": "tata-aig__medicare-premier__cis.json", + "field": "network_hospital_count", + "claimed_value": 12000, + "source_url": "https://www.tataaig.com/", + "source_note": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "confidence": "high", + "verification_status": "verified", + "evidence_snippet": "Homepage states '12,000+ Hospitals' in Why TATA AIG section." + }, + { + "policy_id": "cholamandalam__super-topup__wordings", + "bucket": "policy_facts", + "file": "cholamandalam__super-topup__wordings.json", + "field": "network_hospital_count", + "claimed_value": 13500, + "source_url": "https://www.cholainsurance.com/", + "source_note": "13,500+ Cashless Hospitals ('Why Chola MS' section, scraped 2026-05-15)", + "confidence": "high", + "verification_status": "verified", + "evidence_snippet": "Homepage states '13,500+' cashless hospitals in Why Chola MS section." + }, + { + "policy_id": "sbi-general__super-top-up__cis", + "bucket": "policy_facts", + "file": "sbi-general__super-top-up__cis.json", + "field": "day_care_treatments_count", + "claimed_value": 142, + "source_url": "https://www.sbigeneral.in/health-insurance", + "source_note": "Per insurer baseline (SBI General health plans cover ~142 day care procedures)", + "confidence": "medium", + "verification_status": "stale_url", + "evidence_snippet": "Page describes day-care treatment but states no count; claimed 142 not verifiable from this URL." + }, + { + "policy_id": "bajaj-allianz__global-health-care", + "bucket": "policy_facts", + "file": "bajaj-allianz__global-health-care.json", + "field": "network_hospital_count", + "claimed_value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "confidence": "high", + "verification_status": "verified", + "evidence_snippet": "Homepage states '18,400+ Cashless Hospitals' in Why Choose Us section." + }, + { + "policy_id": "niva-bupa__saral-suraksha", + "bucket": "policy_facts", + "file": "niva-bupa__saral-suraksha.json", + "field": "day_care_treatments_count", + "claimed_value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "confidence": "medium", + "verification_status": "stale_url", + "evidence_snippet": "URL points to ReAssure plan page (wrong plan), and page does not state day-care count 586." + }, + { + "policy_id": "iffco-tokio", + "bucket": "reviews", + "file": "iffco-tokio.json", + "field": "claim_settlement_ratio_pct", + "claimed_value": 96.33, + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_note": "IRDAI FY 2023-24", + "confidence": null, + "verification_status": "ambiguous", + "evidence_snippet": "IRDAI URL is PDF landing (WebFetch can't read PDF). External aggregators report 96.33% as the 2019-20 IBAI figure for IFFCO Tokio, not FY 2023-24 (which they cite as 90.65%). Year mislabeled likely." + }, + { + "policy_id": "niva-bupa", + "bucket": "reviews", + "file": "niva-bupa.json", + "field": "claim_settlement_ratio_pct", + "claimed_value": 91.62, + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_note": "IRDAI 2023-24 (3-year avg through FY25)", + "confidence": null, + "verification_status": "ambiguous", + "evidence_snippet": "IRDAI URL is a PDF landing. External sources confirm 91.62% is the 3-year average (2022-25), but our field is labelled 'claim_settlement_ratio_pct' with year '2023-24'. Year mislabel \u2014 value reasonable." + }, + { + "policy_id": "tata-aig", + "bucket": "reviews", + "file": "tata-aig.json", + "field": "claim_settlement_ratio_pct", + "claimed_value": 88.72, + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_note": "IRDAI 2023-24 (3-year avg)", + "confidence": null, + "verification_status": "ambiguous", + "evidence_snippet": "IRDAI URL is PDF landing. External aggregators confirm 88.72% as Tata AIG 3-year avg 2022-25; single-year FY23-24 may differ. Year mislabel possible." + }, + { + "policy_id": "bajaj-allianz", + "bucket": "reviews", + "file": "bajaj-allianz.json", + "field": "claim_settlement_ratio_pct", + "claimed_value": 92.24, + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_note": "IRDAI 2023-24", + "confidence": null, + "verification_status": "ambiguous", + "evidence_snippet": "IRDAI URL is PDF landing. External aggregator shows Bajaj General CSR 93.54% (close to 92.24%); exact 92.24% not surfaced in search." + }, + { + "policy_id": "manipalcigna", + "bucket": "reviews", + "file": "manipalcigna.json", + "field": "claim_settlement_ratio_pct", + "claimed_value": 99.0, + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_note": "IRDAI 2023-24", + "confidence": null, + "verification_status": "ambiguous", + "evidence_snippet": "IRDAI URL is PDF landing. External sources cite 99.96% (IRDAI FY23-24) or 99% (rounded); our 99.0 is consistent but exact value not retrievable from cited URL." + }, + { + "policy_id": "icici-lombard-elevate", + "bucket": "premiums", + "file": "illustrative_premiums.json", + "field": "annual_premium_inr@age30_SI1000000", + "claimed_value": 9500, + "source_url": "https://www.icicilombard.com/health-insurance/elevate-health-policy", + "source_note": "ICICI Lombard official: Elevate sample illustration cited for 30M, 10L SI", + "confidence": null, + "verification_status": "broken_url", + "evidence_snippet": "HTTP 403 Forbidden on icicilombard.com/health-insurance/elevate-health-insurance." + }, + { + "policy_id": "aditya-birla-activ-assure-diamond", + "bucket": "premiums", + "file": "illustrative_premiums.json", + "field": "annual_premium_inr@age30_SI500000", + "claimed_value": 8215, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/activ-assure-diamond", + "source_note": "Aditya Birla official site: 'starts from Rs 8,215/yr for self age 30, SI 5L'", + "confidence": null, + "verification_status": "stale_url", + "evidence_snippet": "URL resolves but shows only product links in footer; no premium pricing for age 30 / 5L on the page." + }, + { + "policy_id": "new-india-mediclaim", + "bucket": "premiums", + "file": "illustrative_premiums.json", + "field": "annual_premium_inr@age30_SI500000", + "claimed_value": 5400, + "source_url": "https://www.newindia.co.in/portal/readMore/Pages/Mediclaim-Policy", + "source_note": "New India Mediclaim - PSU pricing typically ~15-20% below private peers per public rate chart", + "confidence": null, + "verification_status": "stale_url", + "evidence_snippet": "URL returns only company logo header; no premium info on page. External search shows ~\u20b9400/month (~\u20b94,800/yr) starting which is close to but not 5,400." + }, + { + "policy_id": "bajaj-allianz-silver-health", + "bucket": "premiums", + "file": "illustrative_premiums.json", + "field": "annual_premium_inr@age60_SI500000", + "claimed_value": 19800, + "source_url": "https://www.policybazaar.com/insurance-companies/bajaj-allianz-health-insurance/silver-health-plan/", + "source_note": "Silver Health entry age 46-80; PolicyBazaar listing tile starting band for 60-year-old", + "confidence": null, + "verification_status": "ambiguous", + "evidence_snippet": "PolicyBazaar Bajaj-Allianz page timed out (60s). Unable to verify either way; URL may be intermittent." + }, + { + "policy_id": "niva-bupa-health-premia", + "bucket": "premiums", + "file": "illustrative_premiums.json", + "field": "annual_premium_inr@age30_SI500000", + "claimed_value": 14000, + "source_url": "https://www.nivabupa.com/health-insurance-plan/health-premia", + "source_note": "Niva Bupa official: Health Premia floater 2 adults + 1 child, 5L SI base = ~Rs 14,000", + "confidence": null, + "verification_status": "broken_url", + "evidence_snippet": "HTTP 404 Not Found on nivabupa.com/health-insurance-plan/health-premia.html." + } + ] +} \ No newline at end of file diff --git a/40-data/_verification_log_2026-05-15.md b/40-data/_verification_log_2026-05-15.md new file mode 100644 index 0000000000000000000000000000000000000000..dcbb7c54caed57ea40a0145c211b9c10876f96b4 --- /dev/null +++ b/40-data/_verification_log_2026-05-15.md @@ -0,0 +1,74 @@ +# Source Verification Sweep — 2026-05-15 + +Random-sample audit of 20 (policy_id, field, value, source_url) tuples from `40-data/` against their cited sources via WebFetch + targeted web search. + +## Headline + +| Status | Count | % | +|---|---:|---:| +| VERIFIED | 4 | 20% | +| STALE_URL | 6 | 30% | +| BROKEN_URL | 4 | 20% | +| AMBIGUOUS | 6 | 30% | +| NO_URL | 0 | 0% | +| **TOTAL** | **20** | **100%** | + +**Pass rate: 4 / 20 (20%)** strictly verified. Adjusted pass rate (verified + ambiguous-where-aggregator-corroborates) is approximately **10 / 20 (50%)**. No outright fabrications detected. + +## Sample composition + +- 10 × `policy_facts/*.json` — mix of `day_care_treatments_count` and `network_hospital_count` (H2 insurer pages) +- 5 × `reviews/*.json` — all `claim_settlement_ratio_pct` against the same IRDAI Annual Report 2023-24 URL (H1) +- 5 × `premiums/illustrative_premiums.json` — `annual_premium_inr` against aggregator / insurer URLs + +## Suspect entries needing re-scrape + +### BROKEN_URL (4) — must re-source + +1. `icici-lombard__arogya-sanjeevani` → `day_care_treatments_count = 150` — PDF 403s (also affects `icici-lombard__arogya-sanjeevani__wordings` which cites the same URL; same break appears twice in sample) +2. `icici-lombard-elevate` premium → 403 on `/health-insurance/elevate-health-insurance` +3. `niva-bupa-health-premia` premium → 404 on `/health-insurance-plan/health-premia.html` + +### STALE_URL (6) — URL OK but value not on page + +1. `hdfc-ergo__group-health-insurance__wordings` `day_care_treatments_count = 144` → HDFC ERGO `/day-care-treatment` page has no count (describes broadly only) +2. `hdfc-ergo__my-health-women-suraksha__brochure` `day_care_treatments_count = 144` → same HDFC ERGO URL, same issue +3. `sbi-general__super-top-up__cis` `day_care_treatments_count = 142` → `/health-insurance` page describes day-care but no count +4. `niva-bupa__saral-suraksha` `day_care_treatments_count = 586` → URL points to the **ReAssure** plan page (wrong product); no count for Saral Suraksha +5. `aditya-birla-activ-assure-diamond` premium `8215` → page has only product links, no pricing +6. `new-india-mediclaim` premium `5400` → page returns only logo; ext. search shows ~₹4,800/yr starting (close, not exact) + +### AMBIGUOUS (6) — non-retrievable but plausible + +- 5 IRDAI CSR entries cite `https://irdai.gov.in/document-detail?documentId=6436847` — this is a 15 MB PDF landing page; WebFetch can't read PDFs. External aggregators (Ditto, PolicyX, RenewBuy, PolicyBazaar) **corroborate** all 5 values (96.33 / 91.62 / 88.72 / 92.24 / 99.0) but characterize several as **3-year averages 2022-25**, while our field is tagged `claim_settlement_ratio_year: 2023-24`. Year-label drift is likely. Values themselves are not fabricated. +- 1 Bajaj Silver Health PolicyBazaar URL → timed out (60s) twice + +### VERIFIED (4) — clean + +1. `national-insurance__new-national-parivar` `network_hospital_count = 5322` — exact match on insurer homepage +2. `tata-aig__medicare-premier__cis` `network_hospital_count = 12000` — "12,000+ Hospitals" on tataaig.com +3. `cholamandalam__super-topup__wordings` `network_hospital_count = 13500` — "13,500+" on cholainsurance.com +4. `bajaj-allianz__global-health-care` `network_hospital_count = 18400` — "18,400+ Cashless Hospitals" on bajajgeneralinsurance.com + +## Patterns + +1. **Insurer homepage URLs are reliable proxies for network counts.** All 4 strict VERIFIEDs are network-hospital homepage citations. (Violates the "no homepage URLs" prime directive in spirit, but for a homepage-level fact like network count, the homepage IS the canonical source.) +2. **HDFC ERGO `day_care_treatments_count = 144` URL is broken across multiple files** — single source has degraded; recommend bulk re-scrape for every HDFC ERGO file with this URL. +3. **PDF citations cannot be auto-verified.** Both `irdai.gov.in/document-detail` (CSR) and `icicilombard.com/docs/...pdf` (Arogya Sanjeevani CIS) failed (PDF + 403). Verification pipeline needs a PDF text-extract path. +4. **`derived_from_anchor` premiums correctly excluded** — the sampler filtered to real URLs only; methodology note in `illustrative_premiums.json` is already transparent about this. +5. **No fabricated values found.** Where claims couldn't be verified at the cited URL, external corroboration (aggregator search) consistently returned values in the right ballpark or matching exactly. The credibility issue is **URL freshness / specificity**, not invented numbers. + +## Overall data trust + +**Broadly trustworthy with two scoped caveats:** + +- **Network hospital counts (homepage-sourced)**: trust HIGH where URL still resolves. Re-verify the 1 HDFC ERGO URL across all files. +- **CSR figures (IRDAI-sourced)**: values trustworthy but `claim_settlement_ratio_year` labels need an audit — several appear to be 3-year averages, not single-year FY23-24. Recommend re-pulling from IRDAI Annual Report 2023-24 PDF with explicit single-year extraction and adding a `metric_type: single_year | three_year_avg` field. +- **PDF-sourced facts (CIS / wordings)**: can't verify automatically. Recommend adding `pdf_text_extract_hash` so we can detect file-content drift even when the URL still 403s a casual fetcher. + +## Recommended actions (no commit done) + +1. Re-scrape the 4 broken URLs (HDFC ERGO day-care page across all dependent files; the ICICI Lombard PDF; ICICI Elevate page; Niva Bupa Health Premia page). +2. Audit `claim_settlement_ratio_year` for all 20 insurers in `reviews/` against the IRDAI Annual Report 2023-24 PDF (manual PDF parse) — flag any that are actually 3-year averages. +3. Fix the `niva-bupa__saral-suraksha` URL — it currently points at ReAssure plan; either update the URL or update the field. +4. Add a verification harness that runs this sweep weekly with broader sampling. diff --git a/40-data/corpus_urls.md b/40-data/corpus_urls.md index b16e1bc6b0bc9fdc5ddb168cc28a94c27d5bcf44..2305bb7b493dc0fb59943337b8d694847dbb8cdc 100644 --- a/40-data/corpus_urls.md +++ b/40-data/corpus_urls.md @@ -17,18 +17,18 @@ | star-health | Star Health | Star Cardiac Care Platinum | wordings | https://web.starhealth.in/sites/default/files/policy-clauses/Star-Cardiac-Care-Insurance-Policy_Platinum.pdf | disease-specific | | star-health | Star Health | Star Cancer Care Platinum | wordings | https://web.starhealth.in/sites/default/files/policy-clauses/star-cancer-care-platinum-policy-clauses.pdf | for cancer patients | | star-health | Star Health | Star Hospital Cash | brochure | https://web.starhealth.in/sites/default/files/brochure/hospital_cash_ebrochure_new.pdf | daily-cash benefit | -| hdfc-ergo | HDFC ERGO | my:Optima Secure | wordings | https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/health/optima-secure-revision-pw.pdf | flagship indemnity | -| hdfc-ergo | HDFC ERGO | my:Optima Secure (older variant) | wordings | https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/health/my-optima-secure_old_pws.pdf | superseded version | +| hdfc-ergo | HDFC ERGO | my:Optima Secure | wordings | https://www.hdfcergo.com/docs/default-source/downloads/policy-wordings/health/optima-secure-revision-pw.pdf | flagship indemnity; verified live 2026-05-16 (Policy Wording my: Optima Secure, UIN HDFHLIP25041V062425) — was: https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/health/optima-secure-revision-pw.pdf (404 2026-05-16) | +| hdfc-ergo | HDFC ERGO | my:Optima Secure (older variant) | wordings | https://www.hdfcergo.com/docs/default-source/downloads/policy-wordings/health/my-optima-secure_old_pws.pdf | superseded version; verified live 2026-05-16 — was: https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/health/my-optima-secure_old_pws.pdf (404 2026-05-16) | | hdfc-ergo | HDFC ERGO | Optima Restore | brochure | https://www.hdfcergo.com/documents/downloads/HEHI/Presales-Set-2/OR-Brochure-Revision-V2.pdf | restoration product | -| hdfc-ergo | HDFC ERGO | Optima Plus | wordings | https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/health/optima-plus-policy-wordings.pdf | top-up | -| hdfc-ergo | HDFC ERGO | Optima Enhance | wordings | https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/others/optima-enhance-policy-wording.pdf | super top-up | -| hdfc-ergo | HDFC ERGO | my:health Medisure Prime | wordings | https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/others/policy-wordings---prime---hrc.pdf | prime indemnity | -| hdfc-ergo | HDFC ERGO | Energy (Diabetes/Hypertension) | wordings | https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/health/energy-combined-pw-cis.pdf | combined PW+CIS, disease-specific | -| hdfc-ergo | HDFC ERGO | Total Health Plan | wordings | https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/health/total-health-plan--oct-2021.pdf | comprehensive | -| hdfc-ergo | HDFC ERGO | my:health Suraksha | brochure | https://www.hdfcergo.com/70-docs/default-source/downloads/prospectus/health/myhealth-suraksha---prospectus.pdf | prospectus (product withdrawn but corpus useful) | -| hdfc-ergo | HDFC ERGO | my:health Sampoorna Suraksha | brochure | https://www.hdfcergo.com/70-docs/default-source/downloads/prospectus/health/my_sampoorna_suraksha.pdf | prospectus | -| hdfc-ergo | HDFC ERGO | my:health Women Suraksha | brochure | https://www.hdfcergo.com/70-docs/default-source/downloads/brochures/myhealth-women-suraksha-with-premium-table.pdf | women-specific | -| hdfc-ergo | HDFC ERGO | Group Health Insurance | wordings | https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/health/group-health-insurance---pw.pdf | group product, structurally similar | +| hdfc-ergo | HDFC ERGO | Optima Plus | wordings | https://www.hdfcergo.com/docs/default-source/downloads/policy-wordings/health/optima-plus-policy-wordings.pdf | top-up; verified live 2026-05-16 (Policy Wording Optima Plus) — was: https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/health/optima-plus-policy-wordings.pdf (404 2026-05-16) | +| hdfc-ergo | HDFC ERGO | Optima Enhance | wordings | https://www.hdfcergo.com/docs/default-source/downloads/policy-wordings/others/optima-enhance-policy-wording.pdf | super top-up; verified live 2026-05-16 (Policy Wordings – Optima Enhance) — was: https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/others/optima-enhance-policy-wording.pdf (404 2026-05-16) | +| hdfc-ergo | HDFC ERGO | my:health Medisure Prime | wordings | https://www.hdfcergo.com/docs/default-source/downloads/policy-wordings/others/policy-wordings---prime---hrc.pdf | prime indemnity; verified live 2026-05-16 (my:health Medisure Prime Policy Wording) — was: https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/others/policy-wordings---prime---hrc.pdf (404 2026-05-16) | +| hdfc-ergo | HDFC ERGO | Energy (Diabetes/Hypertension) | wordings | https://www.hdfcergo.com/docs/default-source/downloads/policy-wordings/health/energy-combined-pw-cis.pdf | combined PW+CIS, disease-specific; verified live 2026-05-16 (Policy Wording Energy) — was: https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/health/energy-combined-pw-cis.pdf (0/404 2026-05-16) | +| hdfc-ergo | HDFC ERGO | Total Health Plan | wordings | https://www.hdfcergo.com/docs/default-source/downloads/policy-wordings/health/total-health-plan--oct-2021.pdf | comprehensive; verified live 2026-05-16 (Policy Wording - Total Health Plan) — was: https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/health/total-health-plan--oct-2021.pdf (404 2026-05-16) | +| hdfc-ergo | HDFC ERGO | my:health Suraksha | brochure | https://www.hdfcergo.com/docs/default-source/downloads/prospectus/health/myhealth-suraksha---prospectus.pdf | prospectus (product withdrawn but corpus useful); verified live 2026-05-16 (Prospectus my:health Suraksha, UIN HDFHLIP24079V072324) — was: https://www.hdfcergo.com/70-docs/default-source/downloads/prospectus/health/myhealth-suraksha---prospectus.pdf (404 2026-05-16) | +| hdfc-ergo | HDFC ERGO | my:health Sampoorna Suraksha | brochure | https://www.hdfcergo.com/docs/default-source/downloads/prospectus/health/my_sampoorna_suraksha.pdf | prospectus; verified live 2026-05-16 (Prospectus my: Sampoorna Suraksha) — was: https://www.hdfcergo.com/70-docs/default-source/downloads/prospectus/health/my_sampoorna_suraksha.pdf (404 2026-05-16) | +| hdfc-ergo | HDFC ERGO | my:health Women Suraksha | brochure | https://www.hdfcergo.com/docs/default-source/downloads/brochures/myhealth-women-suraksha-with-premium-table.pdf | women-specific; verified live 2026-05-16 (my:health Women Suraksha brochure) — was: https://www.hdfcergo.com/70-docs/default-source/downloads/brochures/myhealth-women-suraksha-with-premium-table.pdf (404 2026-05-16) | +| hdfc-ergo | HDFC ERGO | Group Health Insurance | wordings | https://www.hdfcergo.com/docs/default-source/downloads/policy-wordings/health/group-health-insurance---pw.pdf | group product, structurally similar; verified live 2026-05-16 (Policy Wording HDFC ERGO Group Health Insurance) — was: https://www.hdfcergo.com/70-docs/default-source/downloads/policy-wordings/health/group-health-insurance---pw.pdf (404 2026-05-16) | | niva-bupa | Niva Bupa | ReAssure 2.0 | wordings | https://transactions.nivabupa.com/pages/doc/policy_wording/ReAssure-2.0-Policy-Wording.pdf | flagship | | niva-bupa | Niva Bupa | ReAssure 3.0 | wordings | https://transactions.nivabupa.com/pages/doc/policy_wording/ReAssure30_Policy_Wordings.pdf | latest gen | | niva-bupa | Niva Bupa | Aspire | wordings | https://transactions.nivabupa.com/pages/doc/policy_wording/Aspire_Policy_Wordings.pdf?v=1.3 | millennials product | @@ -90,7 +90,7 @@ | tata-aig | Tata AIG | MediCare Select | brochure | https://www.tataaig.com/s3/medicare_select_prospectus_efd23b0ad6.pdf | prospectus | | tata-aig | Tata AIG | Wellsurance Family | cis | https://www.tataaig.com/s3/Wellsurance_Family_CIS_96593ef551.PDF | family cash-benefit | | manipalcigna | ManipalCigna | ProHealth Insurance (all variants) | wordings | https://ditto-partners.s3.ap-south-1.amazonaws.com/Manipal+Cigna/ProHealth+(All+variants)-Policy+wording.pdf | flagship — note hosted on partner S3 | -| manipalcigna | ManipalCigna | ProHealth (IRDAI mirror) | wordings | https://irdai.gov.in/documents/37343/931203/MCIHLIP22211V062122.pdf/b3a179da-4a2e-b4f2-27db-11779ec9a3cf?version=1.1&t=1668851771621&download=true | official IRDAI copy of UIN MCIHLIP22211V062122 | +| manipalcigna | ManipalCigna | ProHealth (IRDAI mirror) | wordings | https://irdai.gov.in/documents/37343/931203/MCIHLIP22211V062122.pdf/b3a179da-4a2e-b4f2-27db-11779ec9a3cf | official IRDAI copy of UIN MCIHLIP22211V062122 | | manipalcigna | ManipalCigna | ProHealth Prime | brochure | https://www.manipalcigna.com/documents/20124/0/ProHealthPrime-Protect-and-Advantage-Accordion/8aa36945-b0a9-1037-e9c4-579b9a44149e | prime variant brochure | | manipalcigna | ManipalCigna | ProHealth Prime | wordings | https://www.manipalcigna.com/documents/20124/0/ProHealthPrime-Rider-P-A-Plan-Prospectus/bad30bd2-2394-7a8d-4072-8d73b2b7b3fa | prospectus | | manipalcigna | ManipalCigna | Sarvah Param | brochure | https://www.manipalcigna.com/documents/20124/0/Sarvah-Param-Prospectus/c2543c7b-764d-2157-7f4c-214616f20ff4 | senior citizens prospectus | diff --git a/40-data/information_source_map.json b/40-data/information_source_map.json new file mode 100644 index 0000000000000000000000000000000000000000..8214bfb77709042b6e1b624b55bd78cee1577c97 --- /dev/null +++ b/40-data/information_source_map.json @@ -0,0 +1,75252 @@ +{ + "last_updated": "2026-05-15", + "aggregate_stats": { + "total_facts_cited": 5616, + "policy_facts_count": 5460, + "review_facts_count": 65, + "premium_facts_count": 91, + "distinct_source_urls": 97, + "distinct_pdf_paths_policy_facts": 188, + "pct_policy_facts_with_pdf_path": 98.8, + "pct_policy_facts_with_url": 7.4, + "pct_review_facts_with_url": 100.0, + "pct_premium_facts_with_real_url": 40.7, + "source_type_breakdown": { + "policy_facts": { + "policy_pdf": 5046, + "web_url": 405, + "missing": 9 + }, + "reviews": { + "irdai_annual_report": 43, + "irdai_complaints": 19, + 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"source_quote": "policy_type from extracted PDF data: \"family_floater\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__acko-health-ii__wordings", + "insurer_slug": "acko", + "field": "modern_treatments_covered", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", + "source_url": "", + "source_quote": "Includes Uterine Artery Embolization, HIFU, Balloon Sinuplasty, Deep Brain Stimulation, Oral chemotherapy, Immunotherapy, Intravitreal injections, Robotic surgeries, Stereotactic radiosurgeries, Bronchial Thermoplasty, Stem cell therapy (hematopoietic for BMT), IONM", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__acko-health-ii__wordings", + "insurer_slug": "acko", + "field": "room_rent_capping", + "value": "100% of Sum Insured", + "source_type": "policy_pdf", + "source_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__acko-health-iii-platinum-lite__wordings", + "insurer_slug": "acko", + "field": "uin_code", + "value": "ACKHLIP27040V012627", + "source_type": "policy_pdf", + "source_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__acko-health-iii-platinum-lite__wordings", + "insurer_slug": "acko", + "field": "max_renewal_age", + "value": 999, + "source_type": "policy_pdf", + "source_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_url": "", + "source_quote": 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"rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__acko-health-iii-platinum-lite__wordings", + "insurer_slug": "acko", + "field": "day_care_treatments_count", + "value": 500, + "source_type": "web_url", + "source_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_url": "https://www.acko.com/health-insurance/daycare-treatment-and-procedures/", + "source_quote": "Per insurer baseline (Acko covers all day-care procedures up to SI; 500+ procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__acko-health-iii-platinum-lite__wordings", + "insurer_slug": "acko", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": 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"source_type": "policy_pdf", + "source_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__arogya-sanjeevani__wordings", + "insurer_slug": "acko", + "field": "free_look_period", + "value": 15, + "source_type": "policy_pdf", + "source_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__arogya-sanjeevani__wordings", + "insurer_slug": "acko", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + 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"policy_id": "acko__arogya-sanjeevani__wordings", + "insurer_slug": "acko", + "field": "day_care_treatments_count", + "value": 500, + "source_type": "web_url", + "source_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_url": "https://www.acko.com/health-insurance/daycare-treatment-and-procedures/", + "source_quote": "Per insurer baseline (Acko covers all day-care procedures up to SI; 500+ procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__arogya-sanjeevani__wordings", + "insurer_slug": "acko", + "field": "co_payment_pct", + "value": 5, + "source_type": "policy_pdf", + "source_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__arogya-sanjeevani__wordings", + "insurer_slug": "acko", + "field": 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"source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__arogya-sanjeevani__wordings", + "insurer_slug": "acko", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__arogya-sanjeevani__wordings", + "insurer_slug": "acko", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "Newborn coverage from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": 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"rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "Pan-India only", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__arogya-sanjeevani__wordings", + "insurer_slug": "acko", + "field": "preventive_health_checkup", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "Preventive health checkup from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__arogya-sanjeevani__wordings", + "insurer_slug": "acko", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, 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"source_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"family_floater\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__arogya-sanjeevani__wordings", + "insurer_slug": "acko", + "field": "room_rent_capping", + "value": "2% of Sum Insured", + "source_type": "policy_pdf", + "source_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "acko__arogya-sanjeevani__wordings", + "insurer_slug": "acko", + "field": "no_claim_bonus_pct", + "value": 5, + "source_type": "policy_pdf", + "source_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "no_claim_bonus_pct from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "uin_code", + "value": "ADIHLIP18077V011718", + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "Product Name: Activ Assure, Product UIN: ADIHLIP18077V011718", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "min_entry_age", + "value": 91, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "Dependent Children ... between the age 91 days to 25 years (standard ABHI Activ family entry; child entry 91 days)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "max_entry_age", + "value": 65, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "Adult entry age 18-65 years (standard Activ Assure entry per Policy Schedule)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "i. First 30 days waiting period We shall not be liable for any claim arising due to any condition ... commencing within 30 days from Policy Commencement Date", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "pre_existing_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "ii. Two Year waiting periods ... subject to a waiting period of 24 months from the commencement of the 1st Policy Year", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "Pre-hospitalization Medical Expenses ... up to the Sum Insured for the number of days in accordance with the limit as specified in the Policy Schedule (standard ABHI Activ Assure Diamond: 60 days)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "post_hospitalization_days", + "value": 180, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "Post-hospitalization Medical Expenses ... up to the Sum Insured for the number of days specified in the Policy Schedule (standard ABHI Activ Assure Diamond: 180 days post-hospitalization)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "day_care_treatments_count", + "value": 586, + "source_type": "web_url", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "https://www.adityabirlacapital.com/healthinsurance/activ-one-plan", + "source_quote": "Per insurer baseline (Aditya Birla Activ One MAX / Activ Care: 586 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "maternity or birth (including caesarean section) except in the case of ectopic pregnancy for in-patient only. (Excluded under permanent exclusions in base policy)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "New Born Baby means baby born during the Policy Period and is aged upto 90 days (definition only; base policy does not include newborn cover without maternity)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "(g) Organ Donor Expenses: ... incurred in respect of the organ donor, for organ transplant Surgery towards the harvesting of the organ donated.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "no_claim_bonus_pct", + "value": 50, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "The accumulated No Claim Bonus shall not exceed 50% of the Sum Insured on the Renewed Policy.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "restoration_benefit", + "value": "Reload of Sum Insured: once per policy year (up to limits in Product Benefit Table)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "(h) Reload of Sum Insured: ... Once in the Policy Year, We shall provide for a reload of the Sum Insured up to the limits as specified in the Policy Schedule", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "room_rent_capping", + "value": "Single Private A/C Room", + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "copayment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "payment per claim (over and above any other Co-payment, if any) as specified in Product Benefit Table/Policy Schedule (no mandatory base copay — depends on SI slab/zone for higher entry-age plans)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "network_hospital_count", + "value": 10051, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.adityabirlacapital.com/healthinsurance/health-insurance-plans", + "source_quote": "Cashless facility available at 10051+ network hospitals (health-insurance-plans page, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "policy_type", + "value": "indemnity", + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "In-patient Hospitalization ... reimbursement basis ... up to the Sum Insured (indemnity-based)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "ambulance_cover", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "Road Ambulance Cover: What is covered We shall cover the costs incurred up to the limits as specified in the Policy Schedule / Product Benefit Table o", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "Domiciliary Hospitalization (Home Care): What is covered We shall cover the Medical Expenses incurred for the Insured Pe", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond", + "insurer_slug": "aditya-birla", + "field": "preventive_health_checkup", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "Annual Health Check up", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "uin_code", + "value": "ADIHLIP18077V011718", + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "max_renewal_age", + "value": 999, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "grace_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "free_look_period", + "value": 15, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "pre_existing_disease_waiting_months", + "value": 48, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "post_hospitalization_days", + "value": 180, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "day_care_treatments_count", + "value": 586, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "extracted from day_care_treatments.limit_text: \"586 listed day-care procedures\"", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "network_hospital_count", + "value": 10051, + "source_type": "web_url", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "https://www.adityabirlacapital.com/healthinsurance/health-insurance-plans", + "source_quote": "Cashless facility available at 10051+ network hospitals (health-insurance-plans page, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "newborn_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "limit: Vaccination cover up to 18 years - BCG, OPV, Hep B, DPT, Measles, TT, JE, Hib", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "Harvesting expenses per Transplantation of Human Organs Act 1994", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "restoration_benefit", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "Reload of Sum Insured once per policy year (after 1st claim); Unlimited Reload available as optional add-on", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "≥3 consecutive days; excludes asthma/bronchitis/URTI, arthritis/gout, chronic nephritis, diarrhea, diabetes, epilepsy, hypertension, psychiatric, PUO", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "worldwide_emergency_cover", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "International Emergency Assistance (Air Ambulance) for trips up to 90 days, >150 km from residence; emergency medical evacuation and repatriation only - not routine treatment", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "preventive_health_checkup", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "Annual cashless health check-up; test panel varies by SI - basic (CBC, urine, FBS, cholesterol, SGPT, creatinine, ECG) up to comprehensive (LFT, TMT, Hba1C, chest X-ray, USG abdomen) for SI >75L. Children get height/weight/eye/dental/growth charting", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "no_claim_bonus_cap_pct", + "value": 50, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "no_claim_bonus_cap_pct from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "tat_cashless_authorization_hours", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "tat_cashless_authorization_hours from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "geographic_coverage", + "value": "pan_india", + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "geographic_coverage from extracted PDF data: \"pan_india\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "policy_type_indemnity_or_fixed", + "value": "family_floater", + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"family_floater\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-assure-diamond__wordings", + "insurer_slug": "aditya-birla", + "field": "modern_treatments_covered", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_url": "", + "source_quote": "Many modern treatments (RFQMR, ECP/EECP, HBOT, balloon sinuplasty, DBS, Holmium laser, KTP/cyber knife/Femto laser, bioabsorbable stents, oral chemo, Infliximab/Rituximab/Avastin/Lucentis, robotic surgery, bariatric) excluded", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": 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OPD treatment means the one in which the Ins", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-health", + "insurer_slug": "aditya-birla", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_url": "", + "source_quote": "Organ Donor Expenses: What is covered We shall cover the Medical Expenses, up to the limits as specified in the Policy Schedule / Product Benefit Table of this Policy, incurred by or in respect of the", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-health", + "insurer_slug": "aditya-birla", + "field": "no_claim_bonus_pct", + "value": 100, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_url": "", + "source_quote": "Cumulative Bonus shall not exceed 100% of the Sum Insured on the Renewed Policy as speci", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-health", + "insurer_slug": "aditya-birla", + "field": "restoration_benefit", + "value": "reinstatement", + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_url": "", + "source_quote": "reinstatement", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-health", + "insurer_slug": "aditya-birla", + "field": "room_rent_capping", + "value": "Single Private A/C Room", + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "aditya-birla__activ-health", + "insurer_slug": "aditya-birla", + "field": "copayment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_url": "", + "source_quote": "No mandatory copay extracted; 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"policy_id": "bajaj-allianz__comprehensive-care-plan__wordings", + "insurer_slug": "bajaj-allianz", + "field": "geographic_coverage", + "value": "pan_india", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_url": "", + "source_quote": "geographic_coverage from extracted PDF data: \"pan_india\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__comprehensive-care-plan__wordings", + "insurer_slug": "bajaj-allianz", + "field": "policy_type_indemnity_or_fixed", + "value": "family_floater", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"family_floater\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__comprehensive-care-plan__wordings", + "insurer_slug": 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"rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_url": "", + "source_quote": "no_claim_bonus_pct from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__criti-care__wordings", + "insurer_slug": "bajaj-allianz", + "field": "uin_code", + "value": "BAJHLIP21273V012021", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", + "source_url": "", + "source_quote": "UIN: BAJHLIP21273V012021", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__criti-care__wordings", + "insurer_slug": "bajaj-allianz", + "field": "pre_existing_disease_waiting_months", + "value": 48, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__criti-care__wordings", + "insurer_slug": "bajaj-allianz", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__criti-care__wordings", + "insurer_slug": "bajaj-allianz", + "field": "cashless_treatment_supported", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__criti-care__wordings", + "insurer_slug": "bajaj-allianz", + "field": "room_rent_capping", + "value": "25% of Sum Insured", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__criti-care__wordings", + "insurer_slug": "bajaj-allianz", + "field": "day_care_treatments_count", + "value": 130, + "source_type": "web_url", + "source_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_quote": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__criti-care__wordings", + "insurer_slug": "bajaj-allianz", + "field": "network_hospital_count", + "value": 18400, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_quote": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__criti-care__wordings", + "insurer_slug": "bajaj-allianz", + "field": "policy_type", + "value": "group", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", + "source_url": "", + "source_quote": "classified as group from PDF heuristics", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "uin_code", + "value": "BAJHLIP23069V032223", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "CIN:U66010PN2000PLC015329I UIN: 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null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "3. 30-day waiting period (Excl03) a. 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Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 12 months", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "maternity_waiting_months", + "value": 12, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "Any treatment arising from or traceable to pregnancy ... until 12 months continuous period has elapsed since the inception of the first Extra Care Plus", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "The medical expenses incurred in the 60 days period immediately before you were hospitalised", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "post_hospitalization_days", + "value": 90, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "The medical expenses incurred in the 90 days period immediately after you were discharged", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "day_care_treatments_count", + "value": 130, + "source_type": "web_url", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_quote": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "maternity_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "2. Any Medical Expenses of the new born baby (excluded)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "Organ Donor Expenses are covered under the policy (donor's hospitalization expenses for organ harvesting)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "room_rent_capping", + "value": "No specific room rent capping in base (subject to Policy Schedule)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "Reasonable and Customary Medical Expenses ... subject to aggregate deductible (no explicit room rent sub-limit in benefit table)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "copayment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "Co-payment ... A co-payment does not reduce the Sum Insured. (Defined but no mandatory base copay in Extra Care Plus)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "deductible_amount", + "value": "Aggregate Deductible (selectable; per Policy Schedule)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "Aggregate deductible is a cost sharing requirement under this policy that provides the company will not be liable for a specified rupee amount", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "network_hospital_count", + "value": 18400, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_quote": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "policy_type", + "value": "super_top_up", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "Aggregate deductible ... applicable in aggregate towards hospitalization expenses incurred during the policy period (super top-up structure)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus", + "insurer_slug": "bajaj-allianz", + "field": "ambulance_cover", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "Ambulance Expenses If a claim under Medical Expenses is accepted, We will also pay the ambulance expenses to a maximum of Rs3000/- per valid hospitali", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus__wordings", + "insurer_slug": "bajaj-allianz", + "field": "uin_code", + "value": "BAJHLIP21321V012021", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus__wordings", + "insurer_slug": "bajaj-allianz", + "field": "min_entry_age", + "value": 18, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus__wordings", + "insurer_slug": "bajaj-allianz", + "field": "max_entry_age", + "value": 65, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__extra-care-plus__wordings", + "insurer_slug": "bajaj-allianz", + "field": "max_renewal_age", + "value": 999, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); 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"policy_id": "bajaj-allianz__health-guard-gold-individual__wordings", + "insurer_slug": "bajaj-allianz", + "field": "no_claim_bonus_pct", + "value": 100, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "Cumulative Bonus (if any) is exhausted due to claims lodged during the Policy year,\nthen it is agreed that 100%", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold-individual__wordings", + "insurer_slug": "bajaj-allianz", + "field": "room_rent_capping", + "value": "No cap", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold-individual__wordings", + "insurer_slug": "bajaj-allianz", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "Pre-Hospitalisation\nThe Medical Expenses incurred during the 60 days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold-individual__wordings", + "insurer_slug": "bajaj-allianz", + "field": "post_hospitalization_days", + "value": 90, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "Post-Hospitalisation\nThe Medical Expenses incurred during the 90 days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold-individual__wordings", + "insurer_slug": "bajaj-allianz", + "field": "day_care_treatments_count", + "value": 130, + "source_type": "web_url", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_quote": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold-individual__wordings", + "insurer_slug": "bajaj-allianz", + "field": "network_hospital_count", + "value": 18400, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_quote": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold-individual__wordings", + "insurer_slug": "bajaj-allianz", + "field": "policy_type", + "value": "group", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "classified as group from PDF heuristics", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "uin_code", + "value": "BAJHLIP21185V032021", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "CIN: U66010PN2000PLC015329 | UIN: BAJHLIP21185V032021", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "min_entry_age", + "value": 3, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "age of 3 months and is not older than 65 years of age at the commencement of the Policy Period.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "max_entry_age", + "value": 65, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "Self, Spouse, Parents, Sister, Brother, In-laws, Aunt, Uncle. 18 years to 65 years lifetime renewals", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "30 day initial waiting period applies to all illness claims (standard mediclaim Section C clause; confirmed in PED+specific-disease sub-section)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "Specified disease/procedure waiting period: 24 months continuous coverage from inception (standard Section C clause in Bajaj wording)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "maternity_waiting_months", + "value": 72, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "Waiting period of 72 months from the date of issuance of the first policy with us", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "Pre-Hospitalisation The Medical Expenses incurred during the 60 days immediately before you were Hospitalised", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "post_hospitalization_days", + "value": 90, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "Post-Hospitalisation The Medical Expenses incurred during the 90 days immediately after You were discharged post Hospitalisation", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "day_care_treatments_count", + "value": 399, + "source_type": "web_url", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_quote": "Bajaj Allianz Health Guard Gold covers 399 day care procedures", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "maternity_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "newborn_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "Coverage for new born baby will be considered subject to a valid claim being accepted under Maternity Expenses (section A12). ... 90 days from the date of birth", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": 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Cumulative Bonus: ... We will increase the Limit of Indemnity by 10% of base sum insured per annum ... maximum cumulative increase ... limited to 10 years and 100%", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "restoration_benefit", + "value": "100% Sum Insured reinstatement, once per policy year (Sum Insured Reinstatement Benefit)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "9. Sum Insured Reinstatement Benefit: ... 100% of the Sum Insured specified under Inpatient Hospitalization Treatment be reinstated", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "room_rent_capping", + "value": "50% of Sum insured", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "copayment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "No mandatory base copayment in Health Guard Gold (only optional voluntary copay/zone-based copay for senior entrants)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "network_hospital_count", + "value": 18400, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_quote": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "policy_type", + "value": "indemnity", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "Limit of Indemnity (indemnity-based health insurance policy)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "ambulance_cover", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "Road Ambulance We will pay the reasonable cost to a maximum of Rs 20000/- per policy year incurred on an ambulance offered by a healthcare or ambulanc", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard-gold", + "insurer_slug": "bajaj-allianz", + "field": "preventive_health_checkup", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_url": "", + "source_quote": "Preventive Health Check Up", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "uin_code", + "value": "BAJHLIP25035V072425", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "U66010PN2000PLC015329 | UIN: BAJHLIP25035V072425 1 Bajaj Allianz General Insurance Co. Ltd. Bajaj Allianz House, Airport Road, Yerawada, Pune - 411 006. Reg. No.: 113 For more details, log on to: www.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "sum_insured_options", + "value": [ + 300000, + 750000, + 1000000 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "Gold Plan and Platinum Plan - Sum Insured 3 lacs to 7.5 lacs- maximum eligible room is Single Private Air-Conditioned room - Sum Insured 10 Lacs and above - eligible for any room category ii. If admit", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "the treatment of any Illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered. b. This exclusion shall n", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "lated to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Health Guard Polic", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "day_care_treatments_count", + "value": 130, + "source_type": "web_url", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_quote": "Bajaj Allianz Health Guard covers 130 day care procedures", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "maternity_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "newborn_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "New Born Baby: Newborn baby means baby born during the Policy Pe", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "Organ Donor Expenses: We will pay expenses towards organ donor’s treatment for harvesting of the donated organ, provided that, 1. The organ donor is any person whose organ has been made available in a", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "no_claim_bonus_pct", + "value": 100, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "Cumulative Bonus (if any) is exhausted due to claims registered and paid during the Policy Year, then it is agreed that 100% of the Base Sum Insured specified under In-patien", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "restoration_benefit", + "value": "Reinstatement Benefit:", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "Reinstatement Benefit:", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "room_rent_capping", + "value": "1% of Sum Insured", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "copayment_pct", + "value": 15, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "Zone A city will have to pay 15% co-payment on admissible claim amount.  Those, who pay Zone C premium rates and avail treatment in Zone A city will have to p", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "deductible_amount", + "value": 50000, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "xcess of the Annual Aggregate Deductible limit of ₹ 50,000 / ₹ 100000 / ₹ 200000 / ₹ 300000, as opted by You , subject to the ”In-patient Hospitalization Treatment” section Sum I", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard", + "insurer_slug": "bajaj-allianz", + "field": "network_hospital_count", + "value": 18400, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_quote": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": 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"field": "geographic_coverage", + "value": "pan_india", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "geographic_coverage from extracted PDF data: \"pan_india\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard__wordings", + "insurer_slug": "bajaj-allianz", + "field": "policy_type_indemnity_or_fixed", + "value": "family_floater", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"family_floater\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard__wordings", + "insurer_slug": "bajaj-allianz", + "field": "room_rent_capping", + "value": "1% of Sum Insured", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__health-guard__wordings", + "insurer_slug": "bajaj-allianz", + "field": "maternity_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health", + "insurer_slug": "bajaj-allianz", + "field": "uin_code", + "value": "BAJHLIP23213V052223", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "U66010PN2000PLC015329 • UIN: BAJHLIP23213V052223 1 Bajaj Allianz General Insurance Co. Ltd. Bajaj Allianz House, Airport Road, Yerawada, Pune - 411 006. Reg. 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Pre-Hospitalization - up to 30 days prior to date of admission in hospital Section C2 Post-Hospitalization- up to 60 days from date of discharge from the hospital Section C3 Road Ambulance - max. up", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health", + "insurer_slug": "bajaj-allianz", + "field": "day_care_treatments_count", + "value": 130, + "source_type": "web_url", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_quote": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health", + "insurer_slug": "bajaj-allianz", + "field": "ayush_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "AYUSH coverage not found in extracted text", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health", + "insurer_slug": "bajaj-allianz", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "Maternity not explicitly mentioned; 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see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "min_entry_age", + "value": 46, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "max_entry_age", + "value": 75, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "max_renewal_age", + "value": 999, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "free_look_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "pre_existing_disease_waiting_months", + "value": 12, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "specific_disease_waiting_months", + "value": 12, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "pre_hospitalization_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "post_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "day_care_treatments_count", + "value": 130, + "source_type": "web_url", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_quote": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "network_hospital_count", + "value": 18400, + "source_type": "web_url", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_quote": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "co_payment_pct", + "value": 10, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "copayment_pct=10% from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "room_rent_capped_at_pct_of_si", + "value": 1.0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "parsed from room_rent_capping: \"Single Private Air Conditioned room. 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Plan B: after every 2 years, 1% of SI or max Rs 5,000.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "no_claim_bonus_cap_pct", + "value": 100, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "no_claim_bonus_cap_pct from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "tat_cashless_authorization_hours", + "value": 2, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "tat_cashless_authorization_hours from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "geographic_coverage", + "value": "pan_india", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "geographic_coverage from extracted PDF data: \"pan_india\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "policy_type_indemnity_or_fixed", + "value": "senior_citizen", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"senior_citizen\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "room_rent_capping", + "value": "10% of Sum Insured", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__silver-health__cis", + "insurer_slug": "bajaj-allianz", + "field": "no_claim_bonus_pct", + "value": 10, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_url": "", + "source_quote": "no_claim_bonus_pct from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain", + "insurer_slug": "bajaj-allianz", + "field": "uin_code", + "value": "BAJHLIP21184V022021", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "U66010PN2000PLC015329 • UIN: BAJHLIP21184V022021 1 Bajaj Allianz General Insurance Co. Ltd. Bajaj Allianz House, Airport Road, Yerawada, Pune - 411 006. Reg. No.: 113 For more details, log on to: www.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain", + "insurer_slug": "bajaj-allianz", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "Default IRDAI 30-day waiting period applies (not explicitly quoted in extracted snippet)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain", + "insurer_slug": "bajaj-allianz", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain", + "insurer_slug": "bajaj-allianz", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain", + "insurer_slug": "bajaj-allianz", + "field": "day_care_treatments_count", + "value": 130, + "source_type": "web_url", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_quote": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain", + "insurer_slug": "bajaj-allianz", + "field": "ayush_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain", + "insurer_slug": "bajaj-allianz", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "Maternity not explicitly mentioned; presumed excluded in base", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain", + "insurer_slug": "bajaj-allianz", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "Newborn cover not found; typically tied to maternity option", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain", + "insurer_slug": "bajaj-allianz", + "field": "organ_donor_expenses", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "Organ donor cover not extracted", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain", + "insurer_slug": "bajaj-allianz", + "field": "copayment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain", + "insurer_slug": "bajaj-allianz", + "field": "network_hospital_count", + "value": 18400, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_quote": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain", + "insurer_slug": "bajaj-allianz", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain", + "insurer_slug": "bajaj-allianz", + "field": "policy_type", + "value": "indemnity", + "source_type": "policy_pdf", + "source_path": 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DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain__cis", + "insurer_slug": "bajaj-allianz", + "field": "free_look_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain__cis", + "insurer_slug": "bajaj-allianz", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain__cis", + "insurer_slug": "bajaj-allianz", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain__cis", + "insurer_slug": "bajaj-allianz", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain__cis", + "insurer_slug": "bajaj-allianz", + "field": "day_care_treatments_count", + "value": 130, + "source_type": "web_url", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_quote": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain__cis", + "insurer_slug": "bajaj-allianz", + "field": "network_hospital_count", + "value": 18400, + "source_type": "web_url", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_quote": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain__cis", + "insurer_slug": "bajaj-allianz", + "field": "preventive_health_checkup", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "limit: Preventive health check-up after every 4 continuous policy years.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain__cis", + "insurer_slug": "bajaj-allianz", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain__cis", + "insurer_slug": "bajaj-allianz", + "field": "tat_cashless_authorization_hours", + "value": 2, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "tat_cashless_authorization_hours from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain__cis", + "insurer_slug": "bajaj-allianz", + "field": "geographic_coverage", + "value": "pan_india", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "geographic_coverage from extracted PDF data: \"pan_india\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain__cis", + "insurer_slug": "bajaj-allianz", + "field": "policy_type_indemnity_or_fixed", + "value": "family_floater", + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"family_floater\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "bajaj-allianz__tax-gain__cis", + "insurer_slug": "bajaj-allianz", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-advantage-add-ons-protect-plus-care-shield__brochure", + "insurer_slug": "care-health", + "field": "uin_code", + "value": "CHIHLIP26049V042526", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", + "source_url": "", + "source_quote": "UIN:CHIHLIP26049V042526", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-advantage-add-ons-protect-plus-care-shield__brochure", + "insurer_slug": "care-health", + "field": 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"source_url": "", + "source_quote": "r Initial Wait Period 30 Days Named Ailment wait Period 24 Months Pre-Existing Disease 36 Months Wait Period Pricing Zones Zone 1 - Delhi NCR, Surat, Mathura, Aligarh Zone 2 - Mumbai (incl. 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"family_floater", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"family_floater\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-classic__wordings", + "insurer_slug": "care-health", + "field": "room_rent_capping", + "value": "no\nlimit", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-classic__wordings", + "insurer_slug": "care-health", + "field": "maternity_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-heart__brochure", + "insurer_slug": "care-health", + "field": "uin_code", + "value": "RHIHLIP19066V011819", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-heart__brochure.pdf", + "source_url": "", + "source_quote": "UIN: RHIHLIP19066V011819", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-heart__brochure", + "insurer_slug": "care-health", + "field": "max_renewal_age", + "value": 99, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-heart__brochure.pdf", + "source_url": "", + "source_quote": "Life long Quick quote & buy Online renew", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-heart__brochure", + "insurer_slug": "care-health", + "field": "pre_existing_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-heart__brochure.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-heart__brochure", + "insurer_slug": "care-health", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-heart__brochure.pdf", + "source_url": "", + "source_quote": "Initial Waiting\n30 Days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-heart__brochure", + "insurer_slug": "care-health", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-heart__brochure.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-heart__brochure", + "insurer_slug": "care-health", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-heart__brochure.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-heart__brochure", + "insurer_slug": "care-health", + "field": "copayment_pct", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-heart__brochure.pdf", + "source_url": "", + "source_quote": "Co-payment\nmedical and alternative treatments such as Ayurveda, Unani, Sidha and 30%", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-heart__brochure", + "insurer_slug": "care-health", + "field": "room_rent_capping", + "value": "100% of Sum Insured", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-heart__brochure.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-heart__brochure", + "insurer_slug": "care-health", + "field": "pre_hospitalization_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-heart__brochure.pdf", + "source_url": "", + "source_quote": "Pre-Hospitalization for 30 days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-heart__brochure", + "insurer_slug": "care-health", + "field": "post_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-heart__brochure.pdf", + "source_url": "", + "source_quote": "Post-Hospitalization for 60 days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-heart__brochure", + "insurer_slug": "care-health", + "field": "day_care_treatments_count", + "value": 541, + "source_type": "web_url", + "source_path": "rag/corpus/care-health/care-heart__brochure.pdf", + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_quote": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-heart__brochure", + "insurer_slug": "care-health", + "field": "policy_type", + "value": "group", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-heart__brochure.pdf", + "source_url": "", + "source_quote": "classified as group from PDF heuristics", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "uin_code", + "value": "RHIHLIP21017V052021", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "CIN:U66000DL2007PLC161503 UAN:21034556 UIN:RHIHLIP21017V052021", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "min_entry_age", + "value": 61, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "If your age is 61 years or more, we provide you an option to choose for co-payment of 20% per claim (senior-citizens product; min entry typically 61 years)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "sum_insured_options", + "value": [ + 300000, + 500000, + 700000, + 1000000 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "Benefits/Plan in ` (SI) 3 Lacs 5,7,10 Lacs", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "Waiting period 30 days for any illness except injury", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "pre_existing_disease_waiting_months", + "value": 48, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "Waiting period for named ailments 2 years of continuous coverage", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "pre_hospitalization_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "Pre-Hospitalization & Post Hospitalization Up to SI, 30 days/60 days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "post_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "Pre-Hospitalization & Post Hospitalization Up to SI, 30 days/60 days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "day_care_treatments_count", + "value": 541, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "Day Care Treatments Up to SI, 541 Procedures", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "Alternative Treatments Up to ` 15,000 / Up to ` 20,000 (AYUSH cover with cash sub-limit)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "No maternity benefit listed in Care Senior brochure benefit table", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "Senior-citizens product; no newborn benefit", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "Organ Donor Cover Up to ` 50,000 / Up to ` 1,00,000", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "no_claim_bonus_pct", + "value": 10, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "No Claim Bonus 10% increase in SI per Policy Year in case of claim-free year; Max up to 50% of SI", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "restoration_benefit", + "value": "Automatic Recharge of Sum Insured (once per policy year)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "Automatic Recharge of Sum Insured Yes to SI (Once in a Policy Year) / Yes, Up to SI (Once in a Policy Year)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "room_rent_capping", + "value": "1% of SI per day (3 Lacs plan); Single Private AC Room with max 1% SI per day (5/7/10 Lacs plan)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "Room Eligibility 1% SI per day / Single Private AC Room (Max. up to 1% of SI per day)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "copayment_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "If your age is 61 years or more, we provide you an option to choose for co-payment of 20% per claim (over & above any other co-payment, If any) which applies to you.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "cashless_treatment_supported", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "policy_type", + "value": "indemnity", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "In-Patient Hospitalization Up to Sum Insured (indemnity-based senior citizens plan)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "preventive_health_checkup", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "Annual Health check-up", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior", + "insurer_slug": "care-health", + "field": "co_payment_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "uin_code", + "value": "RHIHLIP21017V052021", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "min_entry_age", + "value": 61, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "max_renewal_age", + "value": 999, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "sum_insured_options", + "value": [ + 300000, + 500000, + 700000, + 1000000 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "pre_existing_disease_waiting_months", + "value": 48, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "pre_hospitalization_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "post_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "day_care_treatments_count", + "value": 541, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "extracted from day_care_treatments.limit_text: \"541 procedures, up to Sum Insured.\"", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "co_payment_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "room_rent_capped_at_pct_of_si", + "value": 1.0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "parsed from room_rent_capping: \"1% of SI per day (SI 3L); Single Private AC Room up to 1% of SI per day (SI 5/7/10L).\"", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "limit: Up to Rs 50,000 (SI 3L); Rs 1,00,000 (SI 5/7/10L).", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "restoration_benefit", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "limit: Automatic recharge once per policy year up to SI.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "limit: Up to 10% of SI for treatment exceeding 3 days.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-senior__brochure", + "insurer_slug": "care-health", + "field": "preventive_health_checkup", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_url": "", + "source_quote": "limit: Annual health check-up for all insured members.", + "confidence": 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"source_quote": "(s) on SUPREME ENHANCE - UIN: CHIHLIP25036V012425 4 1 day care basis without in-patient services and 2.1.11. 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Having at least 5 in-patient beds; would be taken as correct", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance", + "insurer_slug": "care-health", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_url": "", + "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance", + "insurer_slug": "care-health", + "field": "day_care_treatments_count", + "value": 541, + "source_type": "web_url", + "source_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_quote": "Per insurer baseline (Care Health publishes 541+ day care 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null + }, + { + "policy_id": "care-health__care-supreme-enhance", + "insurer_slug": "care-health", + "field": "restoration_benefit", + "value": "restore him to the position in which he was in, Policy Schedule against that benefit for that Insured", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_url": "", + "source_quote": "restore him to the position in which he was in, Policy Schedule against that benefit for that Insured", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance", + "insurer_slug": "care-health", + "field": "room_rent_capping", + "value": "No limit", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance", + "insurer_slug": "care-health", + "field": "copayment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_url": "", + "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance", + "insurer_slug": "care-health", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance", + "insurer_slug": "care-health", + "field": 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"source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance__wordings", + "insurer_slug": "care-health", + "field": "sum_insured_options", + "value": [ + 2000000, + 4500000, + 5000000, + 8500000, + 9000000, + 9300000, + 9500000, + 10000000 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance__wordings", + "insurer_slug": "care-health", + "field": "free_look_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": 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+ "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance__wordings", + "insurer_slug": "care-health", + "field": "post_hospitalization_days", + "value": 90, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance__wordings", + "insurer_slug": "care-health", + "field": "day_care_treatments_count", + "value": 541, + "source_type": "web_url", + "source_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_quote": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance__wordings", + "insurer_slug": "care-health", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance__wordings", + "insurer_slug": "care-health", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_url": "", + "source_quote": "limit: Up to Sum Insured.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance__wordings", + "insurer_slug": "care-health", + "field": "restoration_benefit", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_url": "", + "source_quote": "limit: Unlimited automatic recharge in a policy year for unrelated or same illness.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance__wordings", + "insurer_slug": "care-health", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_url": "", + "source_quote": "limit: Up to Sum Insured for treatment at home exceeding 3 days.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme-enhance__wordings", + "insurer_slug": 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(Standard Care Supreme entry: 91 days for dependent children)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme", + "insurer_slug": "care-health", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "(iii) 30-day waiting period- Code- Excl03 ... any illness within 30 days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme", + "insurer_slug": "care-health", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "Pre-Existing Diseases ... shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme", + "insurer_slug": "care-health", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "Named Ailment Waiting Period: Code- Excl02 ... excluded until the expiry of 24 months of continuous coverage", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme", + "insurer_slug": "care-health", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "(i) For a period of 60 days immediately prior to the Insured Person's date of in-patient admission", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme", + "insurer_slug": "care-health", + "field": "post_hospitalization_days", + "value": 180, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "i) For a period of 180 days immediately ... days after the completion of 180 days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme", + "insurer_slug": "care-health", + "field": "day_care_treatments_count", + "value": 541, + "source_type": "web_url", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_quote": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": 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"rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "Newborn baby ... aged up to 90 days (definition only; coverage tied to maternity which is not a base benefit)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme", + "insurer_slug": "care-health", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "Organ Donor expenses covered for organ harvesting; pre/post hospitalization of donor excluded", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme", + "insurer_slug": "care-health", + "field": "no_claim_bonus_pct", + "value": 50, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "At the end of each Policy Year, the Company will enhance the Sum Insured by 50% flat, on a cumulative basis, as a Cumulative Bonus ... accrued Cumulative Bonus, shall not exceed 100% of the Sum Insured", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme", + "insurer_slug": "care-health", + "field": "restoration_benefit", + "value": "Unlimited Automatic Recharge of base Sum Insured (unlimited times per policy year)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "3.1.4 Benefit : Unlimited Automatic Recharge ... automatically make the re-instatement of up to the base Sum Insured unlimited times in a policy year", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme", + "insurer_slug": "care-health", + "field": "room_rent_capping", + "value": "No 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"confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme", + "insurer_slug": "care-health", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "Domiciliary Hospitalization means medical 2", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme", + "insurer_slug": "care-health", + "field": "preventive_health_checkup", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "Annual Health check-up", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme", + "insurer_slug": "care-health", + "field": "co_payment_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme__wordings", + "insurer_slug": "care-health", + "field": "uin_code", + "value": "CHIHLIP23128V012223", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme__wordings", + "insurer_slug": "care-health", + "field": "free_look_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme__wordings", + "insurer_slug": "care-health", + "field": "day_care_treatments_count", + "value": 541, + "source_type": "web_url", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_quote": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__care-supreme__wordings", + "insurer_slug": "care-health", + "field": "co_payment_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + 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"confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__supreme-enhance__brochure", + "insurer_slug": "care-health", + "field": "uin_code", + "value": "CHIHLIP25036V012425", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", + "source_url": "", + "source_quote": "UIN:CHIHLIP25036V012425", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__supreme-enhance__brochure", + "insurer_slug": "care-health", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__supreme-enhance__brochure", + "insurer_slug": 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medication etc. incurred by you up to 60 days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__supreme-enhance__brochure", + "insurer_slug": "care-health", + "field": "post_hospitalization_days", + "value": 90, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", + "source_url": "", + "source_quote": "Post-Hospitalization Medical\n90 Days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__supreme-enhance__brochure", + "insurer_slug": "care-health", + "field": "day_care_treatments_count", + "value": 541, + "source_type": "web_url", + "source_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_quote": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__supreme-enhance__brochure", + "insurer_slug": "care-health", + "field": "policy_type", + "value": "group", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", + "source_url": "", + "source_quote": "classified as group from PDF heuristics", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__ultimate-care", + "insurer_slug": "care-health", + "field": "uin_code", + "value": "CHIHLIP25044V012425", + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", + "source_url": "", + "source_quote": "ch 2025 Ultimate Care - UIN : CHIHLIP25044V012425 1. PREAMBLE: The proposal and declaration given by the proposer and other documents if any shall form the basis of this Contract and is deemed to be i", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "care-health__ultimate-care", + "insurer_slug": "care-health", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", + "source_url": "", + "source_quote": "ancy, please inform us within 30 days from the date of receipt of the policy, failing which the details relating to the person/s covered would be taken as correct. 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source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-supreme-care__wordings", + "insurer_slug": "go-digit", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-supreme-care__wordings", + "insurer_slug": "go-digit", + "field": "post_hospitalization_days", + "value": 180, + "source_type": "policy_pdf", + "source_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-supreme-care__wordings", + "insurer_slug": "go-digit", + "field": "day_care_treatments_count", + "value": 100, + "source_type": "web_url", + "source_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_url": "https://www.godigit.com/health-insurance/daycare-treatment-and-procedures-in-health-insurance", + "source_quote": "Per insurer baseline (Go Digit Health covers all day-care up to SI; ~100 listed procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-supreme-care__wordings", + "insurer_slug": "go-digit", + "field": "network_hospital_count", + "value": 9000, + "source_type": "web_url", + "source_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_url": "https://www.godigit.com/health-insurance", + "source_quote": "9000+ Cashless Hospitals (health-insurance USP section, scraped 2026-05-15)", + "confidence": 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"source_quote": "Section 33 — newborn baby cover linked to maternity benefit.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-supreme-care__wordings", + "insurer_slug": "go-digit", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_url": "", + "source_quote": "Section 29 — donor harvesting expenses plus 5% donor pre/post-hospitalisation.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-supreme-care__wordings", + "insurer_slug": "go-digit", + "field": "restoration_benefit", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_url": "", + "source_quote": "Section 39 — Sum Insured Refill Benefit.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-supreme-care__wordings", + "insurer_slug": "go-digit", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_url": "", + "source_quote": "Section 38 — home hospitalization > 3 days, listed chronic conditions excluded.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-supreme-care__wordings", + "insurer_slug": "go-digit", + "field": "preventive_health_checkup", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_url": "", + "source_quote": "Section 40 Wellness Benefit Programme + complimentary check-up.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-supreme-care__wordings", + "insurer_slug": "go-digit", + "field": "critical_illness_cover", + 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"rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-top-up__wordings", + "insurer_slug": "go-digit", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-top-up__wordings", + "insurer_slug": "go-digit", + "field": "post_hospitalization_days", + "value": 180, + "source_type": "policy_pdf", + "source_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-top-up__wordings", + "insurer_slug": "go-digit", + "field": "day_care_treatments_count", + "value": 100, + "source_type": "web_url", + "source_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_url": "https://www.godigit.com/health-insurance/daycare-treatment-and-procedures-in-health-insurance", + "source_quote": "Per insurer baseline (Go Digit Health covers all day-care up to SI; ~100 listed procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-top-up__wordings", + "insurer_slug": "go-digit", + "field": "network_hospital_count", + "value": 9000, + "source_type": "web_url", + "source_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_url": "https://www.godigit.com/health-insurance", + "source_quote": "9000+ Cashless Hospitals (health-insurance USP section, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-top-up__wordings", + "insurer_slug": "go-digit", + "field": "co_payment_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_url": "", + "source_quote": "regex extracted from PDF text + rag/extracted structured JSON", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-top-up__wordings", + "insurer_slug": "go-digit", + "field": "policy_term_options_years", + "value": [ + 1 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_url": "", + "source_quote": "premium_payment_term_years from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": 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"rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_url": "", + "source_quote": "Newborn coverage from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-top-up__wordings", + "insurer_slug": "go-digit", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_url": "", + "source_quote": "Section 3 — donor harvesting expenses.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-top-up__wordings", + "insurer_slug": "go-digit", + "field": "restoration_benefit", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_url": "", + "source_quote": "Restoration benefit from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-top-up__wordings", + "insurer_slug": "go-digit", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_url": "", + "source_quote": "Section 4 — home hospitalisation > 3 days with listed exclusions.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-top-up__wordings", + "insurer_slug": "go-digit", + "field": "preventive_health_checkup", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_url": "", + "source_quote": "Preventive health checkup from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "go-digit__digit-top-up__wordings", + "insurer_slug": "go-digit", + "field": "critical_illness_cover", + "value": true, + "source_type": "policy_pdf", + 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II. This exclusion shall ", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus", + "insurer_slug": "hdfc-ergo", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus", + "insurer_slug": "hdfc-ergo", + "field": "day_care_treatments_count", + "value": 144, + "source_type": "web_url", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_quote": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus", + "insurer_slug": "hdfc-ergo", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "ysical bodily injury. Def. 2. AYUSH Day Care Centre means and includes Community Health Centre (CHC), Primary Health Centre (PHC), Dispensary, Clinic, Polyclinic or any such health centre which is reg", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus", + "insurer_slug": "hdfc-ergo", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "ization xv. Maternity: Code – Excl18 a. 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Def. 20. Non Network means any Hospital, day care centre or other provider that is not part of the network. Def. 21. Pre-existing Condition means any c", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus", + "insurer_slug": "hdfc-ergo", + "field": "policy_type", + "value": "indemnity", + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "from one or more insurers to indemnify treatment costs, the insured person shall have the right to require a settlement of his/her claim in terms of any of his/her policies. In all such cases the i", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus", + "insurer_slug": "hdfc-ergo", + "field": "ambulance_cover", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "Emergency Ambulance We will reimburse the expenses incurred on an ambulance offered by a healthcare or ambulance service provider used to transfer the", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "uin_code", + "value": "HDHHLIP21336V022021", + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "max_entry_age", + "value": 65, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "max_renewal_age", + "value": 999, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "min_child_entry_age", + "value": 91, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "grace_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "free_look_period", + "value": 15, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted.json structured field", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "post_hospitalization_days", + "value": 90, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "day_care_treatments_count", + "value": 144, + "source_type": "web_url", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_quote": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "network_hospital_count", + "value": 16000, + "source_type": "web_url", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "https://www.hdfcergo.com/", + "source_quote": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "policy_term_options_years", + "value": [ + 1 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "premium_payment_term_years from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted.json structured field", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted.json structured field", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "Newborn coverage from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "Organ donor expenses from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "restoration_benefit", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "Restoration benefit from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "Home treatment > 3 days when transfer impossible or no room.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "preventive_health_checkup", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "Preventive health checkup from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "critical_illness_cover", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "Critical illness cover from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted.json structured field", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "geographic_coverage", + "value": "pan_india", + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "geographic_coverage from extracted PDF data: \"pan_india\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "policy_type_indemnity_or_fixed", + "value": "super_top_up", + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"super_top_up\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-plus__wordings", + "insurer_slug": "hdfc-ergo", + "field": "deductible_amount", + "value": 300000, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_url": "", + "source_quote": "deductible_amount_inr from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "uin_code", + "value": "HDHHLIP21322V062021", + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "Optima Restore UIN: HDHHLIP21322V062021", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "min_entry_age", + "value": 91, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "Minimum Age: The minimum entry age is 91 days. Children between 91 days and 5 years can be insured provided either parent is getting insured under this Policy.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "max_entry_age", + "value": 65, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "Maximum Age: The maximum entry age is 65 years. There is no maximum cover ceasing age in this Policy.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "sum_insured_options", + "value": [ + 300000, + 500000, + 1000000, + 1500000, + 2000000, + 2500000, + 5000000 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "Basic Sum Insured per Insured Person per Policy Year (Rs. in Lakh) 3.00 5.00 10.00 15.00 20.00, 25.00, 50.00", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "Any treatment within first 30 days of cover except any accidental injury.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "Any Pre-existing diseases/conditions will be covered after a waiting period of 3 years.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "2 years exclusion for specific diseases like cataract, hernia, hysterectomy, joint replacement etc.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "1b) Pre-Hospitalization Covered upto 60 Days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "post_hospitalization_days", + "value": 180, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "1c) Post-Hospitalization Covered upto 180 Days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "day_care_treatments_count", + "value": 144, + "source_type": "web_url", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "https://www.hdfcergo.com/health-insurance/optima-restore-individual", + "source_quote": "HDFC Ergo Optima Restore covers all listed day-care procedures (144 per insurer-wide list)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "ayush_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "Non-allopathic treatment, congenital external diseases, cosmetic surgery (listed under MAJOR EXCLUSIONS)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "Pregnancy, dental treatment, external aids and appliances. (MAJOR EXCLUSIONS)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "Not covered in base (no newborn-specific benefit listed in brochure feature table)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "1f) Organ Donor Covered upto sum insured", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "no_claim_bonus_pct", + "value": 50, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "Bonus of 50% of the Basic Sum Insured for every claim free year, maximum upto 100%", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "restoration_benefit", + "value": "100% of Basic Sum Insured (one-time per policy year)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "2) Restore Benefit Equal to 100% of Basic Sum Insured", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore", + "insurer_slug": "hdfc-ergo", + "field": "room_rent_capping", + "value": "No sub-limit on room rent", + "source_type": 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"source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "https://www.hdfcergo.com/health-insurance/optima-restore-individual", + "source_quote": "HDFC Ergo Optima Restore covers all listed day-care procedures (144 per insurer-wide list)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore__brochure", + "insurer_slug": "hdfc-ergo", + "field": "network_hospital_count", + "value": 16000, + "source_type": "web_url", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "https://www.hdfcergo.com/", + "source_quote": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore__brochure", + "insurer_slug": "hdfc-ergo", + "field": "policy_term_options_years", + "value": [ + 1 + ], + 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"verified": null, + "last_verified": null + }, + { + "policy_id": "hdfc-ergo__optima-restore__brochure", + "insurer_slug": "hdfc-ergo", + "field": "restoration_benefit", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_url": "", + "source_quote": "limit: 100% of Basic SI restored automatically on complete or partial utilisation.; SI restored only once per policy year; expires if unused. 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PREAMBLE 3.6. AYUSH Day Care Centre means and includes Community Health Centre (CHC), Primary Health Centre (PHC), Dispensary, Clinic, Polyclinic or This Policy is a contract of insura", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__arogya-sanjeevani", + "insurer_slug": "icici-lombard", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "15. Maternity Expenses (Code- Excl18): 1.2. 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The within ref", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__arogya-sanjeevani", + "insurer_slug": "icici-lombard", + "field": "restoration_benefit", + "value": "reinstatement OR", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "reinstatement OR", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__arogya-sanjeevani", + "insurer_slug": "icici-lombard", + "field": "room_rent_capping", + "value": "Room Rent, Boarding, Nursing Expenses all inclusive as provided by the Hospital / Nursing Home up to 2% of", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "Room Rent, Boarding, Nursing Expenses all inclusive as provided by the Hospital / Nursing Home up to 2% of", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__arogya-sanjeevani", + "insurer_slug": "icici-lombard", + "field": "copayment_pct", + "value": 5, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "ccess, the insured person may Copayment of 5% applicable to claim amount admissible and payable obtain the treatment as per treating doctor's advice and submit as pe", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__arogya-sanjeevani", + "insurer_slug": "icici-lombard", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_url": "", + "source_quote": "s thereof 3. 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b. has qualified medical practitioner/s in charge c. has fully equip", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__complete-health-umbrella", + "insurer_slug": "icici-lombard", + "field": "sum_insured_options", + "value": [ + 1000000, + 5000000 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", + "source_url": "", + "source_quote": "ed Annual Revised Accumulated Sum Insured (after 5 claim free years) reduced to ` 10 Lacs Sum Insured Guaranteed Cumulative Bonus (GCB) 50 Lac 50 Lac 10Lac 10 Lac UIN : ICIHLIP23144V072223 12 CIN: L67", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__complete-health-umbrella", + "insurer_slug": "icici-lombard", + "field": "initial_waiting_period_days", + "value": 90, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", + "source_url": "", + "source_quote": "f the below mentioned illness within 90 days from the first policy commencement date shall be excluded unless they are pre-existing and disclosed at the time of underwriting I. 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Diabet", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__complete-health-umbrella", + "insurer_slug": "icici-lombard", + "field": "pre_existing_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", + "source_url": "", + "source_quote": "related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first po", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__complete-health-umbrella", + "insurer_slug": "icici-lombard", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", + "source_url": "", + "source_quote": "lated to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. Th", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__complete-health-umbrella", + "insurer_slug": "icici-lombard", + "field": "day_care_treatments_count", + "value": 150, + "source_type": "web_url", + "source_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_quote": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__complete-health-umbrella", + "insurer_slug": "icici-lombard", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", + "source_url": "", + "source_quote": "me where treatment was taken. 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The org", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__complete-health-umbrella", + "insurer_slug": "icici-lombard", + "field": "no_claim_bonus_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", + "source_url": "", + "source_quote": "Cumulative Bonus of 20% of expiring or renewed Annual Sum Insured (whiche", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__complete-health-umbrella", + "insurer_slug": "icici-lombard", + "field": "restoration_benefit", + "value": "restorative, cosmetic services related to disease, disorder and conditions related to natural", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", + "source_url": "", + "source_quote": "restorative, cosmetic services related to disease, disorder and conditions related to natural", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__complete-health-umbrella", + "insurer_slug": "icici-lombard", + "field": "room_rent_capping", + "value": "Single Private Room means an air conditioned room in a Hospital where a single patient is accommodated and which has an attached toilet (lavatory", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", + "source_url": "", + "source_quote": "Single Private Room means an air conditioned room in a Hospital where a single patient is accommodated and which has an attached toilet (lavatory", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__complete-health-umbrella", + "insurer_slug": "icici-lombard", + "field": "copayment_pct", + "value": 10, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", + "source_url": "", + "source_quote": "to Policy Cancellation. iv. A Co-payment of 10% will be applied to every admissible claim v. The coverage is available for 45 consecutive days from the date of travel", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__complete-health-umbrella", + "insurer_slug": "icici-lombard", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", + "source_url": "", + "source_quote": "’s authorized representative. Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the po", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__complete-health-umbrella", + "insurer_slug": "icici-lombard", + "field": "policy_type", + "value": "hospital-cash", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", + "source_url": "", + "source_quote": "Hospital cash / daily benefit policy", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "uin_code", + "value": "ICIHLIP25048V042425", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "IRDA Reg. No. 115 CIN: L67200MH2000PLC129408 UIN: ICIHLIP25048V042425 Product Name: Elevate", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "min_entry_age", + "value": 91, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "Dependent Child means a child (natural or legally adopted), who is unmarried, aged between 91 days and 30 years", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "4. 30-day waiting period- Code- Excl03", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "1. Pre-Existing Diseases - Code- Excl01 ... expiry of 36 months of continuous coverage", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "Specific Waiting Period - Code- Excl02 ... be excluded until the expiry of 24 months", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "maternity_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "Add Ons/Optional Cover - Maternity Benefit shall be reduced from 24 months to 12 months (default 24 months under optional Maternity Benefit)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "pre_hospitalization_days", + "value": 90, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "Pre-Hospitalization Medical Expenses incurred in respect of the Insured Person immediately 90 days before the Insured Person's Admission to Hospital", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "post_hospitalization_days", + "value": 180, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "Post-Hospitalization Medical Expenses ... immediately 180 days following the Insured Person's discharge from Hospital", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "day_care_treatments_count", + "value": 150, + "source_type": "web_url", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "https://www.icicilombard.com/health-insurance/elevate", + "source_quote": "ICICI Lombard Elevate uses the insurer's 150 day-care procedure list", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "Day Care Centre includes an AYUSH Day Care Centre ... AYUSH Day Care Centre means and includes ... (In-patient AYUSH Hospitalization covered)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "Add Ons/Optional Cover - Maternity Benefit (Maternity is opt-in optional, not base)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "Newborn baby (and) post-natal (up to 30 days from date of [birth]) (covered only if optional Maternity Benefit is opted)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "We have accepted a claim under Section 'Inpatient treatment' in respect of the Insured Person. (Organ donor cover under hospitalisation; donor's pre/post hospitalization expenses excluded)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "no_claim_bonus_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "10. Loyalty Bonus We will provide a Loyalty Bonus of 20% of expiring or renewed Annual Sum Insured (whichever is lower) at the end of each Policy Year ... not be accumulated for more than 100%", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "restoration_benefit", + "value": "Reset Benefit: up to 100% Annual Sum Insured, unlimited triggers per policy year", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "11. Reset Benefit We will reset up to 100% of the Annual Sum Insured, for any illness/disease/injury ... triggered unlimited times for any illness/disease/injury.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "room_rent_capping", + "value": "Single Private AC Room (no daily cap on base benefit; proportionate deduction if higher category opted)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "i. Room Rent charges up to Single Private AC ... proportionate share of the total Associated medical expenses", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "copayment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "No mandatory base copayment in Elevate (voluntary copay available per Policy Schedule)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "Cashless facility means a facility extended by the [insurer to the insured] (defined)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "policy_type", + "value": "indemnity", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "In-patient Treatment ... up to the Annual Sum Insured (indemnity-based premium tier)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "ambulance_cover", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "Road Ambulance 7 Robotic surgeries We will cover the expenses incurred on road 8 Stereotactic radio Surgeries ambulance services which are offered by", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "Domiciliary hospitalization” means medical treatment b", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate", + "insurer_slug": "icici-lombard", + "field": "preventive_health_checkup", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "Preventive Health check-up", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "uin_code", + "value": "ICIHLIP25048V042425", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "min_entry_age", + "value": 18, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "max_renewal_age", + "value": 999, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "min_child_entry_age", + "value": 91, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "sum_insured_options", + "value": [ + 500000, + 1000000, + 1500000, + 2000000, + 2500000, + 5000000, + 10000000, + 20000000, + 30000000, + 50000000, + 100000000, + 300000000 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "grace_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "free_look_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "extracted.json structured field", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "maternity_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "post_hospitalization_days", + "value": 180, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "day_care_treatments_count", + "value": 150, + "source_type": "web_url", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "https://www.icicilombard.com/health-insurance/elevate", + "source_quote": "ICICI Lombard Elevate uses the insurer's 150 day-care procedure list", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "network_hospital_count", + "value": 7500, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "7500+ hospitals", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__elevate__wordings", + "insurer_slug": "icici-lombard", + "field": "co_payment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_url": "", + "source_quote": "copayment_pct=0% from extracted PDF data", + "confidence": "high", + 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The org", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-advantedge", + "insurer_slug": "icici-lombard", + "field": "no_claim_bonus_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_url": "", + "source_quote": "Cumulative Bonus of 20% of expiring or renewed Annual Sum Insured (whiche", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-advantedge", + "insurer_slug": "icici-lombard", + "field": "restoration_benefit", + "value": "Reset benefit will not be available for this cover", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_url": "", + "source_quote": "Reset benefit will not be available for this cover", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, 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"source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", + "source_url": "", + "source_quote": "extracted.json structured field", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360-retail__cis", + "insurer_slug": "icici-lombard", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", + "source_url": "", + "source_quote": "extracted.json structured field", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360-retail__cis", + "insurer_slug": "icici-lombard", + "field": "no_claim_bonus_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", + "source_url": "", + "source_quote": "Cumulative bonus - A\nA. 14\nCumulative Bonus of 20%", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360-retail__cis", + "insurer_slug": "icici-lombard", + "field": "room_rent_capping", + "value": "No cap", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", + "source_url": "", + "source_quote": "No cap", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360-retail__cis", + "insurer_slug": "icici-lombard", + "field": "post_hospitalization_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", + "source_url": "", + "source_quote": "Post-hospitalization Medical\nExpenses documents may be provided within\n30 days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": 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"value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "extracted.json structured field", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360-retail__wordings", + "insurer_slug": "icici-lombard", + "field": "maternity_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "extracted.json structured field", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360-retail__wordings", + "insurer_slug": "icici-lombard", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "extracted.json structured field", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360-retail__wordings", + "insurer_slug": "icici-lombard", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "extracted.json structured field", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360-retail__wordings", + "insurer_slug": "icici-lombard", + "field": "copayment_pct", + "value": 10, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "Co-payment of 10%", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360-retail__wordings", + "insurer_slug": "icici-lombard", + "field": "no_claim_bonus_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "Cumulative Bonus (GCB) ix. The Cumulative Bonus shall be reduced in the same\nWe will provide a Cumulative Bonus of 20%", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360-retail__wordings", + "insurer_slug": "icici-lombard", + "field": "room_rent_capping", + "value": "No cap", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "No cap", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360-retail__wordings", + "insurer_slug": "icici-lombard", + "field": "day_care_treatments_count", + "value": 150, + "source_type": "web_url", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_quote": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360-retail__wordings", + "insurer_slug": "icici-lombard", + "field": "network_hospital_count", + "value": 6000, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "6000+ hospitals", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360-retail__wordings", + "insurer_slug": "icici-lombard", + "field": "policy_type", + "value": "group", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "classified as group from PDF heuristics", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "uin_code", + "value": "ICIHLIP23165V012223", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "IRDA Reg. No. 115 UIN: ICIHLIP23165V012223 HEALTH SHIELD 360 RETAIL", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "min_entry_age", + "value": 91, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "[Newborn baby] aged upto 90 days (Dependent child entry standard 91 days)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "30-day waiting period (Code- Excl03) — any illness within 30 days from first policy commencement excluded (standard IRDAI exclusion clause)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "pre_existing_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "Pre-Existing Diseases ... excluded until the expiry of 12/24 months (as per the plan opted) of continuous coverage", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "Code- Excl02: Specified Disease/Procedure waiting period ... excluded until the expiry of 24 months of continuous coverage", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "day_care_treatments_count", + "value": 150, + "source_type": "web_url", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_quote": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "6. In Patient AYUSH Hospitalisation ... at a AYUSH Hospital or AYUSH Day Care Centre.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "Code- Excl18: Maternity (excluded as standard IRDAI exclusion in base Health Shield 360)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "Maternity is excluded; newborn coverage tied to maternity", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "10. Donor Expenses We will cover the medical expenses incurred in respect of an organ donor's Hospitalization during the Policy Period for harvesting of the organ donated", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "no_claim_bonus_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "14. Guaranteed Cumulative Bonus (GCB) We will provide a Cumulative Bonus of 20% of expiring or renewed Annual Sum Insured (whichever is lower) ... not be accumulated for more than 100%", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "restoration_benefit", + "value": "Reset Benefit: up to 100% of Annual Sum Insured, once per policy year", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "7. Reset Benefit We will reset up to 100% of the Annual Sum Insured, Once [per policy year]", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "room_rent_capping", + "value": "Single Private AC Room (per Policy Schedule)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "i. Room Rent charges ... (per Policy Schedule entitlement; proportionate deduction clause applies)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "copayment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "No mandatory base copay in Health Shield 360 (voluntary co-pay add-on available)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "Cashless facility ... extended ... (defined in policy wording)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "icici-lombard__health-shield-360", + "insurer_slug": "icici-lombard", + "field": "policy_type", + "value": "indemnity", + "source_type": "policy_pdf", + "source_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_url": "", + "source_quote": "In-patient Treatment ... up to the Annual Sum Insured (indemnity-based)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "iffco-tokio__critical-illness-benefit__wordings", + "insurer_slug": "iffco-tokio", + "field": "uin_code", + "value": "IFFHLIP19036V011920", + "source_type": "policy_pdf", + "source_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "iffco-tokio__critical-illness-benefit__wordings", + "insurer_slug": "iffco-tokio", + "field": "min_entry_age", + "value": 18, + "source_type": "policy_pdf", + "source_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "iffco-tokio__critical-illness-benefit__wordings", + "insurer_slug": "iffco-tokio", + "field": "max_entry_age", + "value": 65, + "source_type": "policy_pdf", + "source_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + 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see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-parivar-plus__prospectus", + "insurer_slug": "national-insurance", + "field": "pre_hospitalization_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-parivar-plus__prospectus", + "insurer_slug": "national-insurance", + "field": "post_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-parivar-plus__prospectus", + "insurer_slug": "national-insurance", + "field": "day_care_treatments_count", + "value": 140, + "source_type": "web_url", + "source_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_quote": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-parivar-plus__prospectus", + "insurer_slug": "national-insurance", + "field": "network_hospital_count", + "value": 5322, + "source_type": "web_url", + "source_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_url": "https://nationalinsurance.nic.co.in/", + "source_quote": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-parivar-plus__prospectus", + "insurer_slug": "national-insurance", + "field": "room_rent_capped_at_pct_of_si", + "value": "Plan A: per Table of Benefits per-day limit; 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see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "free_look_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "pre_existing_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "pre_hospitalization_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "post_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "day_care_treatments_count", + "value": 140, + "source_type": "web_url", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_quote": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "network_hospital_count", + "value": 5322, + "source_type": "web_url", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "https://nationalinsurance.nic.co.in/", + "source_quote": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "co_payment_pct", + "value": 18, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "copayment_pct=18% from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "room_rent_capped_at_pct_of_si", + "value": 1.0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "parsed from room_rent_capping: \"Plan A: 1% of SI per day (max INR 5,000). Plan B: 2% of SI per day (max INR 10,000). No cap if PPN packaged procedure.\"", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "policy_term_options_years", + "value": [ + 1 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "premium_payment_term_years from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "limit: Up to Sum Insured; In-patient AYUSH at AYUSH Hospital", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "limit: Excluded; Maternity excluded for senior citizens", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "limit: Hospitalisation expenses of organ donor; Per Transplantation of Human Organs Act 1994", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "restoration_benefit", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "limit: Plan B only - Reinstatement of SI if exhausted due to RTA; Once per policy period", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "limit: Up to 20% of Sum Insured; Both plans; min 3 days; first 7 days domiciliary then post-hospitalisation", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-senior-citizen__prospectus", + "insurer_slug": "national-insurance", + "field": "preventive_health_checkup", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_url": "", + "source_quote": "limit: Plan A: block of 2 years. 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see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-super-top-up__prospectus", + "insurer_slug": "national-insurance", + "field": "maternity_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-super-top-up__prospectus", + "insurer_slug": "national-insurance", + "field": "pre_hospitalization_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-super-top-up__prospectus", + "insurer_slug": "national-insurance", + "field": "post_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-super-top-up__prospectus", + "insurer_slug": "national-insurance", + "field": "day_care_treatments_count", + "value": 140, + "source_type": "policy_pdf", + "source_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_url": "", + "source_quote": "extracted from day_care_treatments.limit_text: \"140+ day care procedures\"", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-super-top-up__prospectus", + "insurer_slug": "national-insurance", + "field": "network_hospital_count", + "value": 5322, + "source_type": "web_url", + "source_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_url": "https://nationalinsurance.nic.co.in/", + "source_quote": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "national-insurance__national-super-top-up__prospectus", + "insurer_slug": "national-insurance", + "field": "room_rent_capped_at_pct_of_si", + "value": "No explicit per-day cap; 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This exclusion shall n", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "new-india__janata-mediclaim", + "insurer_slug": "new-india", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "source_url": "", + "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "new-india__janata-mediclaim", + "insurer_slug": "new-india", + "field": "pre_hospitalization_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "source_url": "", + "source_quote": "and Cost of Diagnostics. 3.5 Pre-Hospitalisation medical Expenses up to 30 days. 3.6 Post-Hospitalisation medical Expenses up to 60 days, subject to maximum of 10% of hospital bill. 3.7 COVERAGE FOR A", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "new-india__janata-mediclaim", + "insurer_slug": "new-india", + "field": "post_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "source_url": "", + "source_quote": "l Expenses up to 30 days. 3.6 Post-Hospitalisation medical Expenses up to 60 days, subject to maximum of 10% of hospital bill. 3.7 COVERAGE FOR AYUSH TREATMENT Expenses incurred for Ayurveda, Yoga and", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "new-india__janata-mediclaim", + "insurer_slug": "new-india", + "field": "day_care_treatments_count", + "value": 139, + "source_type": "web_url", + "source_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "source_url": "https://www.newindia.co.in/health-insurance/health-insurance-policy", + "source_quote": "Per insurer baseline (New India Assurance Mediclaim covers ~139 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "new-india__janata-mediclaim", + "insurer_slug": "new-india", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "source_url": "", + "source_quote": "ment may have been taken. 2.3 AYUSH HOSPITAL is a Healthcare facility wherein medical / surgical / para-surgical treatment procedures and interventions are carried out by AYUSH Medical Practitioner(s)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "new-india__janata-mediclaim", + "insurer_slug": "new-india", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "source_url": "", + "source_quote": "15 MATERNITY EXPENSES (Code - Excl18) a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "new-india__janata-mediclaim", + "insurer_slug": "new-india", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "source_url": "", + "source_quote": "Newborn cover not found; typically tied to maternity option", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "new-india__janata-mediclaim", + "insurer_slug": "new-india", + "field": "organ_donor_expenses", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "source_url": "", + "source_quote": "Organ donor cover not extracted", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "new-india__janata-mediclaim", + "insurer_slug": "new-india", + "field": "no_claim_bonus_pct", + "value": 5, + "source_type": "policy_pdf", + "source_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "source_url": "", + "source_quote": "Cumulative bonus in the range of 5% to 30% will have a discount in the base premium f", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "new-india__janata-mediclaim", + "insurer_slug": "new-india", + "field": "restoration_benefit", + "value": "restoration of the previous state of Health", + "source_type": "policy_pdf", + "source_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "source_url": "", + "source_quote": "restoration of the previous state of Health", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "new-india__janata-mediclaim", + "insurer_slug": "new-india", + "field": "copayment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "source_url": "", + "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "new-india__janata-mediclaim", + "insurer_slug": "new-india", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "source_url": "", + "source_quote": "the claim has fallen due. 2.6 CASHLESS FACILITY means a facility extended by the insurer to the Insured where the payments, of the costs of treatment undergone by the Insured in accordance with the po", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "new-india__janata-mediclaim", + "insurer_slug": "new-india", + "field": "policy_type", + "value": "indemnity", + "source_type": "policy_pdf", + "source_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "source_url": "", + "source_quote": "nerative disorders: Our shall indemnify the Hospital or the Insured the Medical Expenses (including Pre and Post Hospitalisation Expenses) related to following and they are covered after a waiting p", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "new-india__mediclaim-policy", + "insurer_slug": "new-india", + "field": "uin_code", + "value": "NIAHLIP23187V052223", + "source_type": "policy_pdf", + "source_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", + "source_url": "", + "source_quote": "INDIA MEDICLAIM POLICY (UIN: NIAHLIP23187V052223) 1. 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max per claim = Base SI; Triggers on first paid claim and stays for life if renewed without break", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__aspire__wordings", + "insurer_slug": "niva-bupa", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_url": "", + "source_quote": "Home Care for chronic conditions with daily monitoring; peritoneal dialysis and chemotherapy at home covered", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__aspire__wordings", + "insurer_slug": "niva-bupa", + "field": "worldwide_emergency_cover", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_url": "", + "source_quote": "limit: Allopathic treatments covered anywhere in the world (Borderless benefit)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__aspire__wordings", + "insurer_slug": "niva-bupa", + "field": "preventive_health_checkup", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_url": "", + "source_quote": "limit: Annual health checkup from Day 1 (cashless only via app); 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Refer to the\nDay Car", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion-v2022__brochure", + "insurer_slug": "niva-bupa", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", + "source_url": "", + "source_quote": "Pre Hospitalisation 60 Days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion-v2022__brochure", + "insurer_slug": "niva-bupa", + "field": "post_hospitalization_days", + "value": 180, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", + "source_url": "", + "source_quote": "Post Hospitalisation 180 Days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion-v2022__brochure", + 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until the expiry of 36 months (under Variant 2, Variant 3 Plans and Family First Policy)/ 48 months (under Variant 1 Plan) of continuous coverage", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion", + "insurer_slug": "niva-bupa", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "Specified disease/procedure Waiting Period (Code- Excl02): ... excluded until the expiry of 24 months of continuous coverage", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion", + "insurer_slug": "niva-bupa", + "field": "pre_hospitalization_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "We 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insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion", + "insurer_slug": "niva-bupa", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "AYUSH treatment covered up to Sum Insured (standard Niva Bupa inclusion)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion", + "insurer_slug": "niva-bupa", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "Maternity Expense defined; excluded in base (optional add-on)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion", + "insurer_slug": "niva-bupa", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "Maternity excluded in base; newborn linked to maternity", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion", + "insurer_slug": "niva-bupa", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "Organ donor expenses covered (standard Niva Bupa inclusion)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion", + "insurer_slug": "niva-bupa", + "field": "restoration_benefit", + "value": "Re-fill of Sum Insured (per Section 3.12)", + 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"source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "No mandatory base copay (voluntary copay options per Policy Schedule)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion", + "insurer_slug": "niva-bupa", + "field": "network_hospital_count", + "value": 10400, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_quote": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion", + "insurer_slug": "niva-bupa", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "Cashless facility through Network Provider", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion", + "insurer_slug": "niva-bupa", + "field": "policy_type", + "value": "indemnity", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "Indemnity-based mid-tier health plan", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "uin_code", + "value": "MAXHLIP21509V042021", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { 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"field": "sum_insured_options", + "value": [ + 300000, + 500000, + 750000, + 1000000, + 1500000, + 2500000, + 5000000, + 10000000 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "grace_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "free_look_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "pre_existing_disease_waiting_months", + "value": 48, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "post_hospitalization_days", + "value": 180, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "day_care_treatments_count", + "value": 586, + "source_type": "web_url", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_quote": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "network_hospital_count", + "value": 10400, + "source_type": "web_url", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_quote": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "co_payment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "copayment_pct=0% from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "room_rent_capped_at_pct_of_si", + "value": "No cap", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "G4 batch extract from rag/extracted; field via structured-source pattern; confidence=medium", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "policy_term_options_years", + "value": [ + 1 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "premium_payment_term_years from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "limit: Covered up to Sum Insured", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "Maternity coverage from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": 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"source_url": "", + "source_quote": "limit: Covered up to Sum Insured", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "preventive_health_checkup", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "limit: Annual checkup from day 1 with sliding limit by SI band", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "cashless_treatment_supported from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "no_claim_bonus_cap_pct", + "value": 100, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "no_claim_bonus_cap_pct from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "tat_cashless_authorization_hours", + "value": 1, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "tat_cashless_authorization_hours from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "geographic_coverage", + "value": "pan_india", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "geographic_coverage from extracted PDF data: \"pan_india\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "policy_type_indemnity_or_fixed", + "value": "family_floater", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"family_floater\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "room_rent_capping", + "value": "No cap", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "room_rent_capping (verbatim): \"No cap\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-companion__wordings", + "insurer_slug": "niva-bupa", + "field": "no_claim_bonus_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_url": "", + "source_quote": "no_claim_bonus_pct from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-plus-top-up", + "insurer_slug": "niva-bupa", + "field": "uin_code", + "value": "NBHHLIP24135V012324", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_url": "", + "source_quote": "t Name: Health+, Product UIN: NBHHLIP24135V012324 2.1.7. Cumulative Bonus means any increase or addition in the Sum Insured granted by the insurer without an associated increase in premium 2.1.8. Day ", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-plus-top-up", + "insurer_slug": "niva-bupa", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_url": "", + "source_quote": "eatment of any Illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered. b. This exclusion shall not, ho", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-plus-top-up", + "insurer_slug": "niva-bupa", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_url": "", + "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-plus-top-up", + "insurer_slug": "niva-bupa", + "field": "pre_hospitalization_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_url": "", + "source_quote": "therapy, diagnostic tests for 30 days before the date of admission and 60 days after date of discharge IF these are related to the condition for which in-patient claim is paid. Conditions: a. We have ", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-plus-top-up", + "insurer_slug": "niva-bupa", + "field": "post_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_url": "", + "source_quote": "ore the date of admission and 60 days after date of discharge IF these are related to the condition for which in-patient claim is paid. Conditions: a. We have accepted a claim under Section 3.1 (Inpat", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-plus-top-up", + "insurer_slug": "niva-bupa", + "field": "day_care_treatments_count", + "value": 586, + "source_type": "web_url", + "source_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_quote": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-plus-top-up", + "insurer_slug": "niva-bupa", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_url": "", + "source_quote": "Policy covers Allopathic and AYUSH treatments taken in India ONLY. 2. Definitions It is IMPORTANT You should go through the definition of some words used in the policy. Definition of these may vary fr", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-plus-top-up", + "insurer_slug": "niva-bupa", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_url": "", + "source_quote": ".17. Maternity Expenses (Code-Excl18) a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during Hospitalization) except ectopic", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-plus-top-up", + "insurer_slug": "niva-bupa", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_url": "", + "source_quote": "Newborn cover not found; typically tied to maternity option", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-plus-top-up", + "insurer_slug": "niva-bupa", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_url": "", + "source_quote": "organ donor’s Inpatient treatment for the harvesting of the organ donated during the Policy Period. Conditions: b. The donation conforms to The Transplantation of Human Organs Act 1994 and amendments ", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-plus-top-up", + "insurer_slug": "niva-bupa", + "field": "room_rent_capping", + "value": "room category opted or Room Rent incurred is higher", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_url": "", + "source_quote": "room category opted or Room Rent incurred is higher", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-plus-top-up", + "insurer_slug": "niva-bupa", + "field": "copayment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_url": "", + "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-plus-top-up", + "insurer_slug": "niva-bupa", + "field": "network_hospital_count", + "value": 10400, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_quote": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-plus-top-up", + "insurer_slug": "niva-bupa", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_url": "", + "source_quote": "nd Homeopathy systems. 2.1.4. 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Conditions - The a", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia", + "insurer_slug": "niva-bupa", + "field": "no_claim_bonus_pct", + "value": 10, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "Cumulative Bonus by increasing the Sum Insured applicable under the Policy by 10% of the Base Sum Insured of the immediately preced", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia", + "insurer_slug": "niva-bupa", + "field": "restoration_benefit", + "value": "restorative services related to disease, disorder and conditions related to", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "restorative services related to disease, disorder and conditions related to", + 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"policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": "free_look_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM 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"verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": "post_hospitalization_days", + "value": 180, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": "day_care_treatments_count", + "value": 586, + "source_type": "web_url", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_quote": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": "network_hospital_count", + "value": 10400, + "source_type": "web_url", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_quote": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": "co_payment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "copayment_pct=0% from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + 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+ "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "limit: Up to Sum Insured", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": "maternity_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "Available on higher Premia plans with 24-month waiting; includes lawful MTP expenses", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": "newborn_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "Newborn covered 1-90 days", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "Organ donor expenses from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": "restoration_benefit", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "limit: Refill benefit up to Base Sum Insured for unrelated illness", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": 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"value": "worldwide", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "geographic_coverage from extracted PDF data: \"worldwide\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": "policy_type_indemnity_or_fixed", + "value": "family_floater", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"family_floater\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__health-premia__wordings", + "insurer_slug": "niva-bupa", + "field": "room_rent_capping", + "value": "No cap on Direct/Aspire/Platinum plans (Silver may have eligibility band)", + "source_type": "policy_pdf", + "source_path": 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This exclusion shall n", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__rise", + "insurer_slug": "niva-bupa", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_url": "", + "source_quote": "lated to the treatment of the listed conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy. This exclu", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__rise", + "insurer_slug": "niva-bupa", + "field": "post_hospitalization_days", + "value": 180, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_url": "", + "source_quote": "ore the date of admission and 180 days after date of discharge IF these are related to the condition for which hospitalization claim is paid. 4.1.4. 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If you donate any of ", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__rise", + "insurer_slug": "niva-bupa", + "field": "room_rent_capping", + "value": "Single Private Room or All Room Category", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_url": "", + "source_quote": "Single Private Room or All Room Category", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__rise", + "insurer_slug": "niva-bupa", + "field": "copayment_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_url": "", + "source_quote": "ide this network, then a flat 20% co-payment will be applicable to the admissible claim amount. This co-payment you would have to bear for every claim. 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"source_quote": "classified as group from PDF heuristics", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__saral-suraksha", + "insurer_slug": "niva-bupa", + "field": "uin_code", + "value": "NBHPAIP22153V012122", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", + "source_url": "", + "source_quote": "surance Co. 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If the period of ", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__saral-suraksha", + "insurer_slug": "niva-bupa", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", + "source_url": "", + "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__saral-suraksha", + "insurer_slug": "niva-bupa", + "field": "day_care_treatments_count", + "value": 586, + "source_type": "web_url", + "source_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_quote": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__saral-suraksha", + "insurer_slug": "niva-bupa", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", + "source_url": "", + "source_quote": "zation due to accident, under AYUSH (as defined in IRDAI (Health Insurance) Regulations, 2016) systems of medicine shall be covered without any sub- Product Name: Saral Suraksha Bima, Niva Bupa Health", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__saral-suraksha", + "insurer_slug": "niva-bupa", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", + "source_url": "", + "source_quote": "Maternity not explicitly mentioned; presumed excluded in base", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__saral-suraksha", + "insurer_slug": "niva-bupa", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", + "source_url": "", + "source_quote": "Newborn cover not found; typically tied to maternity option", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__saral-suraksha", + "insurer_slug": "niva-bupa", + "field": "organ_donor_expenses", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", + "source_url": "", + "source_quote": "Organ donor cover not extracted", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__saral-suraksha", + "insurer_slug": "niva-bupa", + "field": "no_claim_bonus_pct", + "value": 5, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", + "source_url": "", + "source_quote": "cumulative bonus) shall be increased by 5% in respect of each claim free policy year, provid", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__saral-suraksha", + "insurer_slug": "niva-bupa", + "field": "copayment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", + "source_url": "", + "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__saral-suraksha", + "insurer_slug": "niva-bupa", + "field": "network_hospital_count", + "value": 10400, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_quote": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__saral-suraksha", + "insurer_slug": "niva-bupa", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", + "source_url": "", + "source_quote": "sible and violent means. 2.2. Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured person in accordance with", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__saral-suraksha", + "insurer_slug": "niva-bupa", + "field": "policy_type", + "value": "indemnity", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", + "source_url": "", + "source_quote": "o Accident: The Company shall indemnify medical expenses incurred for hospitalisation arising due to accident during the policy period, up to the limit of 10% of the base sum insured, specified in t", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__senior-first", + "insurer_slug": "niva-bupa", + "field": "uin_code", + "value": "MAXHLIP21575V012021", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_url": "", + "source_quote": "Product Name: Senior First | Product UIN: MAXHLIP21575V012021", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__senior-first", + "insurer_slug": "niva-bupa", + "field": "min_entry_age", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_url": "", + "source_quote": "Senior First (senior-citizens-only product; 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Maternity Expenses (Code-Excl18) excluded; senior-citizens product", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__senior-first", + "insurer_slug": "niva-bupa", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_url": "", + "source_quote": "Maternity excluded; no newborn benefit (senior-citizens product)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__senior-first", + "insurer_slug": "niva-bupa", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_url": "", + "source_quote": "3.5. Organ donor If you ever undergo an organ transplant, we will pay the hospitalization expenses of the donor for harvesting the organ", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__senior-first", + "insurer_slug": "niva-bupa", + "field": "no_claim_bonus_pct", + "value": 10, + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_url": "", + "source_quote": "3.6. No Claim Bonus (NCB) For every claim free year, we will add 10% of expiring policy base sum insured as NCB, maximum up to 100%.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__senior-first", + "insurer_slug": "niva-bupa", + "field": "restoration_benefit", + "value": "ReAssure: unlimited Sum Insured triggered after first paid claim (lifetime trigger)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_url": "", + "source_quote": "3.7. ReAssure The first paid claim triggers ReAssure, a benefit with unlimited sum insured.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__senior-first", + "insurer_slug": "niva-bupa", + "field": "room_rent_capping", + "value": "Per eligible room category in Policy Schedule (additional 10% copay if higher room category opted)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_url": "", + "source_quote": "You will have to bear additional 10% co-payment IF treatment is taken in a higher room category than the eligible room category", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "niva-bupa__senior-first", + "insurer_slug": "niva-bupa", + "field": "deductible_amount", + "value": "Annual Aggregate Deductible (optional benefit)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_url": "", + "source_quote": "4.2. 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"policy_id": "royal-sundaram__family-plus__cis", + "insurer_slug": "royal-sundaram", + "field": "policy_term_options_years", + "value": [ + 1 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_url": "", + "source_quote": "premium_payment_term_years from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__cis", + "insurer_slug": "royal-sundaram", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_url": "", + "source_quote": "limit: Up to 100% of sum insured", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__cis", + "insurer_slug": "royal-sundaram", + "field": "maternity_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": 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+ "source_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_url": "", + "source_quote": "limit: Donor harvesting medical expenses covered", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__cis", + "insurer_slug": "royal-sundaram", + "field": "restoration_benefit", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_url": "", + "source_quote": "limit: Re-load of 100% of Individual Base Sum Insured of any one member once per policy year; Triggers when base SI + NCB + floater SI insufficient; for different illness/injury", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__cis", + "insurer_slug": "royal-sundaram", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": 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"verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__cis", + "insurer_slug": "royal-sundaram", + "field": "geographic_coverage", + "value": "pan_india", + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_url": "", + "source_quote": "geographic_coverage from extracted PDF data: \"pan_india\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__cis", + "insurer_slug": "royal-sundaram", + "field": "policy_type_indemnity_or_fixed", + "value": "family_floater", + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"family_floater\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__cis", + "insurer_slug": "royal-sundaram", + "field": "room_rent_capping", + "value": "As per policy schedule", + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_url": "", + "source_quote": "room_rent_capping (verbatim): \"As per policy schedule\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__cis", + "insurer_slug": "royal-sundaram", + "field": "no_claim_bonus_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_url": "", + "source_quote": "no_claim_bonus_pct from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "uin_code", + "value": "RSAHLIP22200V032122", + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "max_renewal_age", + "value": 999, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "grace_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "free_look_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "maternity_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "post_hospitalization_days", + "value": 90, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "day_care_treatments_count", + "value": 200, + "source_type": "web_url", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_quote": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "network_hospital_count", + "value": 12500, + "source_type": "web_url", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "https://www.royalsundaram.in/", + "source_quote": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "co_payment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "copayment_pct=0 from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "policy_term_options_years", + "value": [ + 1 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "premium_payment_term_years from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "limit: Up to 100% of sum insured", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "maternity_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "limit: Rs. 50,000 per delivery; max 2 deliveries per female member during lifetime of policy; After 24-month waiting period", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "newborn_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "limit: Covered from birth in year of delivery; vaccination cover Rs. 10,000", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "limit: Donor inpatient medical expenses for harvesting", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "restoration_benefit", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "limit: Re-load of 100% of Individual Base SI once per policy year per insured; For unrelated illness/injury once base+NCB+floater exhausted", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": "royal-sundaram", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_url": "", + "source_quote": "limit: Up to sum insured; Continuous treatment ≥ 3 days", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__family-plus__wordings", + "insurer_slug": 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DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "max_renewal_age", + "value": 999, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "min_child_entry_age", + "value": 91, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "sum_insured_options", + "value": [ + 200000, + 300000, + 400000, + 500000, + 750000, + 1000000, + 1500000, + 2000000, + 2500000, + 3000000, + 5000000, + 10000000, + 15000000 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "grace_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "free_look_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "maternity_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "post_hospitalization_days", + "value": 180, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "day_care_treatments_count", + "value": 200, + "source_type": "web_url", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_quote": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "network_hospital_count", + "value": 12500, + "source_type": "web_url", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "https://www.royalsundaram.in/", + "source_quote": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "co_payment_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "copayment_pct=20.0% from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "policy_term_options_years", + "value": [ + 1 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "premium_payment_term_years from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "limit: Up to 100% of Sum Insured; Inpatient treatment under Ayurveda, Yoga, Unani, Siddha, Homeopathy", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "maternity_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "limit: Rs.2-2.5 lakhs per delivery (up to 2 deliveries) under Elite Plan only; 36 months waiting period. Husband and wife both covered under floater.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "newborn_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "limit: Rs.6.25-37.5 lakhs (25% of SI) under Elite Plan only; vaccinations up to Rs.10,000 first year; Contingent on Maternity Benefit being availed.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "limit: Covered up to Sum Insured; Excludes pre/post hospitalization and screening expenses of donor.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "restoration_benefit", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "limit: Re-load of Sum Insured up to Base Sum Insured; Available for different illness OR different insured for same illness. Not available for 1st claim.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "limit: Covered up to Sum Insured (3 days minimum continuous treatment); Pre-hospitalization payable; post-hospitalization not payable.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "worldwide_emergency_cover", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "limit: 50% of Base SI up to Rs.20 lakhs; deductible USD 2,000 per hospitalization; Elite Plan only. Excludes US and Canada (option to include with additional premium).", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "preventive_health_checkup", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "limit: Annual (Supreme/Elite); once in 2 years (Classic); Over and above Base Sum Insured for insured 18+.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "critical_illness_cover", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "limit: International treatment abroad for 11 specified CIs (Elite); Second Opinion for 11 CIs (Supreme/Elite); up to 22 CIs with Supreme Plus/Elite Plus; Airfare up to Rs.3 lakhs. Excludes US/Canada unless opted.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "cashless_treatment_supported from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "no_claim_bonus_cap_pct", + "value": 100, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "no_claim_bonus_cap_pct from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "geographic_coverage", + "value": "worldwide_ex_usa_canada", + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "geographic_coverage from extracted PDF data: \"worldwide_ex_usa_canada\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "policy_type_indemnity_or_fixed", + "value": "family_floater", + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"family_floater\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "room_rent_capping", + "value": "No Room Rent Cap (Premier hospitals)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "room_rent_capping (verbatim): \"No Room Rent Cap (Premier hospitals)\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__brochure", + "insurer_slug": "royal-sundaram", + "field": "no_claim_bonus_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_url": "", + "source_quote": "no_claim_bonus_pct from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__cis", + "insurer_slug": "royal-sundaram", + "field": "uin_code", + "value": "RSAHLIP24146V032324", + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__cis", + "insurer_slug": "royal-sundaram", + "field": "min_entry_age", + "value": 18, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__cis", + "insurer_slug": "royal-sundaram", + "field": "max_renewal_age", + "value": 999, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__cis", + "insurer_slug": "royal-sundaram", + "field": "min_child_entry_age", + "value": 91, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__cis", + "insurer_slug": "royal-sundaram", + "field": "sum_insured_options", + "value": [ + 200000, + 300000, + 400000, + 500000, + 750000, + 1000000, + 1500000, + 2000000, + 2500000, + 3000000, + 5000000, + 10000000, + 15000000 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__lifeline__cis", + "insurer_slug": "royal-sundaram", + "field": "grace_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); 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Zone 2 priced 20% lower than Zone 1.", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__multiplier__brochure", + "insurer_slug": "royal-sundaram", + "field": "policy_term_options_years", + "value": [ + 1 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_url": "", + "source_quote": "premium_payment_term_years from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__multiplier__brochure", + "insurer_slug": "royal-sundaram", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_url": "", + "source_quote": "limit: Up to Sum Insured", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__multiplier__brochure", + "insurer_slug": "royal-sundaram", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_url": "", + "source_quote": "Maternity not covered under Multiplier base plan.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__multiplier__brochure", + "insurer_slug": "royal-sundaram", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_url": "", + "source_quote": "Newborn coverage from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__multiplier__brochure", + "insurer_slug": "royal-sundaram", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_url": "", + "source_quote": "limit: Covered up to Sum Insured", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "royal-sundaram__multiplier__brochure", + "insurer_slug": "royal-sundaram", + "field": "restoration_benefit", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_url": "", + "source_quote": "limit: Flexi Reload up to 100% of Base SI from 2nd claim onwards; available even for same illness same insured; Once per policy year. 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Loyalty Bonus: For the Sum Insured options Rs.3,00,000/- and above, the Insured Person shall be eligible for a Loyalty Bonus of 10% of the expiring Sum Insured subject to a maximum accumulation of 100%", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima", + "insurer_slug": "star-health", + "field": "restoration_benefit", + "value": "Automatic Restoration of Sum Insured: 100% each time, available 3 times per policy year (only for unrelated illnesses)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "15. Automatic Restoration of Sum Insured ... 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see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "post_hospitalization_days", + "value": 90, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "day_care_treatments_count", + "value": 540, + "source_type": "web_url", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_quote": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "network_hospital_count", + "value": 14000, + "source_type": "web_url", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "https://www.starhealth.in/", + "source_quote": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "co_payment_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "copayment_pct=20.0% from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "room_rent_capped_at_pct_of_si", + "value": "single_private_ac_room", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "room_rent_capping: \"Single Private A/C Room\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "policy_term_options_years", + "value": [ + 1 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "premium_payment_term_years from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "limit: In-patient AYUSH treatment up to Sum Insured; Ayurveda, Unani, Siddha, Homeopathy. Yoga/Naturopathy requires prior approval.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "newborn_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "limit: 10% of SI or Rs 50,000 whichever is less; from 16th day to policy expiry; Mother must be continuously insured for 12 months without break.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "limit: 10% of SI or Rs 1 lakh whichever is less; Donor in-patient hospitalization for organ transplant; transplantation claim must be payable.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "restoration_benefit", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "limit: Automatic Restoration 3 times at 100% each (SI >= Rs 3L). Plus Recharge Benefit (once per policy period).; Restored SI usable only for unrelated illness. Recharge benefit usable for same hospitalization. Not for Modern Treatment.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "limit: Treatment exceeding 3 days at home; Excludes asthma, bronchitis, hypertension, diabetes, epilepsy, influenza, psychiatric disorders, arthritis and similar listed conditions.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "preventive_health_checkup", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "limit: Network-arranged check-up; Package A (SI Rs 5-10L) / Package B (SI Rs 15L+)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "cashless_treatment_supported from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "no_claim_bonus_cap_pct", + "value": 100, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "no_claim_bonus_cap_pct from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "tat_cashless_authorization_hours", + "value": 1, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "tat_cashless_authorization_hours from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "geographic_coverage", + "value": "pan_india", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "geographic_coverage from extracted PDF data: \"pan_india\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "policy_type_indemnity_or_fixed", + "value": "family_floater", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"family_floater\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "room_rent_capping", + "value": "Single Private A/C Room", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "room_rent_capping (verbatim): \"Single Private A/C Room\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__family-health-optima__wordings", + "insurer_slug": "star-health", + "field": "no_claim_bonus_pct", + "value": 10, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_url": "", + "source_quote": "no_claim_bonus_pct from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier", + "insurer_slug": "star-health", + "field": "uin_code", + "value": "SHAHLIP22226V012122", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "", + "source_quote": "CY Unique Identification No.: SHAHLIP22226V012122 PREAMBLE Insured granted by the insurer without an associated increase in premium. The proposal, declaration and other documents given by the proposer", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier", + "insurer_slug": "star-health", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "", + "source_quote": "the treatment of any illness within 30 days from the first 16 Outpatient Expenses In addition to Sum Insured policy commencement date shall be excluded except claims arising due to an accident, provid", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier", + "insurer_slug": "star-health", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "", + "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier", + "insurer_slug": "star-health", + "field": "day_care_treatments_count", + "value": 540, + "source_type": "web_url", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_quote": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier", + "insurer_slug": "star-health", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "", + "source_quote": "mpany's authorized personnel. AYUSH Day Care Centre: AYUSH Day Care Centre means and includes Community Day Care Treatment: Day care treatment means medical treatment, and/or surgical Health Centre (C", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier", + "insurer_slug": "star-health", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "", + "source_quote": "Maternity not explicitly mentioned; presumed excluded in base", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier", + "insurer_slug": "star-health", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "", + "source_quote": "Newborn cover not found; typically tied to maternity option", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier", + "insurer_slug": "star-health", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "", + "source_quote": "Organ Donor Expenses: In patient hospitalization expenses incurred for organ date specified in the schedule. transplantation from the Donor to the Recipient Insured Person are payable provided the cla", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier", + "insurer_slug": "star-health", + "field": "restoration_benefit", + "value": "Restoration of Sum Insured: There shall be automatic restoration of the", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "", + "source_quote": "Restoration of Sum Insured: There shall be automatic restoration of the", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier", + "insurer_slug": "star-health", + "field": "room_rent_capping", + "value": "room category occupied by the insured person whilst undergoing treatment in some of the", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "", + "source_quote": "room category occupied by the insured person whilst undergoing treatment in some of the", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier", + "insurer_slug": "star-health", + "field": "copayment_pct", + "value": 20, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "", + "source_quote": "Policy shall be subject to a Copayment of 20% applicable to claim amount admissible and payable as per the terms and 7. Medical Concierge Services: The Insured can a", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier", + "insurer_slug": "star-health", + "field": "network_hospital_count", + "value": 14000, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.starhealth.in/", + "source_quote": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier", + "insurer_slug": "star-health", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "", + "source_quote": "on of less than 10,00,000 and Cashless facility: Cashless facility means a facility extended by the insurer to the insured at least 15 in-patient beds in all other places; where the payments, of the c", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier", + "insurer_slug": "star-health", + "field": "policy_type", + "value": "indemnity", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "", + "source_quote": "bove 20 lakhs 5,00,000/- will indemnify the Insured Person such expenses as are reasonably and necessarily incurred under the heads given below but not exceeding the Limit of Coverage stated in the", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier__brochure", + "insurer_slug": "star-health", + "field": "uin_code", + "value": "SHAHLIP22226V012122", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier__brochure", + "insurer_slug": "star-health", + "field": "min_entry_age", + "value": 50, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier__brochure", + "insurer_slug": "star-health", + "field": "max_renewal_age", + "value": 999, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier__brochure", + "insurer_slug": "star-health", + "field": "min_child_entry_age", + "value": 91, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); 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"source_type": "web_url", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_quote": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier__wordings", + "insurer_slug": "star-health", + "field": "network_hospital_count", + "value": 14000, + "source_type": "web_url", + "source_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_url": "https://www.starhealth.in/", + "source_quote": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__health-premier__wordings", + "insurer_slug": "star-health", + "field": "co_payment_pct", + "value": 20, + 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"last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum", + "insurer_slug": "star-health", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "the treatment of any illness within 30 days from the first reproductive technologies such as IVF, ZIFT, GIFT, ICSI policy commencement date shall be excluded except claims arising due to an accident, ", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum", + "insurer_slug": "star-health", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum", + "insurer_slug": "star-health", + "field": "day_care_treatments_count", + "value": 540, + "source_type": "web_url", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_quote": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum", + "insurer_slug": "star-health", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "and all premium paid thereon AYUSH Day Care Centre: AYUSH Day Care Centre means and includes Community shall be forfeited to the Company in the event of misrepresentation, mis-description or non- Heal", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum", + "insurer_slug": "star-health", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "Maternity not explicitly mentioned; presumed excluded in base", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum", + "insurer_slug": "star-health", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "Newborn cover not found; typically tied to maternity option", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum", + "insurer_slug": "star-health", + "field": "organ_donor_expenses", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "Organ donor cover not extracted", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum", + "insurer_slug": "star-health", + "field": "no_claim_bonus_pct", + "value": 10, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "Cumulative bonus calculated at 10% of basic sum insured for each claim free year sub", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum", + "insurer_slug": "star-health", + "field": "restoration_benefit", + "value": "Restoration of Basic Sum Insured (Applicable for Section 1 Only): 1 RF ablation for lumbar and cervical facet joint 50,000/- 65,000/- 75,000/-", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "Restoration of Basic Sum Insured (Applicable for Section 1 Only): 1 RF ablation for lumbar and cervical facet joint 50,000/- 65,000/- 75,000/-", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum", + "insurer_slug": "star-health", + "field": "room_rent_capping", + "value": "Single Private AC Room Part of the sum insured", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "Single Private AC Room Part of the sum insured", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum", + "insurer_slug": "star-health", + "field": "copayment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum", + "insurer_slug": "star-health", + "field": "network_hospital_count", + "value": 14000, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.starhealth.in/", + "source_quote": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum", + "insurer_slug": "star-health", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "s or injury that is likely to Cashless facility: Cashless facility means a facility extended by the insurer to the insured respond quickly to treatment which aims to return the person to his or her st", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum", + "insurer_slug": "star-health", + "field": "policy_type", + "value": "benefit", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "Specialty cardiac/critical illness — benefit-based lump-sum on diagnosis", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "uin_code", + "value": "SHAHLIP22033V022122", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "min_entry_age", + "value": 18, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "max_entry_age", + "value": 65, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "max_renewal_age", + "value": 999, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "grace_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "free_look_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "pre_hospitalization_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "post_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "day_care_treatments_count", + "value": 540, + "source_type": "web_url", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_quote": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "network_hospital_count", + "value": 14000, + "source_type": "web_url", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "https://www.starhealth.in/", + "source_quote": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "policy_term_options_years", + "value": [ + 1 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "premium_payment_term_years from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "AYUSH in-patient up to SI in AYUSH Hospital.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "critical_illness_cover", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "limit: Cardiac/cardiovascular conditions cover; Disease-specific plan focused on cardiac care. Indemnifies hospitalization, surgery, angioplasty, bypass, and related procedures.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "cashless_treatment_supported from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "tat_cashless_authorization_hours", + "value": 1, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "tat_cashless_authorization_hours from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "geographic_coverage", + "value": "pan_india", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "geographic_coverage from extracted PDF data: \"pan_india\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "policy_type_indemnity_or_fixed", + "value": "disease_specific", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"disease_specific\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "room_rent_capping", + "value": "Per policy schedule; proportionate deduction on associated medical expenses if higher room chosen", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_url": "", + "source_quote": "room_rent_capping (verbatim): \"Per policy schedule; proportionate deduction on associated medical expenses if higher room chosen\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "uin_code", + "value": "SHAHLIP22032V052122", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "CY Unique Identification No.: SHAHLIP22032V052122 PREAMBLE policy that provides that the policyholder/insured will bear a specified percentage of the The proposal and declaration given by the proposer", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "the treatment of any illness within 30 days from the first d. Reversal of sterilization policy commencement date shall be excluded except claims arising due to an accident, provided the same are cover", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "pre_hospitalization_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "tion 3 - Out-Patient Expenses 30 days prior to the date of hospitalization, for the disease/illness, injury sustained Expenses reasonably and necessarily incurred at any Networked Facility in India he", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "post_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "ation expenses incurred up to 60 days after discharge from the The limit of benefit under this Section is Rs.500/- per event subject to a maximum of hospital. The amount payable shall not exceed the s", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "day_care_treatments_count", + "value": 540, + "source_type": "web_url", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_quote": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "e accessible to the insurance AYUSH Day Care Centre: AYUSH Day Care Centre means and includes Community company's authorized personnel. Health Centre (CHC), Primary Health Centre (PHC), Dispensary, Cl", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "maternity_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "Maternity not explicitly mentioned; presumed excluded in base", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "newborn_coverage", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "Newborn cover not found; typically tied to maternity option", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "organ_donor_expenses", + "value": false, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "Organ donor cover not extracted", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "room_rent_capping", + "value": "room category occupied by the insured person whilst undergoing treatment in some of the", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "room category occupied by the insured person whilst undergoing treatment in some of the", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "copayment_pct", + "value": 10, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "3. This policy is subject to Co-payment of 10% of each and every claim amount for fresh the same would be reduced to the extent of prior coverage as well as renewal p", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "network_hospital_count", + "value": 14000, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.starhealth.in/", + "source_quote": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "ical condition leading to the Cashless facility: Cashless facility means a facility extended by the insurer to the insured impairment of normal physiological function and requires medical treatment; w", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care", + "insurer_slug": "star-health", + "field": "policy_type", + "value": "benefit", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "Specialty cardiac/critical illness — benefit-based lump-sum on diagnosis", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "uin_code", + "value": "SHAHLIP22032V022122", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "min_entry_age", + "value": 10, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "max_entry_age", + "value": 65, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "max_renewal_age", + "value": 999, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "sum_insured_options", + "value": [ + 300000, + 400000 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "grace_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "free_look_period", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "pre_existing_disease_waiting_months", + "value": 36, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "pre_hospitalization_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "post_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "day_care_treatments_count", + "value": 540, + "source_type": "web_url", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_quote": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "network_hospital_count", + "value": 14000, + "source_type": "web_url", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "https://www.starhealth.in/", + "source_quote": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "policy_term_options_years", + "value": [ + 1 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "premium_payment_term_years from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "AYUSH coverage from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "critical_illness_cover", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "limit: Cardiac/cardiovascular conditions only; Disease-specific cardiac indemnity plan.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "cashless_treatment_supported from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "tat_cashless_authorization_hours", + "value": 1, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "tat_cashless_authorization_hours from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "geographic_coverage", + "value": "pan_india", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "geographic_coverage from extracted PDF data: \"pan_india\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "policy_type_indemnity_or_fixed", + "value": "disease_specific", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"disease_specific\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-cardiac-care__wordings", + "insurer_slug": "star-health", + "field": "room_rent_capping", + "value": "Per policy schedule", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_url": "", + "source_quote": "room_rent_capping (verbatim): \"Per policy schedule\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "uin_code", + "value": "SHAHLIP26044V092526", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "Star Comprehensive Insurance Policy | UIN : SHAHLIP26044V092526", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "min_entry_age", + "value": 91, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "Newborn baby (defined as upto 90 days); dependent entry standard 91 days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "sum_insured_options", + "value": [ + 500000, + 750000, + 1000000, + 1500000, + 2000000, + 2500000, + 5000000, + 7500000, + 10000000 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "Sum Insured 5,00,000 / 7,50,000 / 10,00,000 to 25,00,000 / 50,00,000 / 75,00,000 / 1,00,00,000 (Delivery and New Born SI grid)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "30-day waiting period for illness (standard IRDAI Excl03 applied)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "pre_existing_disease_waiting_months", + "value": 12, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "Pre-Existing Diseases: Code Excl 01 ... shall be excluded until the expiry of 12 months of continuous coverage after the date of inception of the first policy with insurer", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "2. Specified disease / procedure waiting period - Code Excl 02 ... shall be excluded until the expiry of 24 months of continuous coverage", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "maternity_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "i. Benefit under this Section is subject to a waiting period of 24 months from the date of first commencement of Star Comprehensive Insurance Policy", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "5. Pre-Hospitalization Expenses: Medical expenses incurred for a period not exceeding 60 days prior to the date of hospitalization", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "post_hospitalization_days", + "value": 90, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "6. Post-Hospitalization Expenses: Medical expenses incurred for a period up to 90 days from the date of discharge", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "day_care_treatments_count", + "value": 540, + "source_type": "web_url", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_quote": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "treatments given under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH covered)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "maternity_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "14. Delivery and New Born A. Expenses for a Delivery including Delivery by Caesarean Section (including pre-natal and post-natal expenses) ... subject to a maximum of 2 deliveries in the entire life time of the Insured Person", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "newborn_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "B. Expenses up to the limits mentioned in the table below, incurred in a hospital/nursing home on treatment of the New-born ... including any congenital disorders", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "9. Organ Donor Expenses: In-patient hospitalization expenses incurred for organ transplantation from the Donor to the Recipient Insured Person are payable", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "no_claim_bonus_pct", + "value": 100, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "Where the Sum Insured under the policy is Rs.7,50,000/-or above, the Insured Person would be entitled to the benefit of Cumulative Bonus calculated at 100% of the Basic Sum Insured under this policy following a claim free year. The maximum benefit of cumulative bonus is 100%", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "restoration_benefit", + "value": "Automatic Restoration of Basic Sum Insured by 100%, once per policy period (usable even for same illness)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "13. Automatic Restoration of Sum Insured: There shall be automatic restoration of the Basic Sum Insured by 100% immediately upon exhaustion of the Basic Sum Insured and accrued Cumulative Bonus if any, once during the Policy Period.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "room_rent_capping", + "value": "Per eligible room category in Policy Schedule (proportionate deduction if higher category opted)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "proportion to the room rent limit / room (proportionate deduction clause applies)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "network_hospital_count", + "value": 14000, + 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"Indemnity-based comprehensive individual / family floater plan", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "ambulance_cover", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "Air Ambulance: Subject to an admissible expenses incurred for a period not hospitalization claim, the Insured Person(s) exceeding 60 days prior to the", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive", + "insurer_slug": "star-health", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "Domiciliary Hospitalization: Domiciliary places; 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"source_type": "web_url", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_quote": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive__wordings", + "insurer_slug": "star-health", + "field": "network_hospital_count", + "value": 14000, + "source_type": "web_url", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "https://www.starhealth.in/", + "source_quote": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive__wordings", + "insurer_slug": "star-health", + "field": 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"source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "tat_cashless_authorization_hours from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive__wordings", + "insurer_slug": "star-health", + "field": "geographic_coverage", + "value": "pan_india", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "geographic_coverage from extracted PDF data: \"pan_india\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive__wordings", + "insurer_slug": "star-health", + "field": "policy_type_indemnity_or_fixed", + "value": "family_floater", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "policy_type from extracted PDF data: \"family_floater\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive__wordings", + "insurer_slug": "star-health", + "field": "room_rent_capping", + "value": "Single Private A/C Room or per-day cap per SI tier", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "room_rent_capping (verbatim): \"Single Private A/C Room or per-day cap per SI tier\"", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-comprehensive__wordings", + "insurer_slug": "star-health", + "field": "no_claim_bonus_pct", + "value": 50, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_url": "", + "source_quote": "no_claim_bonus_pct from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-hospital-cash__brochure", + "insurer_slug": "star-health", + "field": "pre_existing_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", + "source_url": "", + "source_quote": "pre-existing diseases. 24 months", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-hospital-cash__brochure", + "insurer_slug": "star-health", + "field": "maternity_coverage", + "value": true, + "source_type": "missing", + "source_path": "", + "source_url": "", + "source_quote": "limit: Child Birth Hospital Cash (Enhanced Plan only); 24-month waiting period from first commencement.", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-hospital-cash__brochure", + "insurer_slug": 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"source_type": "missing", + "source_path": "", + "source_url": "", + "source_quote": "network_hospital_count from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "star-health__star-hospital-cash__brochure", + "insurer_slug": "star-health", + "field": "policy_type", + "value": "hospital_cash", + "source_type": "policy_pdf", + "source_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", + "source_url": "", + "source_quote": "classified as hospital_cash from PDF heuristics", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__criti-medicare__wordings", + "insurer_slug": "tata-aig", + "field": "uin_code", + "value": "TATHLIP22176V012122", + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", + "source_url": "", + "source_quote": "UIN: TATHLIP22176V012122", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__criti-medicare__wordings", + "insurer_slug": "tata-aig", + "field": "pre_existing_disease_waiting_months", + "value": 48, + "source_type": "missing", + "source_path": "", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4; see source PDF for verbatim", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__criti-medicare__wordings", + "insurer_slug": "tata-aig", + "field": "ayush_coverage", + "value": true, + "source_type": "missing", + "source_path": "", + "source_url": "", + "source_quote": "limit: ", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__criti-medicare__wordings", + "insurer_slug": "tata-aig", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", + "source_url": "", + 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dependent child entry standard 91 days", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "max_entry_age", + "value": 65, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "Adult entry per Policy Schedule (Tata AIG MediCare Premier brochure: 18-65 years)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "initial_waiting_period_days", + "value": 30, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "30-day waiting period for illness (standard IRDAI Excl03)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "pre_existing_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "specific_disease_waiting_months", + "value": 24, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "Specified Disease/Procedure Waiting Period (Code-Excl02): Expenses ... shall be excluded until the expiry of 24 months of continuous coverage", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "maternity_waiting_months", + "value": 48, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "B21. Maternity Cover We will cover for Maternity Expenses upto a maximum of Rs. 50,000/- per policy subject to a waiting period of 4 years of continuous coverage", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "pre_hospitalization_days", + "value": 60, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "B2. Pre-Hospitalization expenses We will cover for expenses for Pre-Hospitalization consultations, investigations and medicines incurred upto 60 days before the date of admission", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "post_hospitalization_days", + "value": 90, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "B3. Post-Hospitalization expenses ... incurred upto 90 days after discharge from the hospital.", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "day_care_treatments_count", + "value": 540, + "source_type": "web_url", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "https://www.tataaig.com/health-insurance/medicare", + "source_quote": "Per insurer baseline (Tata AIG product pages state 540+ day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "qualified registered AYUSH Medical Practitioner (AYUSH coverage standard inclusion)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "maternity_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "B21. Maternity Cover We will cover for Maternity Expenses upto a maximum of Rs. 50,000/- per policy ... In case of birth of a girl child, the maximum limit ... would be Rs. 60,000/-", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "newborn_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "B22. New Born Baby Cover We will cover for medical expenses incurred for the medically necessary treatment of the new born baby upto Rs.10,000/- for complications related to delivery", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "organ_donor_expenses", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "Organ Donor Expenses (standard inclusion in Tata AIG MediCare Premier)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "restoration_benefit", + "value": "Restore Benefit: automatic restoration of Basic Sum Insured upon exhaustion, once per policy period", + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "B7. Restore benefits We will automatically restore the Basic Sum Insured upon exhaustion of the Sum Insured and accrued Cumulative Bonus, during the policy period. This benefit can be availed once during the policy period", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "room_rent_capping", + "value": "Per Policy Schedule (Single Private AC Room or higher; voluntary copay for higher category)", + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "Room Rent means the amount charged (per Policy Schedule entitlement)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "copayment_pct", + "value": 0, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "No mandatory base copay (voluntary copay add-on)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "network_hospital_count", + "value": 12000, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.tataaig.com/", + "source_quote": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "cashless_treatment_supported", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "Cashless facility through Network Provider (standard)", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "policy_type", + "value": "indemnity", + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "Indemnity-based comprehensive plan", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "ambulance_cover", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "Ambulance Cover Railway ticket or any other document to We will cover for expenses incurred on show proof of travel transportation of Insured Person i", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier", + "insurer_slug": "tata-aig", + "field": "domiciliary_treatment", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_url": "", + "source_quote": "Domiciliary Hospitalization addition in the Sum Insured granted by the Domiciliary hospitalization means medical insurer", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier__cis", + "insurer_slug": "tata-aig", + "field": "uin_code", + "value": "TATHLIP26052V052526", + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier__cis", + "insurer_slug": "tata-aig", + "field": "min_entry_age", + "value": 18, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier__cis", + "insurer_slug": "tata-aig", + "field": "max_renewal_age", + "value": 999, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare-premier__cis", + "insurer_slug": "tata-aig", + "field": "min_child_entry_age", + "value": 91, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_url": "", + "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); 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see source PDF for verbatim", + "confidence": "unspecified", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare__wordings", + "insurer_slug": "tata-aig", + "field": "day_care_treatments_count", + "value": 540, + "source_type": "web_url", + "source_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_url": "https://www.tataaig.com/health-insurance/medicare", + "source_quote": "Per insurer baseline (Tata AIG product pages state 540+ day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare__wordings", + "insurer_slug": "tata-aig", + "field": "network_hospital_count", + "value": 12000, + "source_type": "web_url", + "source_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_url": "https://www.tataaig.com/", + "source_quote": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare__wordings", + "insurer_slug": "tata-aig", + "field": "policy_term_options_years", + "value": [ + 1 + ], + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_url": "", + "source_quote": "premium_payment_term_years from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare__wordings", + "insurer_slug": "tata-aig", + "field": "ayush_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_url": "", + "source_quote": "limit: In-patient AYUSH treatment up to Sum Insured", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__medicare__wordings", + "insurer_slug": "tata-aig", + "field": "maternity_coverage", + "value": true, + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_url": "", + "source_quote": "limit: Maternity benefit (per Schedule); 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see source PDF for verbatim", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__wellsurance-family__cis", + "insurer_slug": "tata-aig", + "field": "maternity_coverage", + "value": false, + "source_type": "missing", + "source_path": "", + "source_url": "", + "source_quote": "maternity_coverage.covered=false from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__wellsurance-family__cis", + "insurer_slug": "tata-aig", + "field": "ayush_coverage", + "value": false, + "source_type": "missing", + "source_path": "", + "source_url": "", + "source_quote": "ayush_coverage.covered=false from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__wellsurance-family__cis", + "insurer_slug": "tata-aig", + "field": "cashless_treatment_supported", + "value": false, + "source_type": "missing", + "source_path": "", + "source_url": "", + "source_quote": "cashless_treatment_supported from extracted PDF data", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__wellsurance-family__cis", + "insurer_slug": "tata-aig", + "field": "day_care_treatments_count", + "value": 540, + "source_type": "web_url", + "source_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", + "source_url": "https://www.tataaig.com/health-insurance/medicare", + "source_quote": "Per insurer baseline (Tata AIG product pages state 540+ day care procedures)", + "confidence": "medium", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__wellsurance-family__cis", + "insurer_slug": "tata-aig", + "field": "network_hospital_count", + "value": 12000, + "source_type": "web_url", + "source_path": "", + "source_url": "https://www.tataaig.com/", + "source_quote": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "confidence": "high", + "verified": null, + "last_verified": null + }, + { + "policy_id": "tata-aig__wellsurance-family__cis", + "insurer_slug": "tata-aig", + "field": "policy_type", + "value": "hospital_cash", + "source_type": "policy_pdf", + "source_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", + "source_url": "", + "source_quote": "classified as hospital_cash from PDF heuristics", + "confidence": "unspecified", + "verified": null, + "last_verified": null + } + ], + "insurer_reviews": [ + { + "insurer_slug": "acko", + "field": "claim_settlement_ratio_pct", + "value": 96.31, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://joinditto.in/articles/health-insurance/acko-health-insurance-claim-settlement-ratio/", + "company_url": "https://www.acko.com/health-insurance/claim-settlement-ratio/", + "year": "FY 2023-24", + "notes": "Health-specific CSR from Acko public disclosure (Form NL-37). Complaints metric is 'per 10K claims' from IRDAI FY24-25; comparable proxy for per-10K-policies. Acko also led private GI insurers with 99.91% of claims paid within 3 months in 2023-24." + }, + { + "insurer_slug": "acko", + "field": "complaints_per_10k_policies", + "value": 16, + "source_type": "irdai_complaints", + "source_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "secondary_url": "https://joinditto.in/articles/health-insurance/acko-health-insurance-claim-settlement-ratio/", + "company_url": "https://www.acko.com/health-insurance/claim-settlement-ratio/", + "year": "FY 2024-25", + "notes": "Health-specific CSR from Acko public disclosure (Form NL-37). Complaints metric is 'per 10K claims' from IRDAI FY24-25; comparable proxy for per-10K-policies. Acko also led private GI insurers with 99.91% of claims paid within 3 months in 2023-24." + }, + { + "insurer_slug": "acko", + "field": "three_year_avg_csr_pct", + "value": 96.5, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://joinditto.in/articles/health-insurance/acko-health-insurance-claim-settlement-ratio/", + "company_url": "https://www.acko.com/health-insurance/claim-settlement-ratio/", + "year": "FY 2023-24", + "notes": "Health-specific CSR from Acko public disclosure (Form NL-37). Complaints metric is 'per 10K claims' from IRDAI FY24-25; comparable proxy for per-10K-policies. Acko also led private GI insurers with 99.91% of claims paid within 3 months in 2023-24." + }, + { + "insurer_slug": "aditya-birla", + "field": "claim_settlement_ratio_pct", + "value": 92.97, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/aditya-birla-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.angelone.in/news/market-updates/aditya-birla-health-insurance-claims-settlement-ratio-analysis-for-2024-25", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "aditya-birla", + "field": "complaints_per_10k_policies", + "value": 13, + "source_type": "irdai_complaints", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/aditya-birla-health-insurance/claim-settlement-ratio/", + "company_url": 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"company_url": "https://www.bajajgeneralinsurance.com/about-us/financial-information.html", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "bajaj-allianz", + "field": "complaints_per_10k_policies", + "value": 3, + "source_type": "irdai_complaints", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/bajaj-general-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.bajajgeneralinsurance.com/about-us/financial-information.html", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "bajaj-allianz", + "field": "incurred_claim_ratio_pct", + "value": 76.0, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/bajaj-general-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.bajajgeneralinsurance.com/about-us/financial-information.html", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "bajaj-allianz", + "field": "three_year_avg_csr_pct", + "value": 96.78, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/bajaj-general-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.bajajgeneralinsurance.com/about-us/financial-information.html", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "care-health", + "field": "claim_settlement_ratio_pct", + "value": 93.13, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/religare-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.careinsurance.com/health-insurance/health-insurance-claim-settlement-ratio", + "year": "2023-24 (3-year avg)", + "notes": "" + }, + { + "insurer_slug": "care-health", + "field": "complaints_per_10k_policies", + "value": 42, + "source_type": "irdai_complaints", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/religare-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.careinsurance.com/health-insurance/health-insurance-claim-settlement-ratio", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "care-health", + "field": "claims_rejected_fy24", + "value": 76903, + "source_type": "irdai", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/religare-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.careinsurance.com/health-insurance/health-insurance-claim-settlement-ratio", + "year": "2023-24 (3-year avg)", + "notes": "" + }, + { + "insurer_slug": "care-health", + "field": "incurred_claim_ratio_pct", + "value": 57.69, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/religare-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.careinsurance.com/health-insurance/health-insurance-claim-settlement-ratio", + "year": "2023-24 (3-year avg)", + "notes": "" + }, + { + "insurer_slug": "cholamandalam", + "field": "claim_settlement_ratio_pct", + "value": 94.5, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/cholamandalam-ms-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.cholainsurance.com/", + "year": "FY 2023-24", + "notes": "Cholamandalam settled 96.52% of claims in <30 days in FY24. ICR 73.04% per IRDAI 2023-24. CSR 94.5% from PolicyX aggregator (sourced from public disclosure)." + }, + { + "insurer_slug": "cholamandalam", + "field": "complaints_per_10k_policies", + "value": 13, + "source_type": "irdai_complaints", + "source_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "secondary_url": "https://www.policyx.com/health-insurance/cholamandalam-ms-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.cholainsurance.com/", + "year": "FY 2024-25", + "notes": "Cholamandalam settled 96.52% of claims in <30 days in FY24. ICR 73.04% per IRDAI 2023-24. CSR 94.5% from PolicyX aggregator (sourced from public disclosure)." + }, + { + "insurer_slug": "cholamandalam", + "field": "incurred_claim_ratio_pct", + "value": 73.04, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/cholamandalam-ms-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.cholainsurance.com/", + "year": "FY 2023-24", + "notes": "Cholamandalam settled 96.52% of claims in <30 days in FY24. ICR 73.04% per IRDAI 2023-24. CSR 94.5% from PolicyX aggregator (sourced from public disclosure)." + }, + { + "insurer_slug": "go-digit", + "field": "claim_settlement_ratio_pct", + "value": 90.69, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policybazaar.com/insurance-companies/digit-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.godigit.com/digest/reports/transparency-report-10", + "year": "FY 2023-24", + "notes": "Go Digit was the highest payer among private GI insurers with ICR 93.87% (Rs 4.69 of every Rs 5 claimed) in FY 2023-24. CSR 90.69% per IRDAI public disclosure March 2024." + }, + { + "insurer_slug": "go-digit", + "field": "complaints_per_10k_policies", + "value": 19, + "source_type": "irdai_complaints", + "source_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "secondary_url": "https://www.policybazaar.com/insurance-companies/digit-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.godigit.com/digest/reports/transparency-report-10", + "year": "FY 2024-25", + "notes": "Go Digit was the highest payer among private GI insurers with ICR 93.87% (Rs 4.69 of every Rs 5 claimed) in FY 2023-24. CSR 90.69% per IRDAI public disclosure March 2024." + }, + { + "insurer_slug": "go-digit", + "field": "incurred_claim_ratio_pct", + "value": 93.87, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policybazaar.com/insurance-companies/digit-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.godigit.com/digest/reports/transparency-report-10", + "year": "FY 2023-24", + "notes": "Go Digit was the highest payer among private GI insurers with ICR 93.87% (Rs 4.69 of every Rs 5 claimed) in FY 2023-24. CSR 90.69% per IRDAI public disclosure March 2024." + }, + { + "insurer_slug": "hdfc-ergo", + "field": "claim_settlement_ratio_pct", + "value": 99.1, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "http://web.archive.org/web/20260211155805/https://www.policybazaar.com/insurance-companies/hdfc-ergo-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.hdfcergo.com/blogs/health-insurance/hdfc-ergo-claim-settlement-ratio", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "hdfc-ergo", + "field": "complaints_per_10k_policies", + "value": 15, + "source_type": "irdai_complaints", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "http://web.archive.org/web/20260211155805/https://www.policybazaar.com/insurance-companies/hdfc-ergo-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.hdfcergo.com/blogs/health-insurance/hdfc-ergo-claim-settlement-ratio", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "hdfc-ergo", + "field": "incurred_claim_ratio_pct", + "value": 88.0, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "http://web.archive.org/web/20260211155805/https://www.policybazaar.com/insurance-companies/hdfc-ergo-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.hdfcergo.com/blogs/health-insurance/hdfc-ergo-claim-settlement-ratio", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "hdfc-ergo", + "field": "three_year_avg_csr_pct", + "value": 96.71, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "http://web.archive.org/web/20260211155805/https://www.policybazaar.com/insurance-companies/hdfc-ergo-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.hdfcergo.com/blogs/health-insurance/hdfc-ergo-claim-settlement-ratio", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "icici-lombard", + "field": "claim_settlement_ratio_pct", + "value": 85.0, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/icici-lombard-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.icicilombard.com/health-insurance/blogs/icici-lombard-health-insurance-claim-settlement-ratio", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "icici-lombard", + "field": "complaints_per_10k_policies", + "value": 10, + "source_type": "irdai_complaints", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/icici-lombard-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.icicilombard.com/health-insurance/blogs/icici-lombard-health-insurance-claim-settlement-ratio", + "year": "2023-24 (3-year avg ~9-10)", + "notes": "" + }, + { + "insurer_slug": "icici-lombard", + "field": "incurred_claim_ratio_pct", + "value": 78.67, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/icici-lombard-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.icicilombard.com/health-insurance/blogs/icici-lombard-health-insurance-claim-settlement-ratio", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "icici-lombard", + "field": "three_year_avg_csr_pct", + "value": 84.5, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/icici-lombard-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.icicilombard.com/health-insurance/blogs/icici-lombard-health-insurance-claim-settlement-ratio", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "iffco-tokio", + "field": "claim_settlement_ratio_pct", + "value": 96.33, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/iffco-tokio-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.iffcotokio.co.in/content/dam/iffcotokio/iffco-pdf/public-disclosure-march-2024.pdf", + "year": "FY 2023-24", + "notes": "IFFCO Tokio CSR 96.33% per IRDAI 2023-24 (PolicyX). Complaints per 10K claims at 41 places IFFCO Tokio above the 20-per-10K industry benchmark." + }, + { + "insurer_slug": "iffco-tokio", + "field": "complaints_per_10k_policies", + "value": 41, + "source_type": "irdai_complaints", + "source_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "secondary_url": "https://www.policyx.com/health-insurance/iffco-tokio-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.iffcotokio.co.in/content/dam/iffcotokio/iffco-pdf/public-disclosure-march-2024.pdf", + "year": "FY 2024-25", + "notes": "IFFCO Tokio CSR 96.33% per IRDAI 2023-24 (PolicyX). Complaints per 10K claims at 41 places IFFCO Tokio above the 20-per-10K industry benchmark." + }, + { + "insurer_slug": "iffco-tokio", + "field": "incurred_claim_ratio_pct", + "value": 86.33, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/iffco-tokio-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.iffcotokio.co.in/content/dam/iffcotokio/iffco-pdf/public-disclosure-march-2024.pdf", + "year": "FY 2023-24", + "notes": "IFFCO Tokio CSR 96.33% per IRDAI 2023-24 (PolicyX). Complaints per 10K claims at 41 places IFFCO Tokio above the 20-per-10K industry benchmark." + }, + { + "insurer_slug": "indusind-general", + "field": "claim_settlement_ratio_pct", + "value": 86.38, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.beshak.org/insurance/insurance-companies/indus-ind-general-insurance-company-limited/claim-settlement-ratio/", + "company_url": "https://www.indusindinsurance.com/insurance/press-release/news-and-coverage/reliance-general-insurance-has-one-of-the-highest-claim-settlement-ratios-in-the-country.aspx", + "year": "FY 2024-25", + "notes": "IndusInd General Insurance is the rebrand of Reliance General Insurance (rebrand October 2025). Predecessor Reliance General had CSR 98.75% (claims settled in <3 months) in FY 2023-24 and 99.32% in FY 2024-25. Standalone post-rebrand health-only CSR is 86.38% per Beshak/public disclosure FY24-25. Co" + }, + { + "insurer_slug": "manipalcigna", + "field": "claim_settlement_ratio_pct", + "value": 99.0, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/manipalcigna-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.manipalcigna.com/blog/claim-settlement-ratio", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "manipalcigna", + "field": "complaints_per_10k_policies", + "value": 24, + "source_type": "irdai_complaints", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/manipalcigna-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.manipalcigna.com/blog/claim-settlement-ratio", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "manipalcigna", + "field": "incurred_claim_ratio_pct", + "value": 74.81, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/manipalcigna-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.manipalcigna.com/blog/claim-settlement-ratio", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "national-insurance", + "field": "claim_settlement_ratio_pct", + "value": 91.18, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/national-health-insurance/claim-settlement-ratio/", + "company_url": "https://nationalinsurance.nic.co.in/", + "year": "FY 2023-24", + "notes": "National Insurance is a public-sector general insurer. Ranked 4th by absolute complaint volume in FY24 (2,196 complaints per Business Standard). FY24-25 CSR rose to 91.79% per IRDAI 2026 release. Complaints per 10K claims = 29 (above 20-benchmark)." + }, + { + "insurer_slug": "national-insurance", + "field": "complaints_per_10k_policies", + "value": 29, + "source_type": "irdai_complaints", + "source_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "secondary_url": "https://www.policyx.com/health-insurance/national-health-insurance/claim-settlement-ratio/", + "company_url": "https://nationalinsurance.nic.co.in/", + "year": "FY 2024-25", + "notes": "National Insurance is a public-sector general insurer. Ranked 4th by absolute complaint volume in FY24 (2,196 complaints per Business Standard). FY24-25 CSR rose to 91.79% per IRDAI 2026 release. Complaints per 10K claims = 29 (above 20-benchmark)." + }, + { + "insurer_slug": "national-insurance", + "field": "incurred_claim_ratio_pct", + "value": 95.9, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/national-health-insurance/claim-settlement-ratio/", + "company_url": "https://nationalinsurance.nic.co.in/", + "year": "FY 2023-24", + "notes": "National Insurance is a public-sector general insurer. Ranked 4th by absolute complaint volume in FY24 (2,196 complaints per Business Standard). FY24-25 CSR rose to 91.79% per IRDAI 2026 release. Complaints per 10K claims = 29 (above 20-benchmark)." + }, + { + "insurer_slug": "new-india", + "field": "claim_settlement_ratio_pct", + "value": 95.04, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policybazaar.com/insurance-companies/new-india-assurance-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.newindia.co.in/public-disclosure", + "year": "2023-24 (by claim count)", + "notes": "" + }, + { + "insurer_slug": "new-india", + "field": "complaints_per_10k_policies", + "value": 20, + "source_type": "irdai_complaints", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policybazaar.com/insurance-companies/new-india-assurance-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.newindia.co.in/public-disclosure", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "new-india", + "field": "incurred_claim_ratio_pct", + "value": 103.38, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policybazaar.com/insurance-companies/new-india-assurance-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.newindia.co.in/public-disclosure", + "year": "2023-24 (by claim count)", + "notes": "" + }, + { + "insurer_slug": "new-india", + "field": "claim_amount_settlement_pct", + "value": 98.74, + "source_type": "irdai", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policybazaar.com/insurance-companies/new-india-assurance-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.newindia.co.in/public-disclosure", + "year": "2023-24 (by claim count)", + "notes": "" + }, + { + "insurer_slug": "niva-bupa", + "field": "claim_settlement_ratio_pct", + "value": 91.62, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://joinditto.in/articles/health-insurance/niva-bupa-health-insurance-claim-settlement-ratio/", + "company_url": "", + "year": "2023-24 (3-year avg through FY25)", + "notes": "" + }, + { + "insurer_slug": "niva-bupa", + "field": "complaints_per_10k_policies", + "value": 43, + "source_type": "irdai_complaints", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://joinditto.in/articles/health-insurance/niva-bupa-health-insurance-claim-settlement-ratio/", + "company_url": "", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "niva-bupa", + "field": "incurred_claim_ratio_pct", + "value": 59.0, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://joinditto.in/articles/health-insurance/niva-bupa-health-insurance-claim-settlement-ratio/", + "company_url": "", + "year": "2023-24 (3-year avg through FY25)", + "notes": "" + }, + { + "insurer_slug": "oriental-insurance", + "field": "claim_settlement_ratio_pct", + "value": 93.96, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/oriental-health-insurance/claim-settlement-ratio/", + "company_url": "https://orientalinsurance.org.in/", + "year": "FY 2023-24", + "notes": "Oriental Insurance is a public-sector general insurer. CSR 93.96% per IRDAI 2023-24 aggregated by PolicyX. ICR 98.89% (near break-even on premium-vs-claims). FY24-25 CSR per IRDAI 2026 release = 90.17%. Per-10K complaints not separately surfaced in the IRDAI FY24-25 grievance digest." + }, + { + "insurer_slug": "oriental-insurance", + "field": "incurred_claim_ratio_pct", + "value": 98.89, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/oriental-health-insurance/claim-settlement-ratio/", + "company_url": "https://orientalinsurance.org.in/", + "year": "FY 2023-24", + "notes": "Oriental Insurance is a public-sector general insurer. CSR 93.96% per IRDAI 2023-24 aggregated by PolicyX. ICR 98.89% (near break-even on premium-vs-claims). FY24-25 CSR per IRDAI 2026 release = 90.17%. Per-10K complaints not separately surfaced in the IRDAI FY24-25 grievance digest." + }, + { + "insurer_slug": "reliance-general", + "field": "claim_settlement_ratio_pct", + "value": 98.75, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policybazaar.com/insurance-companies/reliance-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.indusindinsurance.com/insurance/press-release/news-and-coverage/reliance-general-insurance-has-one-of-the-highest-claim-settlement-ratios-in-the-country.aspx", + "year": "FY 2023-24", + "notes": "Reliance General Insurance topped private GI insurers with 98.75% claims paid within 3 months in FY 2023-24. Complaints per 10K claims = 5 (well below industry benchmark of 20). Insurer rebranded to IndusInd General Insurance in October 2025." + }, + { + "insurer_slug": "reliance-general", + "field": "complaints_per_10k_policies", + "value": 5, + "source_type": "irdai_complaints", + "source_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "secondary_url": "https://www.policybazaar.com/insurance-companies/reliance-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.indusindinsurance.com/insurance/press-release/news-and-coverage/reliance-general-insurance-has-one-of-the-highest-claim-settlement-ratios-in-the-country.aspx", + "year": "FY 2024-25", + "notes": "Reliance General Insurance topped private GI insurers with 98.75% claims paid within 3 months in FY 2023-24. Complaints per 10K claims = 5 (well below industry benchmark of 20). Insurer rebranded to IndusInd General Insurance in October 2025." + }, + { + "insurer_slug": "reliance-general", + "field": "incurred_claim_ratio_pct", + "value": 81.06, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policybazaar.com/insurance-companies/reliance-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.indusindinsurance.com/insurance/press-release/news-and-coverage/reliance-general-insurance-has-one-of-the-highest-claim-settlement-ratios-in-the-country.aspx", + "year": "FY 2023-24", + "notes": "Reliance General Insurance topped private GI insurers with 98.75% claims paid within 3 months in FY 2023-24. Complaints per 10K claims = 5 (well below industry benchmark of 20). Insurer rebranded to IndusInd General Insurance in October 2025." + }, + { + "insurer_slug": "royal-sundaram", + "field": "claim_settlement_ratio_pct", + "value": 95.95, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/royal-sundaram-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.royalsundaram.in/", + "year": "FY 2023-24", + "notes": "Royal Sundaram CSR 95.95% (industry avg 94.21%). Complaints per 10K claims = 18 (just below 20-benchmark). ICR 77.62% per PolicyX FY24." + }, + { + "insurer_slug": "royal-sundaram", + "field": "complaints_per_10k_policies", + "value": 18, + "source_type": "irdai_complaints", + "source_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "secondary_url": "https://www.policyx.com/health-insurance/royal-sundaram-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.royalsundaram.in/", + "year": "FY 2024-25", + "notes": "Royal Sundaram CSR 95.95% (industry avg 94.21%). Complaints per 10K claims = 18 (just below 20-benchmark). ICR 77.62% per PolicyX FY24." + }, + { + "insurer_slug": "royal-sundaram", + "field": "incurred_claim_ratio_pct", + "value": 77.62, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/royal-sundaram-health-insurance/claim-settlement-ratio/", + "company_url": "https://www.royalsundaram.in/", + "year": "FY 2023-24", + "notes": "Royal Sundaram CSR 95.95% (industry avg 94.21%). Complaints per 10K claims = 18 (just below 20-benchmark). ICR 77.62% per PolicyX FY24." + }, + { + "insurer_slug": "sbi-general", + "field": "claim_settlement_ratio_pct", + "value": 96.14, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://joinditto.in/articles/health-insurance/sbi-health-insurance-claim-settlement-ratio/", + "company_url": "https://www.sbigeneral.in/", + "year": "FY 2022-25 (3-yr avg)", + "notes": "SBI General 3-yr avg CSR (FY22-25) = 96.14% per Ditto (industry avg 91.22%). ICR 82.19% per FY24-25 IRDAI. Complaints per 10K claims = 15 (well below 20-benchmark). PolicyX shows SBI General CSR as 0% in their data-lab listing which is a confirmed PolicyX data error (excluded)." + }, + { + "insurer_slug": "sbi-general", + "field": "complaints_per_10k_policies", + "value": 15, + "source_type": "irdai_complaints", + "source_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "secondary_url": "https://joinditto.in/articles/health-insurance/sbi-health-insurance-claim-settlement-ratio/", + "company_url": "https://www.sbigeneral.in/", + "year": "FY 2024-25", + "notes": "SBI General 3-yr avg CSR (FY22-25) = 96.14% per Ditto (industry avg 91.22%). ICR 82.19% per FY24-25 IRDAI. Complaints per 10K claims = 15 (well below 20-benchmark). PolicyX shows SBI General CSR as 0% in their data-lab listing which is a confirmed PolicyX data error (excluded)." + }, + { + "insurer_slug": "sbi-general", + "field": "incurred_claim_ratio_pct", + "value": 82.19, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://joinditto.in/articles/health-insurance/sbi-health-insurance-claim-settlement-ratio/", + "company_url": "https://www.sbigeneral.in/", + "year": "FY 2022-25 (3-yr avg)", + "notes": "SBI General 3-yr avg CSR (FY22-25) = 96.14% per Ditto (industry avg 91.22%). ICR 82.19% per FY24-25 IRDAI. Complaints per 10K claims = 15 (well below 20-benchmark). PolicyX shows SBI General CSR as 0% in their data-lab listing which is a confirmed PolicyX data error (excluded)." + }, + { + "insurer_slug": "sbi-general", + "field": "three_year_avg_csr_pct", + "value": 96.14, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://joinditto.in/articles/health-insurance/sbi-health-insurance-claim-settlement-ratio/", + "company_url": "https://www.sbigeneral.in/", + "year": "FY 2022-25 (3-yr avg)", + "notes": "SBI General 3-yr avg CSR (FY22-25) = 96.14% per Ditto (industry avg 91.22%). ICR 82.19% per FY24-25 IRDAI. Complaints per 10K claims = 15 (well below 20-benchmark). PolicyX shows SBI General CSR as 0% in their data-lab listing which is a confirmed PolicyX data error (excluded)." + }, + { + "insurer_slug": "star-health", + "field": "claim_settlement_ratio_pct", + "value": 82.31, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.business-standard.com/finance/personal-finance/star-health-care-niva-bupa-record-most-policyholder-complaints-in-fy24-125090100487_1.html", + "company_url": "", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "star-health", + "field": "complaints_per_10k_policies", + "value": 52, + "source_type": "irdai_complaints", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.business-standard.com/finance/personal-finance/star-health-care-niva-bupa-record-most-policyholder-complaints-in-fy24-125090100487_1.html", + "company_url": "", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "star-health", + "field": "total_complaints_fy24", + "value": 13308, + "source_type": "irdai_complaints", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.business-standard.com/finance/personal-finance/star-health-care-niva-bupa-record-most-policyholder-complaints-in-fy24-125090100487_1.html", + "company_url": "", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "star-health", + "field": "claims_rejected_fy24", + "value": 296356, + "source_type": "irdai", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.business-standard.com/finance/personal-finance/star-health-care-niva-bupa-record-most-policyholder-complaints-in-fy24-125090100487_1.html", + "company_url": "", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "star-health", + "field": "incurred_claim_ratio_pct", + "value": 66.47, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.business-standard.com/finance/personal-finance/star-health-care-niva-bupa-record-most-policyholder-complaints-in-fy24-125090100487_1.html", + "company_url": "", + "year": "2023-24", + "notes": "" + }, + { + "insurer_slug": "tata-aig", + "field": "claim_settlement_ratio_pct", + "value": 88.72, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/tata-aig-health-insurance/claim-settlement-ratio/", + "company_url": "", + "year": "2023-24 (3-year avg)", + "notes": "" + }, + { + "insurer_slug": "tata-aig", + "field": "complaints_per_10k_policies", + "value": 11, + "source_type": "irdai_complaints", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/tata-aig-health-insurance/claim-settlement-ratio/", + "company_url": "", + "year": "2023-24 (3-year avg ~10.65)", + "notes": "" + }, + { + "insurer_slug": "tata-aig", + "field": "incurred_claim_ratio_pct", + "value": 76.24, + "source_type": "irdai_annual_report", + "source_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "secondary_url": "https://www.policyx.com/health-insurance/tata-aig-health-insurance/claim-settlement-ratio/", + "company_url": "", + "year": "2023-24 (3-year avg)", + "notes": "" + } + ], + "premiums": [ + { + "policy_id": "hdfc-ergo-optima-secure", + "policy_name": "HDFC ERGO my:Optima Secure", + "field": "annual_premium_inr", + "value": 4800, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "policybazaar_tile", + "source_url": "https://www.policybazaar.com/insurance-companies/hdfc-ergo-health-insurance/optima-secure-plan/", + "source_note": "PolicyBazaar tile: Rs 400/month for 30M/29F Delhi no PED, 5L SI" + }, + { + "policy_id": "hdfc-ergo-optima-secure", + "policy_name": "HDFC ERGO my:Optima Secure", + "field": "annual_premium_inr", + "value": 6492, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "policybazaar_tile", + "source_url": "https://www.policybazaar.com/insurance-companies/hdfc-ergo-health-insurance/optima-secure-plan/", + "source_note": "PolicyBazaar tile: Rs 541/month for 30M/29F Delhi no PED, 10L SI" + }, + { + "policy_id": "hdfc-ergo-optima-secure", + "policy_name": "HDFC ERGO my:Optima Secure", + "field": "annual_premium_inr", + "value": 9089, + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "anchor 30/10L * age_multiplier(36-45)/age_multiplier(26-35) = 6492 * 1.4" + }, + { + "policy_id": "hdfc-ergo-optima-secure", + "policy_name": "HDFC ERGO my:Optima Secure", + "field": "annual_premium_inr", + "value": 22500, + "sample_profile": { + "age": 50, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "anchor 30/10L * age 1.4-2.1 * floater 1.65" + }, + { + "policy_id": "hdfc-ergo-optima-secure", + "policy_name": "HDFC ERGO my:Optima Secure", + "field": "annual_premium_inr", + "value": 35200, + "sample_profile": { + "age": 35, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "anchor 30/5L=4800 * SI 3.1 * floater 2.4" + }, + { + "policy_id": "hdfc-ergo-optima-restore", + "policy_name": "HDFC ERGO Optima Restore", + "field": "annual_premium_inr", + "value": 6800, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "Optima Restore typically ~40% higher than Optima Secure entry for same age/SI per Beshak comparison" + }, + { + "policy_id": "hdfc-ergo-optima-restore", + "policy_name": "HDFC ERGO Optima Restore", + "field": "annual_premium_inr", + "value": 9100, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "hdfc-ergo-optima-restore", + "policy_name": "HDFC ERGO Optima Restore", + "field": "annual_premium_inr", + "value": 21000, + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "hdfc-ergo-optima-plus", + "policy_name": "HDFC ERGO Optima Plus", + "field": "annual_premium_inr", + "value": 7200, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "policybazaar_tile", + "source_url": "https://www.policybazaar.com/insurance-companies/hdfc-ergo-health-insurance/optima-plus-insurance-plan/", + "source_note": "starts ~50% higher than Optima Secure tile in PolicyBazaar listing" + }, + { + "policy_id": "hdfc-ergo-optima-plus", + "policy_name": "HDFC ERGO Optima Plus", + "field": "annual_premium_inr", + "value": 16000, + "sample_profile": { + "age": 35, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "hdfc-ergo-energy", + "policy_name": "HDFC ERGO Energy (Diabetes/Hypertension focused)", + "field": "annual_premium_inr", + "value": 9180, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "hdfc-ergo-energy", + "policy_name": "HDFC ERGO Energy (Diabetes/Hypertension focused)", + "field": "annual_premium_inr", + "value": 21840, + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "hdfc-ergo-energy", + "policy_name": "HDFC ERGO Energy (Diabetes/Hypertension focused)", + "field": "annual_premium_inr", + "value": 54100, + "sample_profile": { + "age": 50, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "care-health-care-supreme", + "policy_name": "Care Health Care Supreme", + "field": "annual_premium_inr", + "value": 4800, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "policybazaar_tile", + "source_url": "https://www.policybazaar.com/insurance-companies/religare-health-insurance/care-supreme/", + "source_note": "PolicyBazaar tile: Rs 400/month for 30M/29F Delhi no PED, 5L SI" + }, + { + "policy_id": "care-health-care-supreme", + "policy_name": "Care Health Care Supreme", + "field": "annual_premium_inr", + "value": 6492, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "policybazaar_tile", + "source_url": "https://www.policybazaar.com/insurance-companies/religare-health-insurance/care-supreme/", + "source_note": "PolicyBazaar tile: Rs 541/month for 30M/29F Delhi no PED, 10L SI" + }, + { + "policy_id": "care-health-care-supreme", + "policy_name": "Care Health Care Supreme", + "field": "annual_premium_inr", + "value": 9089, + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "care-health-care-supreme", + "policy_name": "Care Health Care Supreme", + "field": "annual_premium_inr", + "value": 33800, + "sample_profile": { + "age": 35, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "care-health-care-supreme", + "policy_name": "Care Health Care Supreme", + "field": "annual_premium_inr", + "value": 49500, + "sample_profile": { + "age": 50, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "care-health-care-classic", + "policy_name": "Care Health Care Classic", + "field": "annual_premium_inr", + "value": 5400, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "policybazaar_tile", + "source_url": "https://www.policybazaar.com/insurance-companies/religare-health-insurance/", + "source_note": "Care Classic is base variant of Care; ~12% above Supreme entry per Care brochure" + }, + { + "policy_id": "care-health-care-classic", + "policy_name": "Care Health Care Classic", + "field": "annual_premium_inr", + "value": 7300, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "care-health-care-senior", + "policy_name": "Care Health Care Senior", + "field": "annual_premium_inr", + "value": 22500, + "sample_profile": { + "age": 65, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "policybazaar_tile", + "source_url": "https://www.policybazaar.com/insurance-companies/religare-health-insurance/senior-citizens/", + "source_note": "Care Senior typical 65-year-old 5L entry per PolicyBazaar listing tier" + }, + { + "policy_id": "care-health-care-senior", + "policy_name": "Care Health Care Senior", + "field": "annual_premium_inr", + "value": 32500, + "sample_profile": { + "age": 65, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "care-health-care-senior", + "policy_name": "Care Health Care Senior", + "field": "annual_premium_inr", + "value": 31000, + "sample_profile": { + "age": 70, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "care-health-care-advantage", + "policy_name": "Care Health Care Advantage", + "field": "annual_premium_inr", + "value": 5100, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "insurer_or_other_url", + "source_url": "https://www.careinsurance.com/product/care-supreme", + "source_note": "Advantage variant priced between Classic and Supreme; brochure-indicated entry" + }, + { + "policy_id": "aditya-birla-activ-assure-diamond", + "policy_name": "Aditya Birla Activ Assure Diamond", + "field": "annual_premium_inr", + "value": 8215, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "insurer_or_other_url", + "source_url": "https://www.adityabirlacapital.com/healthinsurance/activ-assure-diamond", + "source_note": "Aditya Birla official site: 'starts from Rs 8,215/yr for self age 30, SI 5L'" + }, + { + "policy_id": "aditya-birla-activ-assure-diamond", + "policy_name": "Aditya Birla Activ Assure Diamond", + "field": "annual_premium_inr", + "value": 11100, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "anchor 5L * SI_multiplier 1.0->1.7 attenuated to 1.35 (typical ABHI 5L->10L delta on rate card)" + }, + { + "policy_id": "aditya-birla-activ-assure-diamond", + "policy_name": "Aditya Birla Activ Assure Diamond", + "field": "annual_premium_inr", + "value": 15500, + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "aditya-birla-activ-assure-diamond", + "policy_name": "Aditya Birla Activ Assure Diamond", + "field": "annual_premium_inr", + "value": 35500, + "sample_profile": { + "age": 50, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "aditya-birla-activ-assure-diamond", + "policy_name": "Aditya Birla Activ Assure Diamond", + "field": "annual_premium_inr", + "value": 41000, + "sample_profile": { + "age": 35, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "aditya-birla-group-activ-health", + "policy_name": "Aditya Birla Group Activ Health", + "field": "annual_premium_inr", + "value": 4928, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "aditya-birla-group-activ-health", + "policy_name": "Aditya Birla Group Activ Health", + "field": "annual_premium_inr", + "value": 11375, + "sample_profile": { + "age": 40, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "aditya-birla-group-activ-health", + "policy_name": "Aditya Birla Group Activ Health", + "field": "annual_premium_inr", + "value": 49680, + "sample_profile": { + "age": 50, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "bajaj-allianz-health-guard", + "policy_name": "Bajaj Allianz Health Guard / Comprehensive Care Plan", + "field": "annual_premium_inr", + "value": 6962, + "sample_profile": { + "age": 30, + "sum_insured_inr": 350000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "insurer_or_other_url", + "source_url": "https://www.bajajfinserv.in/insurance/bajaj-general-health-guard-insurance-plan", + "source_note": "Bajaj Finserv listing: 'Coverage up to Rs 35 lakh starting at Rs 6,962'" + }, + { + "policy_id": "bajaj-allianz-health-guard", + "policy_name": "Bajaj Allianz Health Guard / Comprehensive Care Plan", + "field": "annual_premium_inr", + "value": 8200, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "anchor 3.5L*1.0 -> 5L * ~1.18 SI delta typical Bajaj rate card" + }, + { + "policy_id": "bajaj-allianz-health-guard", + "policy_name": "Bajaj Allianz Health Guard / Comprehensive Care Plan", + "field": "annual_premium_inr", + "value": 11500, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "bajaj-allianz-health-guard", + "policy_name": "Bajaj Allianz Health Guard / Comprehensive Care Plan", + "field": "annual_premium_inr", + "value": 26500, + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "bajaj-allianz-health-guard", + "policy_name": "Bajaj Allianz Health Guard / Comprehensive Care Plan", + "field": "annual_premium_inr", + "value": 39000, + "sample_profile": { + "age": 35, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "bajaj-allianz-silver-health", + "policy_name": "Bajaj Allianz Silver Health (Senior 46-80)", + "field": "annual_premium_inr", + "value": 19800, + "sample_profile": { + "age": 60, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "policybazaar_tile", + "source_url": "https://www.policybazaar.com/insurance-companies/bajaj-allianz-health-insurance/silver-health-plan/", + "source_note": "Silver Health entry age 46-80; PolicyBazaar listing tile starting band for 60-year-old" + }, + { + "policy_id": "bajaj-allianz-silver-health", + "policy_name": "Bajaj Allianz Silver Health (Senior 46-80)", + "field": "annual_premium_inr", + "value": 24500, + "sample_profile": { + "age": 65, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "bajaj-allianz-silver-health", + "policy_name": "Bajaj Allianz Silver Health (Senior 46-80)", + "field": "annual_premium_inr", + "value": 32000, + "sample_profile": { + "age": 70, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "bajaj-allianz-tax-gain", + "policy_name": "Bajaj Allianz Tax Gain", + "field": "annual_premium_inr", + "value": 11500, + "sample_profile": { + "age": 35, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "source_type": "insurer_or_other_url", + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/", + "source_note": "Tax Gain is a family floater 80D-optimized variant; entry premium per Bajaj catalog" + }, + { + "policy_id": "icici-lombard-elevate", + "policy_name": "ICICI Lombard Elevate", + "field": "annual_premium_inr", + "value": 9500, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "insurer_or_other_url", + "source_url": "https://www.icicilombard.com/health-insurance/elevate-health-policy", + "source_note": "ICICI Lombard official: Elevate sample illustration cited for 30M, 10L SI" + }, + { + "policy_id": "icici-lombard-elevate", + "policy_name": "ICICI Lombard Elevate", + "field": "annual_premium_inr", + "value": 7000, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "icici-lombard-elevate", + "policy_name": "ICICI Lombard Elevate", + "field": "annual_premium_inr", + "value": 22500, + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "icici-lombard-elevate", + "policy_name": "ICICI Lombard Elevate", + "field": "annual_premium_inr", + "value": 36500, + "sample_profile": { + "age": 35, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "icici-lombard-health-advantedge", + "policy_name": "ICICI Lombard Health AdvantEdge", + "field": "annual_premium_inr", + "value": 6500, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "policybazaar_tile", + "source_url": "https://www.policybazaar.com/insurance-companies/icici-lombard-health-insurance/", + "source_note": "AdvantEdge entry tile on PolicyBazaar comparison page" + }, + { + "policy_id": "icici-lombard-health-advantedge", + "policy_name": "ICICI Lombard Health AdvantEdge", + "field": "annual_premium_inr", + "value": 8800, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "niva-bupa-reassure", + "policy_name": "Niva Bupa ReAssure 2.0", + "field": "annual_premium_inr", + "value": 21047, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "joinditto_chart", + "source_url": "https://joinditto.in/articles/health-insurance/niva-bupa-reassure-2-0-premium-chart/", + "source_note": "JoinDitto chart: Platinum+ 26-30 / 5L SI Zone 1 = Rs 21,047 incl tax" + }, + { + "policy_id": "niva-bupa-reassure", + "policy_name": "Niva Bupa ReAssure 2.0", + "field": "annual_premium_inr", + "value": 21560, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "joinditto_chart", + "source_url": "https://joinditto.in/articles/health-insurance/niva-bupa-reassure-2-0-premium-chart/", + "source_note": "JoinDitto chart: Titanium+ variant 26-30 / 5L SI = Rs 21,560 incl tax" + }, + { + "policy_id": "niva-bupa-reassure", + "policy_name": "Niva Bupa ReAssure 2.0", + "field": "annual_premium_inr", + "value": 26500, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "niva-bupa-reassure", + "policy_name": "Niva Bupa ReAssure 2.0", + "field": "annual_premium_inr", + "value": 58000, + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "niva-bupa-health-premia", + "policy_name": "Niva Bupa Health Premia", + "field": "annual_premium_inr", + "value": 14000, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 3 + }, + "source_type": "insurer_or_other_url", + "source_url": "https://www.nivabupa.com/health-insurance-plan/health-premia", + "source_note": "Niva Bupa official: Health Premia floater 2 adults + 1 child, 5L SI base = ~Rs 14,000" + }, + { + "policy_id": "niva-bupa-health-premia", + "policy_name": "Niva Bupa Health Premia", + "field": "annual_premium_inr", + "value": 24500, + "sample_profile": { + "age": 35, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "niva-bupa-health-premia", + "policy_name": "Niva Bupa Health Premia", + "field": "annual_premium_inr", + "value": 52000, + "sample_profile": { + "age": 45, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "niva-bupa-aspire", + "policy_name": "Niva Bupa Aspire", + "field": "annual_premium_inr", + "value": 7200, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "insurer_or_other_url", + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/aspire.html", + "source_note": "Aspire Titanium+ entry for 30 single adult per Niva Bupa product page sample" + }, + { + "policy_id": "niva-bupa-aspire", + "policy_name": "Niva Bupa Aspire", + "field": "annual_premium_inr", + "value": 9700, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "niva-bupa-aspire", + "policy_name": "Niva Bupa Aspire", + "field": "annual_premium_inr", + "value": 16500, + "sample_profile": { + "age": 35, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "new-india-asha-kiran", + "policy_name": "New India Assurance Asha Kiran Policy", + "field": "annual_premium_inr", + "value": 3650, + "sample_profile": { + "age": 30, + "sum_insured_inr": 300000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "insurer_or_other_url", + "source_url": "https://www.newindia.co.in/portal/readMore/Pages/Asha-Kiran-Policy", + "source_note": "Asha Kiran is single-girl-child focused; base rate per New India product page" + }, + { + "policy_id": "new-india-asha-kiran", + "policy_name": "New India Assurance Asha Kiran Policy", + "field": "annual_premium_inr", + "value": 6800, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 3 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "new-india-mediclaim", + "policy_name": "New India Mediclaim", + "field": "annual_premium_inr", + "value": 5400, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "insurer_or_other_url", + "source_url": "https://www.newindia.co.in/portal/readMore/Pages/Mediclaim-Policy", + "source_note": "New India Mediclaim - PSU pricing typically ~15-20% below private peers per public rate chart" + }, + { + "policy_id": "new-india-mediclaim", + "policy_name": "New India Mediclaim", + "field": "annual_premium_inr", + "value": 7300, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "new-india-mediclaim", + "policy_name": "New India Mediclaim", + "field": "annual_premium_inr", + "value": 18500, + "sample_profile": { + "age": 50, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "tata-aig-medicare", + "policy_name": "Tata AIG MediCare", + "field": "annual_premium_inr", + "value": 7100, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "official_rate_card", + "source_url": "https://www.axisbank.com/docs/default-source/default-document-library/medicare-rate-chart-06-12-22.pdf", + "source_note": "Tata AIG MediCare base variant rate chart - 19-35 / 5L = Rs 7,108 ex-tax [link-rot 2026-05-16: axisbank /70-docs/ -> /docs/; replacement verified live, identical Tata AIG rate-chart content]" + }, + { + "policy_id": "tata-aig-medicare", + "policy_name": "Tata AIG MediCare", + "field": "annual_premium_inr", + "value": 8800, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "official_rate_card", + "source_url": "https://www.axisbank.com/docs/default-source/default-document-library/medicare-rate-chart-06-12-22.pdf", + "source_note": "[link-rot 2026-05-16: axisbank /70-docs/ -> /docs/; replacement verified live, identical Tata AIG rate-chart content]" + }, + { + "policy_id": "tata-aig-medicare", + "policy_name": "Tata AIG MediCare", + "field": "annual_premium_inr", + "value": 10300, + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "tata-aig-medicare-premier", + "policy_name": "Tata AIG MediCare Premier", + "field": "annual_premium_inr", + "value": 8362, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "official_rate_card", + "source_url": "https://www.axisbank.com/docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", + "source_note": "Official Tata AIG MediCare Premier rate chart: 19-35 age band, 5L SI = Rs 8,362 ex-tax [link-rot 2026-05-16: axisbank /70-docs/ -> /docs/; replacement verified live, identical Tata AIG rate-chart content]" + }, + { + "policy_id": "tata-aig-medicare-premier", + "policy_name": "Tata AIG MediCare Premier", + "field": "annual_premium_inr", + "value": 10319, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "official_rate_card", + "source_url": "https://www.axisbank.com/docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", + "source_note": "Official rate chart: 19-35 / 10L = Rs 10,319 ex-tax [link-rot 2026-05-16: axisbank /70-docs/ -> /docs/; replacement verified live, identical Tata AIG rate-chart content]" + }, + { + "policy_id": "tata-aig-medicare-premier", + "policy_name": "Tata AIG MediCare Premier", + "field": "annual_premium_inr", + "value": 9868, + "sample_profile": { + "age": 40, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "official_rate_card", + "source_url": "https://www.axisbank.com/docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", + "source_note": "Official rate chart: 36-45 / 5L = Rs 9,868 ex-tax [link-rot 2026-05-16: axisbank /70-docs/ -> /docs/; replacement verified live, identical Tata AIG rate-chart content]" + }, + { + "policy_id": "tata-aig-medicare-premier", + "policy_name": "Tata AIG MediCare Premier", + "field": "annual_premium_inr", + "value": 12266, + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "official_rate_card", + "source_url": "https://www.axisbank.com/docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", + "source_note": "Official rate chart: 36-45 / 10L = Rs 12,266 ex-tax [link-rot 2026-05-16: axisbank /70-docs/ -> /docs/; replacement verified live, identical Tata AIG rate-chart content]" + }, + { + "policy_id": "tata-aig-medicare-premier", + "policy_name": "Tata AIG MediCare Premier", + "field": "annual_premium_inr", + "value": 38500, + "sample_profile": { + "age": 35, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "manipalcigna-prohealth-prime-active", + "policy_name": "ManipalCigna ProHealth Prime Active", + "field": "annual_premium_inr", + "value": 6200, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "insurer_or_other_url", + "source_url": "https://www.manipalcigna.com/hospitalization-cover/prohealth-insurance/prohealthprime-active", + "source_note": "ManipalCigna ProHealth Prime Active - product page sample for 30/5L/Zone 1; mandatory 10% co-pay applies" + }, + { + "policy_id": "manipalcigna-prohealth-prime-active", + "policy_name": "ManipalCigna ProHealth Prime Active", + "field": "annual_premium_inr", + "value": 8400, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "manipalcigna-prohealth-prime-active", + "policy_name": "ManipalCigna ProHealth Prime Active", + "field": "annual_premium_inr", + "value": 19500, + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "star-health-family-health-optima", + "policy_name": "Star Family Health Optima", + "field": "annual_premium_inr", + "value": 7968, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 3 + }, + "source_type": "official_rate_card", + "source_url": "https://www.scribd.com/document/667873826/Annexure-2-Premium-Chart-Family-Health-Optima-Insurance-Plan-Revised", + "source_note": "Star Annexure-2 official premium chart: Zone A, 1A+1C floater, age 30-35, 5L SI = Rs 7,968" + }, + { + "policy_id": "star-health-family-health-optima", + "policy_name": "Star Family Health Optima", + "field": "annual_premium_inr", + "value": 10046, + "sample_profile": { + "age": 40, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "source_type": "official_rate_card", + "source_url": "https://www.scribd.com/document/667873826/Annexure-2-Premium-Chart-Family-Health-Optima-Insurance-Plan-Revised", + "source_note": "Star Annexure-2: Zone A, age 36-45 = Rs 10,046" + }, + { + "policy_id": "star-health-family-health-optima", + "policy_name": "Star Family Health Optima", + "field": "annual_premium_inr", + "value": 13669, + "sample_profile": { + "age": 48, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "source_type": "official_rate_card", + "source_url": "https://www.scribd.com/document/667873826/Annexure-2-Premium-Chart-Family-Health-Optima-Insurance-Plan-Revised", + "source_note": "Star Annexure-2: Zone A, age 46-50 = Rs 13,669" + }, + { + "policy_id": "star-health-family-health-optima", + "policy_name": "Star Family Health Optima", + "field": "annual_premium_inr", + "value": 14500, + "sample_profile": { + "age": 35, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "star-health-family-health-optima", + "policy_name": "Star Family Health Optima", + "field": "annual_premium_inr", + "value": 26800, + "sample_profile": { + "age": 35, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "star-health-comprehensive", + "policy_name": "Star Comprehensive Health Insurance", + "field": "annual_premium_inr", + "value": 8500, + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "policybazaar_tile", + "source_url": "https://www.policybazaar.com/insurance-companies/star-health-insurance/star-comprehensive-insurance-policy/", + "source_note": "Star Comprehensive - higher-tier individual variant, PolicyBazaar entry tile" + }, + { + "policy_id": "star-health-comprehensive", + "policy_name": "Star Comprehensive Health Insurance", + "field": "annual_premium_inr", + "value": 11200, + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "star-health-comprehensive", + "policy_name": "Star Comprehensive Health Insurance", + "field": "annual_premium_inr", + "value": 27800, + "sample_profile": { + "age": 45, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "star-health-senior-red-carpet", + "policy_name": "Star Senior Citizens Red Carpet", + "field": "annual_premium_inr", + "value": 6710, + "sample_profile": { + "age": 60, + "sum_insured_inr": 100000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "insurer_or_other_url", + "source_url": "https://www.starhealth.in/health-insurance/health-insurance-for-senior-citizens/", + "source_note": "Star Senior Red Carpet base entry per official site: Rs 6,710 ex-tax for 1L SI (lowest band)" + }, + { + "policy_id": "star-health-senior-red-carpet", + "policy_name": "Star Senior Citizens Red Carpet", + "field": "annual_premium_inr", + "value": 18900, + "sample_profile": { + "age": 60, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "star-health-senior-red-carpet", + "policy_name": "Star Senior Citizens Red Carpet", + "field": "annual_premium_inr", + "value": 24500, + "sample_profile": { + "age": 65, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "star-health-senior-red-carpet", + "policy_name": "Star Senior Citizens Red Carpet", + "field": "annual_premium_inr", + "value": 31200, + "sample_profile": { + "age": 70, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "star-health-senior-red-carpet", + "policy_name": "Star Senior Citizens Red Carpet", + "field": "annual_premium_inr", + "value": 55000, + "sample_profile": { + "age": 75, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "derived_anchor", + "source_url": "derived_from_anchor", + "source_note": "" + }, + { + "policy_id": "royal-sundaram-advanced-top-up", + "policy_name": "Advanced Top Up", + "field": "annual_premium_inr", + "value": 2494, + "sample_profile": { + "age": 35, + "sum_insured_inr": 4500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "insurer_or_other_url", + "source_url": "extracted_from_brochure", + "source_note": "Found in royal-sundaram__advanced-top-up__brochure PDF: premium_range_indicative_inr[\"26-45_SI_45L_deductible_5L_1A\"]=2494" + }, + { + "policy_id": "royal-sundaram-advanced-top-up", + "policy_name": "Advanced Top Up", + "field": "annual_premium_inr", + "value": 5542, + "sample_profile": { + "age": 53, + "sum_insured_inr": 4500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "insurer_or_other_url", + "source_url": "extracted_from_brochure", + "source_note": "Found in royal-sundaram__advanced-top-up__brochure PDF: premium_range_indicative_inr[\"46-60_SI_45L_deductible_5L_1A\"]=5542" + }, + { + "policy_id": "royal-sundaram-advanced-top-up", + "policy_name": "Advanced Top Up", + "field": "annual_premium_inr", + "value": 9976, + "sample_profile": { + "age": 63, + "sum_insured_inr": 4500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "source_type": "insurer_or_other_url", + "source_url": "extracted_from_brochure", + "source_note": "Found in royal-sundaram__advanced-top-up__brochure PDF: premium_range_indicative_inr[\"61-65_SI_45L_deductible_5L_1A\"]=9976" + }, + { + "policy_id": "sbi-general-arogya-supreme", + "policy_name": "Arogya Supreme", + "field": "annual_premium_inr", + "value": 38903, + "sample_profile": { + "age": 35, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "insurer_or_other_url", + "source_url": "https://www.sbigeneral.in", + "source_note": "Found in sbi-general__arogya-supreme__brochure PDF: premium_range_indicative_inr[\"35y_SI_5L_floater\"]=38903" + }, + { + "policy_id": "sbi-general-arogya-supreme", + "policy_name": "Arogya Supreme", + "field": "annual_premium_inr", + "value": 62424, + "sample_profile": { + "age": 35, + "sum_insured_inr": 1500000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "source_type": "insurer_or_other_url", + "source_url": "https://www.sbigeneral.in", + "source_note": "Found in sbi-general__arogya-supreme__brochure PDF: premium_range_indicative_inr[\"35y_SI_15L_floater\"]=62424" + } + ], + "needs_source": { + "policy_facts": [ + { + "policy_id": "star-health__star-cancer-care-platinum__wordings", + "insurer_slug": "star-health", + "field": "network_hospital_count", + "value": 14000, + "reason": "no_source_metadata" + }, + { + "policy_id": "star-health__star-hospital-cash__brochure", + "insurer_slug": "star-health", + "field": "maternity_coverage", + "value": true, + "reason": "no_source_metadata" + }, + { + "policy_id": "star-health__star-hospital-cash__brochure", + "insurer_slug": "star-health", + "field": "network_hospital_count", + "value": 14000, + "reason": "no_source_metadata" + }, + { + "policy_id": "tata-aig__criti-medicare__wordings", + "insurer_slug": "tata-aig", + "field": "pre_existing_disease_waiting_months", + "value": 48, + "reason": "no_source_metadata" + }, + { + "policy_id": "tata-aig__criti-medicare__wordings", + "insurer_slug": "tata-aig", + "field": "ayush_coverage", + "value": true, + "reason": "no_source_metadata" + }, + { + "policy_id": "tata-aig__wellsurance-family__cis", + "insurer_slug": "tata-aig", + "field": "pre_existing_disease_waiting_months", + "value": 48, + "reason": "no_source_metadata" + }, + { + "policy_id": "tata-aig__wellsurance-family__cis", + "insurer_slug": "tata-aig", + "field": "maternity_coverage", + "value": false, + "reason": "no_source_metadata" + }, + { + "policy_id": "tata-aig__wellsurance-family__cis", + "insurer_slug": "tata-aig", + "field": "ayush_coverage", + "value": false, + "reason": "no_source_metadata" + }, + { + "policy_id": "tata-aig__wellsurance-family__cis", + "insurer_slug": "tata-aig", + "field": "cashless_treatment_supported", + "value": false, + "reason": "no_source_metadata" + } + ], + "reviews": [], + "premiums": [ + { + "policy_id": "hdfc-ergo-optima-secure", + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 9089, + "reason": "derived_from_anchor" + }, + { + "policy_id": "hdfc-ergo-optima-secure", + "sample_profile": { + "age": 50, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "value": 22500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "hdfc-ergo-optima-secure", + "sample_profile": { + "age": 35, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "value": 35200, + "reason": "derived_from_anchor" + }, + { + "policy_id": "hdfc-ergo-optima-restore", + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 6800, + "reason": "derived_from_anchor" + }, + { + "policy_id": "hdfc-ergo-optima-restore", + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 9100, + "reason": "derived_from_anchor" + }, + { + "policy_id": "hdfc-ergo-optima-restore", + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "value": 21000, + "reason": "derived_from_anchor" + }, + { + "policy_id": "hdfc-ergo-optima-plus", + "sample_profile": { + "age": 35, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "value": 16000, + "reason": "derived_from_anchor" + }, + { + "policy_id": "hdfc-ergo-energy", + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 9180, + "reason": "derived_from_anchor" + }, + { + "policy_id": "hdfc-ergo-energy", + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 21840, + "reason": "derived_from_anchor" + }, + { + "policy_id": "hdfc-ergo-energy", + "sample_profile": { + "age": 50, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "value": 54100, + "reason": "derived_from_anchor" + }, + { + "policy_id": "care-health-care-supreme", + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 9089, + "reason": "derived_from_anchor" + }, + { + "policy_id": "care-health-care-supreme", + "sample_profile": { + "age": 35, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "value": 33800, + "reason": "derived_from_anchor" + }, + { + "policy_id": "care-health-care-supreme", + "sample_profile": { + "age": 50, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "value": 49500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "care-health-care-classic", + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 7300, + "reason": "derived_from_anchor" + }, + { + "policy_id": "care-health-care-senior", + "sample_profile": { + "age": 65, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 32500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "care-health-care-senior", + "sample_profile": { + "age": 70, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 31000, + "reason": "derived_from_anchor" + }, + { + "policy_id": "aditya-birla-activ-assure-diamond", + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 11100, + "reason": "derived_from_anchor" + }, + { + "policy_id": "aditya-birla-activ-assure-diamond", + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 15500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "aditya-birla-activ-assure-diamond", + "sample_profile": { + "age": 50, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "value": 35500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "aditya-birla-activ-assure-diamond", + "sample_profile": { + "age": 35, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "value": 41000, + "reason": "derived_from_anchor" + }, + { + "policy_id": "aditya-birla-group-activ-health", + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 4928, + "reason": "derived_from_anchor" + }, + { + "policy_id": "aditya-birla-group-activ-health", + "sample_profile": { + "age": 40, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "value": 11375, + "reason": "derived_from_anchor" + }, + { + "policy_id": "aditya-birla-group-activ-health", + "sample_profile": { + "age": 50, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "value": 49680, + "reason": "derived_from_anchor" + }, + { + "policy_id": "bajaj-allianz-health-guard", + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 8200, + "reason": "derived_from_anchor" + }, + { + "policy_id": "bajaj-allianz-health-guard", + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 11500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "bajaj-allianz-health-guard", + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "value": 26500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "bajaj-allianz-health-guard", + "sample_profile": { + "age": 35, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "value": 39000, + "reason": "derived_from_anchor" + }, + { + "policy_id": "bajaj-allianz-silver-health", + "sample_profile": { + "age": 65, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 24500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "bajaj-allianz-silver-health", + "sample_profile": { + "age": 70, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 32000, + "reason": "derived_from_anchor" + }, + { + "policy_id": "icici-lombard-elevate", + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 7000, + "reason": "derived_from_anchor" + }, + { + "policy_id": "icici-lombard-elevate", + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "value": 22500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "icici-lombard-elevate", + "sample_profile": { + "age": 35, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "value": 36500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "icici-lombard-health-advantedge", + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 8800, + "reason": "derived_from_anchor" + }, + { + "policy_id": "niva-bupa-reassure", + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 26500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "niva-bupa-reassure", + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "value": 58000, + "reason": "derived_from_anchor" + }, + { + "policy_id": "niva-bupa-health-premia", + "sample_profile": { + "age": 35, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "value": 24500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "niva-bupa-health-premia", + "sample_profile": { + "age": 45, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "value": 52000, + "reason": "derived_from_anchor" + }, + { + "policy_id": "niva-bupa-aspire", + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 9700, + "reason": "derived_from_anchor" + }, + { + "policy_id": "niva-bupa-aspire", + "sample_profile": { + "age": 35, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "value": 16500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "new-india-asha-kiran", + "sample_profile": { + "age": 30, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 3 + }, + "value": 6800, + "reason": "derived_from_anchor" + }, + { + "policy_id": "new-india-mediclaim", + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 7300, + "reason": "derived_from_anchor" + }, + { + "policy_id": "new-india-mediclaim", + "sample_profile": { + "age": 50, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "value": 18500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "tata-aig-medicare", + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 10300, + "reason": "derived_from_anchor" + }, + { + "policy_id": "tata-aig-medicare-premier", + "sample_profile": { + "age": 35, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "value": 38500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "manipalcigna-prohealth-prime-active", + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 8400, + "reason": "derived_from_anchor" + }, + { + "policy_id": "manipalcigna-prohealth-prime-active", + "sample_profile": { + "age": 40, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "value": 19500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "star-health-family-health-optima", + "sample_profile": { + "age": 35, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "value": 14500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "star-health-family-health-optima", + "sample_profile": { + "age": 35, + "sum_insured_inr": 2500000, + "city_tier": "metro", + "smoker": false, + "family_size": 4 + }, + "value": 26800, + "reason": "derived_from_anchor" + }, + { + "policy_id": "star-health-comprehensive", + "sample_profile": { + "age": 30, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 11200, + "reason": "derived_from_anchor" + }, + { + "policy_id": "star-health-comprehensive", + "sample_profile": { + "age": 45, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 2 + }, + "value": 27800, + "reason": "derived_from_anchor" + }, + { + "policy_id": "star-health-senior-red-carpet", + "sample_profile": { + "age": 60, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 18900, + "reason": "derived_from_anchor" + }, + { + "policy_id": "star-health-senior-red-carpet", + "sample_profile": { + "age": 65, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 24500, + "reason": "derived_from_anchor" + }, + { + "policy_id": "star-health-senior-red-carpet", + "sample_profile": { + "age": 70, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 31200, + "reason": "derived_from_anchor" + }, + { + "policy_id": "star-health-senior-red-carpet", + "sample_profile": { + "age": 75, + "sum_insured_inr": 1000000, + "city_tier": "metro", + "smoker": false, + "family_size": 1 + }, + "value": 55000, + "reason": "derived_from_anchor" + } + ] + } +} diff --git a/40-data/information_source_map.md b/40-data/information_source_map.md index 2bb124eb2aa4f60e4d5ad4fc8f721f1a9d71a266..a6c29eb9fe5664560f8675d381c58650fc0d22b9 100644 --- a/40-data/information_source_map.md +++ b/40-data/information_source_map.md @@ -1,647 +1,154 @@ -# Insurance Sales Bot — Information Source Map - -Generated: 2026-05-15 (KI-125–KI-150 sync; slug renames applied) -Total claims audited: **2772** - -## Verdict Summary - -| Category | ✅ verified | ⚠️ url-ok-quote-missing | ❌ url-broken | ⏳ no-claim / no-source | -|---|---:|---:|---:|---:| -| policy_facts | 798 | 321 | 0 | 1385 | -| premiums | 0 | 47 | 9 | 0 | -| reviews | 0 | 203 | 3 | 6 | -| **TOTAL** | **798** | **571** | **12** | **1391** | - -## Must Fix — 12 broken source(s) - -| Record | Field | Value | Source | Notes | -|---|---|---|---|---| -| `care-health` | `reddit.sample_post_urls[2]` | https://www.quora.com/What-are-peoples-opinions-on-Care-Indi | `https://www.quora.com/What-are-peoples-opinions-on-Care-Indias-health-insurance` | HEAD returned status=403 | -| `star-health` | `reddit.sample_post_urls[0]` | https://www.quora.com/Is-Star-Health-Insurance-good-Has-anyb | `https://www.quora.com/Is-Star-Health-Insurance-good-Has-anybody-experienced-problems-in-claim-settlement` | HEAD returned status=403 | -| `star-health` | `reddit.sample_post_urls[3]` | https://www.quora.com/Is-Star-Health-Insurance-a-good-compan | `https://www.quora.com/Is-Star-Health-Insurance-a-good-company` | HEAD returned status=403 | -| `premiums_meta` | `sources_consulted[2]` | https://www.policybazaar.com/insurance-companies/aditya-birl | `https://www.policybazaar.com/insurance-companies/aditya-birla-health-insurance/activ-assure-diamond-plan/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[3]` | https://www.policybazaar.com/insurance-companies/bajaj-allia | `https://www.policybazaar.com/insurance-companies/bajaj-allianz-health-insurance/individual-health-guard-plan/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[4]` | https://www.policybazaar.com/insurance-companies/star-health | `https://www.policybazaar.com/insurance-companies/star-health-insurance/family-health-optima-insurance-plan/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[5]` | https://www.policybazaar.com/insurance-companies/star-health | `https://www.policybazaar.com/insurance-companies/star-health-insurance/senior-citizens-red-carpet-health-insurance-policy/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[6]` | https://www.policybazaar.com/insurance-companies/icici-lomba | `https://www.policybazaar.com/insurance-companies/icici-lombard-health-insurance/elevate-plan/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[7]` | https://www.policybazaar.com/insurance-companies/tata-aig-he | `https://www.policybazaar.com/insurance-companies/tata-aig-health-insurance/medicare-premier/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[8]` | https://www.policybazaar.com/insurance-companies/manipalcign | `https://www.policybazaar.com/insurance-companies/manipalcigna-health-insurance/prohealth-prime/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[9]` | https://www.policybazaar.com/insurance-companies/max-bupa-he | `https://www.policybazaar.com/insurance-companies/max-bupa-health-insurance/premium-calculator/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[23]` | https://www.policybazaar.com/health-insurance/smokers/ | `https://www.policybazaar.com/health-insurance/smokers/` | HEAD returned status=503 | - -## policy_facts - -Audited 2504 claims — ✅ 798 verified, ⚠️ 321 quote-missing, ❌ 0 broken. - -### Flagged claims - -| Record | Field | Verdict | Source | Notes | -|---|---|---|---|---| -| `aditya-birla__activ-assure-diamond` | `min_entry_age` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-assure-diamond` | `max_entry_age` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-assure-diamond` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-assure-diamond` | `post_hospitalization_days` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-assure-diamond` | `organ_donor_expenses` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-assure-diamond` | `restoration_benefit` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-assure-diamond` | `cashless_treatment_supported` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-assure-diamond` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-health-individual__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-health-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-health` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-health-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-health` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-health-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-health` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-health-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-one` | `max_entry_age` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-health-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-one` | `newborn_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-health-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-one` | `organ_donor_expenses` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-health-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-one` | `restoration_benefit` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-health-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-one` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-health-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-one` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-health-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-secure-cancer-secure__brochure` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__activ-secure-personal-accident-cancer-secure__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `aditya-birla__group-activ-health__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/aditya-birla/group-activ-health__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__comprehensive-care-plan` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__comprehensive-care-plan` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__criti-care__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/criti-care__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__extra-care-plus` | `ayush_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__extra-care-plus` | `maternity_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__extra-care-plus` | `organ_donor_expenses` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__extra-care-plus` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__extra-care-plus` | `cashless_treatment_supported` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__extra-care-plus` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__global-health-care` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/global-health-care__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__global-health-care` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/global-health-care__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__group-health-guard-silver__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__group-personal-accident__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__health-guard-gold-individual__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__health-guard-gold` | `max_entry_age` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__health-guard-gold` | `initial_waiting_period_days` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__health-guard-gold` | `maternity_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__health-guard-gold` | `organ_donor_expenses` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__health-guard-gold` | `no_claim_bonus_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__health-guard-gold` | `room_rent_capping` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__health-guard-gold` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__health-guard-gold` | `cashless_treatment_supported` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__health-guard-gold` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__health-guard` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/health-guard__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__silver-health` | `initial_waiting_period_days` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/silver-health__cis.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__silver-health` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/silver-health__cis.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__silver-health` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/silver-health__cis.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__tax-gain` | `initial_waiting_period_days` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/tax-gain__cis.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__tax-gain` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/tax-gain__cis.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__tax-gain` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/tax-gain__cis.pdf` | PDF exists but source_quote not found in extracted text | -| `bajaj-allianz__tax-gain` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/bajaj-allianz/tax-gain__cis.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-advantage-add-ons-protect-plus-care-shield__brochure` | `no_claim_bonus_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-advantage-add-ons-protect-plus-care-shield__brochure` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-advantage` | `initial_waiting_period_days` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-advantage__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-advantage` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-advantage__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-classic` | `min_entry_age` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-classic__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-classic` | `initial_waiting_period_days` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-classic__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-classic` | `pre_existing_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-classic__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-classic` | `maternity_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-classic__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-classic` | `maternity_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-classic__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-classic` | `newborn_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-classic__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-classic` | `organ_donor_expenses` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-classic__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-classic` | `no_claim_bonus_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-classic__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-classic` | `room_rent_capping` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-classic__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-classic` | `cashless_treatment_supported` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-classic__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-classic` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-classic__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-heart__brochure` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-heart__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-senior` | `pre_hospitalization_days` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-senior__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-senior` | `post_hospitalization_days` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-senior__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-senior` | `maternity_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-senior__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-senior` | `newborn_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-senior__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-senior` | `no_claim_bonus_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-senior__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-senior` | `restoration_benefit` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-senior__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-senior` | `cashless_treatment_supported` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-senior__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-supreme-enhance` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-supreme-enhance__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-supreme-enhance` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-supreme-enhance__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-supreme-enhance` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-supreme-enhance__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-supreme` | `min_entry_age` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-supreme__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-supreme` | `pre_existing_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-supreme__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-supreme` | `maternity_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-supreme__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-supreme` | `newborn_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-supreme__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-supreme` | `organ_donor_expenses` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-supreme__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-supreme` | `no_claim_bonus_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-supreme__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-supreme` | `cashless_treatment_supported` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-supreme__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__care-supreme` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/care-supreme__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__supreme-enhance__brochure` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/supreme-enhance__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__ultimate-care` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/ultimate-care__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__ultimate-care` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/ultimate-care__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `care-health__ultimate-care` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/care-health/ultimate-care__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__energy-diabetes-hypertension__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__energy` | `initial_waiting_period_days` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__energy` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__energy` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__group-health-insurance__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-health-medisure-prime` | `initial_waiting_period_days` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-health-medisure-prime` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-health-medisure-prime` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-health-sampoorna-suraksha` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-health-sampoorna-suraksha` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-health-sampoorna-suraksha` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-health-suraksha` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-health-suraksha` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-health-suraksha` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-health-women-suraksha` | `initial_waiting_period_days` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-health-women-suraksha` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-health-women-suraksha` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-health-women-suraksha` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-optima-secure-older-variant__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__my-optima-secure__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-enhance` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-enhance` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-enhance` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-plus` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/optima-plus__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-plus` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/optima-plus__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-restore` | `sum_insured_options` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/optima-restore__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-restore` | `newborn_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/optima-restore__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-restore` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/optima-restore__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-restore` | `network_hospital_count` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/optima-restore__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-restore` | `cashless_treatment_supported` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/optima-restore__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-secure-older-variant` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-secure-older-variant` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-secure-older-variant` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-secure` | `ayush_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-secure` | `maternity_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-secure` | `newborn_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__optima-secure` | `room_rent_capping` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/optima-restore__brochure.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__total-health-plan` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__total-health-plan` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `hdfc-ergo__total-health-plan` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__arogya-sanjeevani` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__complete-health-insurance-health-shield__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__complete-health-insurance-umbrella__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__complete-health-insurance` | `min_entry_age` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__complete-health-insurance` | `pre_hospitalization_days` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__complete-health-insurance` | `maternity_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__complete-health-insurance` | `newborn_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__complete-health-insurance` | `organ_donor_expenses` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__complete-health-insurance` | `no_claim_bonus_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__complete-health-insurance` | `restoration_benefit` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__complete-health-insurance` | `room_rent_capping` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__complete-health-insurance` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__complete-health-insurance` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__complete-health-umbrella` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__elevate` | `min_entry_age` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/elevate__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__elevate` | `maternity_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/elevate__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__elevate` | `newborn_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/elevate__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__elevate` | `no_claim_bonus_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/elevate__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__elevate` | `restoration_benefit` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/elevate__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__elevate` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/elevate__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__elevate` | `cashless_treatment_supported` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/elevate__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__elevate` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/elevate__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-advantedge` | `initial_waiting_period_days` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-advantedge__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-advantedge` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-advantedge__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-advantedge` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-advantedge__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-advantedge` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-advantedge__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-booster-top-up__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-booster` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-booster` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-booster` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-elite-plus` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-elite-plus__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-elite-plus` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-elite-plus__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-elite-plus` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-elite-plus__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-shield-360-retail__cis` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-shield-360-retail__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-shield-360` | `min_entry_age` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-shield-360` | `initial_waiting_period_days` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-shield-360` | `pre_existing_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-shield-360` | `maternity_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-shield-360` | `newborn_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-shield-360` | `organ_donor_expenses` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-shield-360` | `restoration_benefit` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-shield-360` | `room_rent_capping` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-shield-360` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-shield-360` | `cashless_treatment_supported` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `icici-lombard__health-shield-360` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-insurance-all-variants__wordings` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-prime` | `min_entry_age` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-prime` | `initial_waiting_period_days` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-prime` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-prime` | `maternity_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-prime` | `maternity_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-prime` | `newborn_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-prime` | `restoration_benefit` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-prime` | `room_rent_capping` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-prime` | `cashless_treatment_supported` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-protect` | `min_entry_age` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-protect` | `initial_waiting_period_days` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-protect` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-protect` | `newborn_coverage` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-protect` | `restoration_benefit` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-protect` | `room_rent_capping` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-protect` | `cashless_treatment_supported` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-protect` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-select` | `initial_waiting_period_days` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-select__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-select` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-select__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__prohealth-select` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/prohealth-select__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__sarvah-param` | `specific_disease_waiting_months` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/sarvah-param__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `manipalcigna__sarvah-param` | `copayment_pct` | ⚠️ url-ok-quote-missing | `rag/corpus/manipalcigna/sarvah-param__wordings.pdf` | PDF exists but source_quote not found in extracted text | -| `new-india__asha-kiran-policy__brochure` | `policy_type` | ⚠️ url-ok-quote-missing | `rag/corpus/new-india/asha-kiran-policy__brochure.pdf` | PDF exists but source_quote not found in extracted text | - -_... and 121 more rows truncated; see eval/info_source_map.json for full data._ - -## premiums - -Audited 56 claims — ✅ 0 verified, ⚠️ 47 quote-missing, ❌ 9 broken. - -### Flagged claims - -| Record | Field | Verdict | Source | Notes | -|---|---|---|---|---| -| `premiums_meta` | `sources_consulted[0]` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/hdfc-ergo-health-insurance/optima-secure-plan/` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[1]` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/religare-health-insurance/care-supreme/` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[2]` | ❌ url-broken | `https://www.policybazaar.com/insurance-companies/aditya-birla-health-insurance/activ-assure-diamond-plan/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[3]` | ❌ url-broken | `https://www.policybazaar.com/insurance-companies/bajaj-allianz-health-insurance/individual-health-guard-plan/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[4]` | ❌ url-broken | `https://www.policybazaar.com/insurance-companies/star-health-insurance/family-health-optima-insurance-plan/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[5]` | ❌ url-broken | `https://www.policybazaar.com/insurance-companies/star-health-insurance/senior-citizens-red-carpet-health-insurance-policy/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[6]` | ❌ url-broken | `https://www.policybazaar.com/insurance-companies/icici-lombard-health-insurance/elevate-plan/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[7]` | ❌ url-broken | `https://www.policybazaar.com/insurance-companies/tata-aig-health-insurance/medicare-premier/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[8]` | ❌ url-broken | `https://www.policybazaar.com/insurance-companies/manipalcigna-health-insurance/prohealth-prime/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[9]` | ❌ url-broken | `https://www.policybazaar.com/insurance-companies/max-bupa-health-insurance/premium-calculator/` | HEAD returned status=503 | -| `premiums_meta` | `sources_consulted[10]` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/hdfc-ergo-optima-secure-premium-chart/` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[11]` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/niva-bupa-reassure-2-0-premium-chart/` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[12]` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/care-supreme-health-insurance-premium-chart/` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[13]` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/tata-aig-health-insurance-premium-rate-chart/` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[14]` | ⚠️ url-ok-quote-missing | `https://www.axisbank.com/70-docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[15]` | ⚠️ url-ok-quote-missing | `https://transactions.nivabupa.com/pages/doc/premium_chart/Health%20Premia%20-%20Rate%20Card.pdf` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[16]` | ⚠️ url-ok-quote-missing | `https://www.scribd.com/document/667873826/Annexure-2-Premium-Chart-Family-Health-Optima-Insurance-Plan-Revised` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[17]` | ⚠️ url-ok-quote-missing | `https://www.scribd.com/document/682628786/ReAssure-2-0-Rate-Card-with-Tax` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[18]` | ⚠️ url-ok-quote-missing | `https://www.adityabirlacapital.com/healthinsurance/activ-assure-diamond` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[19]` | ⚠️ url-ok-quote-missing | `https://www.beshak.org/insurance/health-insurance/best-health-insurance-plans/hdfc-ergo-optima-secure/` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[20]` | ⚠️ url-ok-quote-missing | `https://www.beshak.org/insurance/health-insurance/best-health-insurance-plans/care-insurance-care-supreme/` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[21]` | ⚠️ url-ok-quote-missing | `https://www.beshak.org/insurance/health-insurance/best-health-insurance-plans/bajaj-allianz-health-guard-gold/` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[22]` | ⚠️ url-ok-quote-missing | `https://www.acko.com/health-insurance/for-smokers/` | URL reachable but no source_quote provided | -| `premiums_meta` | `sources_consulted[23]` | ❌ url-broken | `https://www.policybazaar.com/health-insurance/smokers/` | HEAD returned status=503 | -| `hdfc-ergo__optima-secure` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/hdfc-ergo-health-insurance/optima-secure-plan/` | URL reachable but no source_quote provided | -| `hdfc-ergo__optima-secure` | `samples[1].age=30_si=1000000` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/hdfc-ergo-health-insurance/optima-secure-plan/` | URL reachable but no source_quote provided | -| `hdfc-ergo__optima-plus` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/hdfc-ergo-health-insurance/optima-plus-insurance-plan/` | URL reachable but no source_quote provided | -| `care-health__care-supreme` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/religare-health-insurance/care-supreme/` | URL reachable but no source_quote provided | -| `care-health__care-supreme` | `samples[1].age=30_si=1000000` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/religare-health-insurance/care-supreme/` | URL reachable but no source_quote provided | -| `care-health__care-classic` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/religare-health-insurance/` | URL reachable but no source_quote provided | -| `care-health__care-senior` | `samples[0].age=65_si=500000` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/religare-health-insurance/senior-citizens/` | URL reachable but no source_quote provided | -| `care-health__care-advantage` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.careinsurance.com/product/care-supreme` | URL reachable but no source_quote provided | -| `aditya-birla__activ-assure-diamond` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.adityabirlacapital.com/healthinsurance/activ-assure-diamond` | URL reachable but no source_quote provided | -| `bajaj-allianz__health-guard` | `samples[0].age=30_si=350000` | ⚠️ url-ok-quote-missing | `https://www.bajajfinserv.in/insurance/bajaj-general-health-guard-insurance-plan` | URL reachable but no source_quote provided | -| `bajaj-allianz__silver-health` | `samples[0].age=60_si=500000` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/bajaj-allianz-health-insurance/silver-health-plan/` | URL reachable but no source_quote provided | -| `bajaj-allianz__tax-gain` | `samples[0].age=35_si=500000` | ⚠️ url-ok-quote-missing | `https://www.bajajgeneralinsurance.com/health-insurance-plans/` | URL reachable but no source_quote provided | -| `icici-lombard__elevate` | `samples[0].age=30_si=1000000` | ⚠️ url-ok-quote-missing | `https://www.icicilombard.com/health-insurance/elevate-health-policy` | URL reachable but no source_quote provided | -| `icici-lombard__health-advantedge` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/icici-lombard-health-insurance/` | URL reachable but no source_quote provided | -| `niva-bupa__reassure` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/niva-bupa-reassure-2-0-premium-chart/` | URL reachable but no source_quote provided | -| `niva-bupa__reassure` | `samples[1].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/niva-bupa-reassure-2-0-premium-chart/` | URL reachable but no source_quote provided | -| `niva-bupa__health-premia` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.nivabupa.com/health-insurance-plan/health-premia` | URL reachable but no source_quote provided | -| `niva-bupa__aspire` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.nivabupa.com/family-health-insurance-plans/aspire.html` | URL reachable but no source_quote provided | -| `new-india__asha-kiran` | `samples[0].age=30_si=300000` | ⚠️ url-ok-quote-missing | `https://www.newindia.co.in/portal/readMore/Pages/Asha-Kiran-Policy` | URL reachable but no source_quote provided | -| `new-india__mediclaim` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.newindia.co.in/portal/readMore/Pages/Mediclaim-Policy` | URL reachable but no source_quote provided | -| `tata-aig__medicare` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.axisbank.com/70-docs/default-source/default-document-library/medicare-rate-chart-06-12-22.pdf` | URL reachable but no source_quote provided | -| `tata-aig__medicare` | `samples[1].age=30_si=1000000` | ⚠️ url-ok-quote-missing | `https://www.axisbank.com/70-docs/default-source/default-document-library/medicare-rate-chart-06-12-22.pdf` | URL reachable but no source_quote provided | -| `tata-aig__medicare-premier` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.axisbank.com/70-docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf` | URL reachable but no source_quote provided | -| `tata-aig__medicare-premier` | `samples[1].age=30_si=1000000` | ⚠️ url-ok-quote-missing | `https://www.axisbank.com/70-docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf` | URL reachable but no source_quote provided | -| `tata-aig__medicare-premier` | `samples[2].age=40_si=500000` | ⚠️ url-ok-quote-missing | `https://www.axisbank.com/70-docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf` | URL reachable but no source_quote provided | -| `tata-aig__medicare-premier` | `samples[3].age=40_si=1000000` | ⚠️ url-ok-quote-missing | `https://www.axisbank.com/70-docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf` | URL reachable but no source_quote provided | -| `manipalcigna__prohealth-prime-active` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.manipalcigna.com/hospitalization-cover/prohealth-insurance/prohealthprime-active` | URL reachable but no source_quote provided | -| `star-health__family-health-optima` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.scribd.com/document/667873826/Annexure-2-Premium-Chart-Family-Health-Optima-Insurance-Plan-Revised` | URL reachable but no source_quote provided | -| `star-health__family-health-optima` | `samples[1].age=40_si=500000` | ⚠️ url-ok-quote-missing | `https://www.scribd.com/document/667873826/Annexure-2-Premium-Chart-Family-Health-Optima-Insurance-Plan-Revised` | URL reachable but no source_quote provided | -| `star-health__family-health-optima` | `samples[2].age=48_si=500000` | ⚠️ url-ok-quote-missing | `https://www.scribd.com/document/667873826/Annexure-2-Premium-Chart-Family-Health-Optima-Insurance-Plan-Revised` | URL reachable but no source_quote provided | -| `star-health__comprehensive` | `samples[0].age=30_si=500000` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/star-health-insurance/star-comprehensive-insurance-policy/` | URL reachable but no source_quote provided | -| `star-health__senior-citizens-red-carpet` | `samples[0].age=60_si=100000` | ⚠️ url-ok-quote-missing | `https://www.starhealth.in/health-insurance/health-insurance-for-senior-citizens/` | URL reachable but no source_quote provided | - -## reviews - -Audited 212 claims — ✅ 0 verified, ⚠️ 203 quote-missing, ❌ 3 broken. - -### Flagged claims - -| Record | Field | Verdict | Source | Notes | -|---|---|---|---|---| -| `aditya-birla` | `claim_metrics.source_irdai_url` | ⚠️ url-ok-quote-missing | `https://irdai.gov.in/document-detail?documentId=6436847` | URL reachable but quote not found in fetched body | -| `aditya-birla` | `claim_metrics.source_secondary_url` | ⚠️ url-ok-quote-missing | `https://www.policyx.com/health-insurance/aditya-birla-health-insurance/claim-settlement-ratio/` | URL reachable but quote not found in fetched body | -| `aditya-birla` | `claim_metrics.source_company_url` | ⚠️ url-ok-quote-missing | `https://www.angelone.in/news/market-updates/aditya-birla-health-insurance-claims-settlement-ratio-analysis-for-2024-25` | URL reachable but quote not found in fetched body | -| `aditya-birla` | `aggregator_ratings.policybazaar` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/aditya-birla-health-insurance/claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `aditya-birla` | `aggregator_ratings.insuredekho` | ⚠️ url-ok-quote-missing | `https://www.insurancedekho.com/health-insurance/aditya-birla/claim-settlement` | URL reachable but no source_quote provided | -| `aditya-birla` | `aggregator_ratings.joinditto` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/aditya-birla-health-insurance-claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `aditya-birla` | `reddit.sample_post_urls[0]` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/health-insurance/companies/aditya-birla-vs-tata-aig/` | URL reachable but no source_quote provided | -| `aditya-birla` | `reddit.sample_post_urls[1]` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/health-insurance/comparison/aditya-birla-activ-one-vs-tata-aig-medicare/` | URL reachable but no source_quote provided | -| `aditya-birla` | `reddit.sample_post_urls[2]` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/is-aditya-birla-health-insurance-good/` | URL reachable but no source_quote provided | -| `aditya-birla` | `reddit.sample_post_urls[3]` | ⚠️ url-ok-quote-missing | `https://www.indiainvestments.wiki/start-here/insurance-policies/health` | URL reachable but no source_quote provided | -| `aditya-birla` | `youtube[0].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=d5CIAwrpEdQ` | URL reachable but no source_quote provided | -| `aditya-birla` | `youtube[1].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=Wb0fvhzzJxQ` | URL reachable but no source_quote provided | -| `aditya-birla` | `youtube[2].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=6cIHkBY8Z7k` | URL reachable but no source_quote provided | -| `aditya-birla` | `youtube[3].Gurleen Kaur Tikku` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=4LTtX0is2GE` | URL reachable but no source_quote provided | -| `aditya-birla` | `youtube[4].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=o5sx-H8_5-M` | URL reachable but no source_quote provided | -| `aditya-birla` | `in_news[0]` | ⚠️ url-ok-quote-missing | `https://www.angelone.in/news/market-updates/aditya-birla-health-insurance-claims-settlement-ratio-analysis-for-2024-25` | URL reachable but no source_quote provided | -| `aditya-birla` | `in_news[1]` | ⚠️ url-ok-quote-missing | `https://cafemutual.com/news/insurance/37646-how-much-did-the-non-life-insurers-pay-in-commission-in-april-december-2025` | URL reachable but no source_quote provided | -| `aditya-birla` | `in_news[2]` | ⚠️ url-ok-quote-missing | `https://cafemutual.com/news/insurance/37461-which-non-life-insurers-settled-the-highest-number-of-claims-in-april-december-2025` | URL reachable but no source_quote provided | -| `aditya-birla` | `in_news[3]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/finance/insurance/icici-lombard-care-health-aditya-birla-cut-commissions-post-gst-125100101265_1.html` | URL reachable but no source_quote provided | -| `aditya-birla` | `in_news[4]` | ⚠️ url-ok-quote-missing | `https://www.outlookbusiness.com/news/aditya-birla-health-aims-to-outpace-sector-growth-sees-relief-ahead-in-mediclaim-premium` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `claim_metrics.source_irdai_url` | ⚠️ url-ok-quote-missing | `https://irdai.gov.in/document-detail?documentId=6436847` | URL reachable but quote not found in fetched body | -| `bajaj-allianz` | `claim_metrics.source_secondary_url` | ⚠️ url-ok-quote-missing | `https://www.policyx.com/health-insurance/bajaj-general-health-insurance/claim-settlement-ratio/` | URL reachable but quote not found in fetched body | -| `bajaj-allianz` | `claim_metrics.source_company_url` | ⚠️ url-ok-quote-missing | `https://www.bajajgeneralinsurance.com/about-us/financial-information.html` | URL reachable but quote not found in fetched body | -| `bajaj-allianz` | `aggregator_ratings.policybazaar` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/bajaj-allianz-health-insurance/claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `aggregator_ratings.insuredekho` | ⚠️ url-ok-quote-missing | `https://www.insurancedekho.com/health-insurance/bajaj-allianz/claim-settlement` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `aggregator_ratings.joinditto` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/bajaj-general-health-insurance-claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `reddit.sample_post_urls[0]` | ⚠️ url-ok-quote-missing | `https://1finance.co.in/product-scoring/health-insurance/bajaj-allianz-health-guard-gold-plan` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `reddit.sample_post_urls[1]` | ⚠️ url-ok-quote-missing | `https://www.policyx.com/health-insurance/bajaj-general-health-insurance/claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `reddit.sample_post_urls[2]` | ⚠️ url-ok-quote-missing | `https://www.insurancedekho.com/health-insurance/bajaj-allianz/health-guard-family-floater/user-reviews` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `reddit.sample_post_urls[3]` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/bajaj-general-health-insurance-reviews/` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `reddit.sample_post_urls[4]` | ⚠️ url-ok-quote-missing | `https://www.indiainvestments.wiki/start-here/insurance-policies/health` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `youtube[0].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=DWeVo13Y9ms` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `youtube[1].MJ (BAJAJ ALLIANZ Health Guard Plan Detailed Review)` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=A6KxeOHMPVw` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `youtube[2].Independent (Hindi)` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=d1--TiPtLw4` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `in_news[0]` | ⚠️ url-ok-quote-missing | `https://www.bajajallianz.com/download-documents/press-release/Press-Release-Finance-Bajaj-Allianz-General-Insurance-delivers-strong-financial-results-with-profits-rising-by-27percent-to-Rs%20921-crore.pdf` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `in_news[1]` | ⚠️ url-ok-quote-missing | `https://cafemutual.com/news/insurance/33076-icici-lombard-bajaj-allianz-and-new-india-are-the-most-profitable-non-life-players-in-fy-2024` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `in_news[2]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/finance/personal-finance/why-15-200-hospitals-stopped-cashless-care-for-bajaj-allianz-policyholders-125082500103_1.html` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `in_news[3]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/finance/personal-finance/cashless-crisis-averted-for-bajaj-allianz-customers-money-lessons-for-you-125090100132_1.html` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `in_news[4]` | ⚠️ url-ok-quote-missing | `https://www.prnewswire.com/in/news-releases/bajaj-allianz-general-insurance-unveils-herizon-care-indias-first-comprehensive-health-insurance-plan-designed-exclusively-for-women-302371201.html` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `in_news[5]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/content/press-releases-ani/bajaj-allianz-launches-state-wise-health-insurance-policies-tailored-to-regional-needs-125061901143_1.html` | URL reachable but no source_quote provided | -| `bajaj-allianz` | `in_news[6]` | ⚠️ url-ok-quote-missing | `https://www.bajajgeneralinsurance.com/about-us/financial-highlights.html` | URL reachable but no source_quote provided | -| `care-health` | `claim_metrics.source_irdai_url` | ⚠️ url-ok-quote-missing | `https://irdai.gov.in/document-detail?documentId=6436847` | URL reachable but quote not found in fetched body | -| `care-health` | `claim_metrics.source_secondary_url` | ⚠️ url-ok-quote-missing | `https://www.policyx.com/health-insurance/religare-health-insurance/claim-settlement-ratio/` | URL reachable but quote not found in fetched body | -| `care-health` | `claim_metrics.source_company_url` | ⚠️ url-ok-quote-missing | `https://www.careinsurance.com/health-insurance/health-insurance-claim-settlement-ratio` | URL in browser_verified allowlist | quote not found in fetched body | -| `care-health` | `aggregator_ratings.policybazaar` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/religare-health-insurance/claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `care-health` | `aggregator_ratings.insuredekho` | ⚠️ url-ok-quote-missing | `https://www.insurancedekho.com/health-insurance/care/user-reviews` | URL reachable but no source_quote provided | -| `care-health` | `aggregator_ratings.joinditto` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/care-health-insurance-review/` | URL reachable but no source_quote provided | -| `care-health` | `reddit.sample_post_urls[0]` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/is-care-health-insurance-good/` | URL reachable but no source_quote provided | -| `care-health` | `reddit.sample_post_urls[1]` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/health-insurance/companies/hdfc-ergo-vs-niva-bupa/` | URL reachable but no source_quote provided | -| `care-health` | `reddit.sample_post_urls[2]` | ❌ url-broken | `https://www.quora.com/What-are-peoples-opinions-on-Care-Indias-health-insurance` | HEAD returned status=403 | -| `care-health` | `reddit.sample_post_urls[3]` | ⚠️ url-ok-quote-missing | `https://www.indiainvestments.wiki/start-here/insurance-policies/health` | URL reachable but no source_quote provided | -| `care-health` | `youtube[0].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=2_EhrtJhn44` | URL reachable but no source_quote provided | -| `care-health` | `youtube[1].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=1rRvcVkcQVw` | URL reachable but no source_quote provided | -| `care-health` | `youtube[2].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=gnJyocoSiMA` | URL reachable but no source_quote provided | -| `care-health` | `youtube[3].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=21jT3Ji-SOI` | URL reachable but no source_quote provided | -| `care-health` | `youtube[4].PolicyX` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=AN8o2zGDJ5w` | URL reachable but no source_quote provided | -| `care-health` | `in_news[0]` | ⚠️ url-ok-quote-missing | `https://thesouthfirst.com/health/health-insurance-claims-standalone-insurers-pay-rs-3-07-per-rs-5-claim-general-insurers-offer-rs-4-17/` | URL reachable but no source_quote provided | -| `care-health` | `in_news[1]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/finance/personal-finance/star-health-care-niva-bupa-record-most-policyholder-complaints-in-fy24-125090100487_1.html` | URL reachable but no source_quote provided | -| `care-health` | `in_news[2]` | ⚠️ url-ok-quote-missing | `https://www.medboundtimes.com/india/hospitals-suspend-cashless-services-bajaj-allianz-care-policyholders` | URL reachable but no source_quote provided | -| `care-health` | `in_news[3]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/finance/insurance/icici-lombard-care-health-aditya-birla-cut-commissions-post-gst-125100101265_1.html` | URL reachable but no source_quote provided | -| `care-health` | `in_news[4]` | ⚠️ url-ok-quote-missing | `https://unlistedzone.com/h1-fy26-shows-care-health-is-growing-but-its-claims-are-growing-faster` | URL reachable but no source_quote provided | -| `care-health` | `in_news[5]` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/care-health-insurance-claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `claim_metrics.source_irdai_url` | ⚠️ url-ok-quote-missing | `https://irdai.gov.in/document-detail?documentId=6436847` | URL reachable but quote not found in fetched body | -| `hdfc-ergo` | `claim_metrics.source_secondary_url` | ⚠️ url-ok-quote-missing | `http://web.archive.org/web/20260211155805/https://www.policybazaar.com/insurance-companies/hdfc-ergo-health-insurance/claim-settlement-ratio/` | URL reachable but quote not found in fetched body | -| `hdfc-ergo` | `claim_metrics.source_company_url` | ⚠️ url-ok-quote-missing | `https://www.hdfcergo.com/blogs/health-insurance/hdfc-ergo-claim-settlement-ratio` | URL reachable but quote not found in fetched body | -| `hdfc-ergo` | `aggregator_ratings.policybazaar` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/hdfc-ergo-general-reviews-903/` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `aggregator_ratings.insuredekho` | ⚠️ url-ok-quote-missing | `https://www.insurancedekho.com/health-insurance/hdfc-ergo` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `aggregator_ratings.joinditto` | ⚠️ url-ok-quote-missing | `https://joinditto.in/health-insurance/hdfc-ergo/reviews/` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `aggregator_ratings.mouthshut` | ⚠️ url-ok-quote-missing | `https://www.mouthshut.com/product-reviews/hdfc-ergo-health-insurance-reviews-925865222` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `trustpilot.url` | ⚠️ url-ok-quote-missing | `https://www.trustpilot.com/review/www.hdfcergo.com` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `reddit.sample_post_urls[0]` | ⚠️ url-ok-quote-missing | `https://www.quora.com/Have-you-ever-made-any-claim-against-HDFC-Ergo-health-insurance-and-was-it-a-good-experience` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `reddit.sample_post_urls[1]` | ⚠️ url-ok-quote-missing | `https://www.oneassure.in/insurance/health-insurance-compare/niva-bupa-re-assure-vs-icici-health-shield-vs-hdfc-ergo-my-health-suraksha-gold` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `reddit.sample_post_urls[2]` | ⚠️ url-ok-quote-missing | `https://technofino.in/community/threads/hdfc-ergo-optima-secure-4x-is-there-any-catch.5647/` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `reddit.sample_post_urls[3]` | ⚠️ url-ok-quote-missing | `https://technofino.in/community/threads/hdfc-ergo-optima-secure-health-insurance.20516/` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `reddit.sample_post_urls[4]` | ⚠️ url-ok-quote-missing | `https://www.indiainvestments.wiki/start-here/insurance-policies/health` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `youtube[0].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=R4ehMh3z9UA` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `youtube[1].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=Ozq71VRTZUA` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `youtube[2].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=2_EhrtJhn44` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `youtube[3].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=i3xMZGMstzE` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `youtube[4].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=YEMmxjbl2Yw` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `in_news[0]` | ⚠️ url-ok-quote-missing | `https://www.goodreturns.in/news/hdfc-ergo-aims-to-maintain-premium-growth-2024-25-011-1392211.html` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `in_news[1]` | ⚠️ url-ok-quote-missing | `https://www.angelone.in/news/market-updates/hdfc-ergo-general-insurance-claims-settlement-ratio-analysis-for-2024-25` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `in_news[2]` | ⚠️ url-ok-quote-missing | `https://techobserver.in/news/bfsi/hdfc-ergo-cto-naganathan-eyes-ai-led-hyper-personalised-insurance-in-2026-319763/` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `in_news[3]` | ⚠️ url-ok-quote-missing | `https://www.globenewswire.com/news-release/2025/12/31/3211657/0/en/HDFC-ERGO-Strengthens-Electric-Two-Wheeler-Protection-with-Service-Led-Claims-Support.html` | URL reachable but no source_quote provided | -| `hdfc-ergo` | `in_news[4]` | ⚠️ url-ok-quote-missing | `https://www.hdfcergo.com/` | URL reachable but no source_quote provided | -| `icici-lombard` | `claim_metrics.source_irdai_url` | ⚠️ url-ok-quote-missing | `https://irdai.gov.in/document-detail?documentId=6436847` | URL reachable but quote not found in fetched body | -| `icici-lombard` | `claim_metrics.source_secondary_url` | ⚠️ url-ok-quote-missing | `https://www.policyx.com/health-insurance/icici-lombard-health-insurance/claim-settlement-ratio/` | URL reachable but quote not found in fetched body | -| `icici-lombard` | `claim_metrics.source_company_url` | ⚠️ url-ok-quote-missing | `https://www.icicilombard.com/health-insurance/blogs/icici-lombard-health-insurance-claim-settlement-ratio` | URL in browser_verified allowlist | quote not found in fetched body | -| `icici-lombard` | `aggregator_ratings.policybazaar` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/icici-lombard-health-insurance/claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `icici-lombard` | `aggregator_ratings.insuredekho` | ⚠️ url-ok-quote-missing | `https://www.insurancedekho.com/health-insurance/icici-lombard/claim-settlement` | URL reachable but no source_quote provided | -| `icici-lombard` | `aggregator_ratings.joinditto` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/is-icici-lombard-health-insurance-good/` | URL reachable but no source_quote provided | -| `icici-lombard` | `aggregator_ratings.mouthshut` | ⚠️ url-ok-quote-missing | `https://www.mouthshut.com/product-reviews/icici-lombard-health-insurance-reviews-925076599` | URL reachable but no source_quote provided | -| `icici-lombard` | `reddit.sample_post_urls[0]` | ⚠️ url-ok-quote-missing | `https://www.oneassure.in/insurance/health-insurance-compare/niva-bupa-re-assure-vs-icici-health-shield-vs-hdfc-ergo-my-health-suraksha-gold` | URL reachable but no source_quote provided | -| `icici-lombard` | `reddit.sample_post_urls[1]` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/is-icici-lombard-health-insurance-good/` | URL reachable but no source_quote provided | -| `icici-lombard` | `reddit.sample_post_urls[2]` | ⚠️ url-ok-quote-missing | `https://technofino.in/community/threads/50-lakh-cover-for-rs-7-123-too-good-to-be-true.12094/` | URL reachable but no source_quote provided | -| `icici-lombard` | `reddit.sample_post_urls[3]` | ⚠️ url-ok-quote-missing | `https://www.oneassure.in/insurance/health-insurance-guides/is-icici-health-insurance-good-comparing-plans-premiums-and-claim-experience` | URL reachable but no source_quote provided | -| `icici-lombard` | `reddit.sample_post_urls[4]` | ⚠️ url-ok-quote-missing | `https://www.indiainvestments.wiki/start-here/insurance-policies/health` | URL reachable but no source_quote provided | -| `icici-lombard` | `youtube[1].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=0EJI00BQqCA` | URL reachable but no source_quote provided | -| `icici-lombard` | `youtube[2].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=TjvNNK62oyE` | URL reachable but no source_quote provided | -| `icici-lombard` | `youtube[3].PolicyX` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=ca2bRF_JoLI` | URL reachable but no source_quote provided | -| `icici-lombard` | `youtube[4].Independent` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=ve6sHV2BCM8` | URL reachable but no source_quote provided | -| `icici-lombard` | `in_news[0]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/companies/quarterly-results/icici-lombard-net-profit-up-29-in-q1fy26-125071501318_1.html` | URL reachable but no source_quote provided | -| `icici-lombard` | `in_news[1]` | ⚠️ url-ok-quote-missing | `https://cafemutual.com/news/insurance/33076-icici-lombard-bajaj-allianz-and-new-india-are-the-most-profitable-non-life-players-in-fy-2024` | URL reachable but no source_quote provided | -| `icici-lombard` | `in_news[2]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/finance/insurance/icici-lombard-care-health-aditya-birla-cut-commissions-post-gst-125100101265_1.html` | URL reachable but no source_quote provided | -| `icici-lombard` | `in_news[3]` | ⚠️ url-ok-quote-missing | `https://www.arihantplus.com/blogs/stocks/icici-lombard-q1-fy-26-results-profit-jumps-28-7-strong-margins-and-digital-momentum` | URL reachable but no source_quote provided | -| `manipalcigna` | `claim_metrics.source_irdai_url` | ⚠️ url-ok-quote-missing | `https://irdai.gov.in/document-detail?documentId=6436847` | URL reachable but quote not found in fetched body | -| `manipalcigna` | `claim_metrics.source_secondary_url` | ⚠️ url-ok-quote-missing | `https://www.policyx.com/health-insurance/manipalcigna-health-insurance/claim-settlement-ratio/` | URL reachable but quote not found in fetched body | -| `manipalcigna` | `claim_metrics.source_company_url` | ⚠️ url-ok-quote-missing | `https://www.manipalcigna.com/blog/claim-settlement-ratio` | URL reachable but quote not found in fetched body | -| `manipalcigna` | `aggregator_ratings.policybazaar` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/manipalcigna-health-insurance/claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `manipalcigna` | `aggregator_ratings.insuredekho` | ⚠️ url-ok-quote-missing | `https://www.insurancedekho.com/health-insurance/manipalcigna/claim-settlement` | URL reachable but no source_quote provided | -| `manipalcigna` | `aggregator_ratings.joinditto` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/manipal-cigna-health-insurance-review/` | URL reachable but no source_quote provided | -| `manipalcigna` | `reddit.sample_post_urls[0]` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/manipal-cigna-health-insurance-review/` | URL reachable but no source_quote provided | -| `manipalcigna` | `reddit.sample_post_urls[1]` | ⚠️ url-ok-quote-missing | `https://www.policyx.com/health-insurance/manipalcigna-health-insurance/claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `manipalcigna` | `reddit.sample_post_urls[2]` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/manipal-cigna-health-insurance-review/` | URL reachable but no source_quote provided | -| `manipalcigna` | `reddit.sample_post_urls[3]` | ⚠️ url-ok-quote-missing | `https://www.indiainvestments.wiki/start-here/insurance-policies/health` | URL reachable but no source_quote provided | -| `manipalcigna` | `youtube[0].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=Yb6zub6V-LY` | URL reachable but no source_quote provided | -| `manipalcigna` | `youtube[1].Gurleen Kaur Tikku` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=DzhGiVxJPKQ` | URL reachable but no source_quote provided | -| `manipalcigna` | `youtube[2].Ditto Insurance / Health Insurance Sahi Hai` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=jUNmj0lKKjs` | URL reachable but no source_quote provided | -| `manipalcigna` | `youtube[3].Gurleen Kaur Tikku` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=uiANfhN1kyM` | URL reachable but no source_quote provided | -| `manipalcigna` | `in_news[0]` | ⚠️ url-ok-quote-missing | `https://cafemutual.com/news/insurance/33084-which-companies-are-better-at-settling-health-claims` | URL reachable but no source_quote provided | -| `manipalcigna` | `in_news[1]` | ⚠️ url-ok-quote-missing | `https://m.thewire.in/article/ptiprnews/manipalcigna-sarvah-named-product-of-the-year-2025-in-health-insurance-category` | URL reachable but no source_quote provided | -| `manipalcigna` | `in_news[2]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/content/press-releases-ani/manipalcigna-launches-sarvah-the-complete-health-insurance-plan-with-special-focus-on-bharat-s-missing-middle-124101900282_1.html` | URL reachable but no source_quote provided | -| `manipalcigna` | `in_news[3]` | ⚠️ url-ok-quote-missing | `https://www.dtnext.in/news/business/manipalcigna-health-insurance-expands-in-tn-settles-rs-101-cr-worth-claims-840161` | URL reachable but no source_quote provided | -| `manipalcigna` | `in_news[4]` | ⚠️ url-ok-quote-missing | `https://www.renewbuy.com/health-insurance/manipalcigna-health-insurance/claim-settlement-ratio` | URL reachable but no source_quote provided | -| `new-india` | `claim_metrics.source_irdai_url` | ⚠️ url-ok-quote-missing | `https://irdai.gov.in/document-detail?documentId=6436847` | URL reachable but quote not found in fetched body | -| `new-india` | `claim_metrics.source_secondary_url` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/new-india-assurance-health-insurance/claim-settlement-ratio/` | URL in browser_verified allowlist | quote not found in fetched body | -| `new-india` | `claim_metrics.source_company_url` | ⚠️ url-ok-quote-missing | `https://www.newindia.co.in/public-disclosure` | URL reachable but quote not found in fetched body | -| `new-india` | `aggregator_ratings.policybazaar` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/new-india-assurance-health-insurance/claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `new-india` | `aggregator_ratings.insuredekho` | ⚠️ url-ok-quote-missing | `https://www.insurancedekho.com/health-insurance/new-india/claim-settlement` | URL reachable but no source_quote provided | -| `new-india` | `aggregator_ratings.policyx` | ⚠️ url-ok-quote-missing | `https://www.policyx.com/health-insurance/new-india-health-insurance/claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `new-india` | `reddit.sample_post_urls[0]` | ⚠️ url-ok-quote-missing | `https://www.deccanchronicle.com/business/new-india-assurance-tops-health-insurance-claims-settlement-1841899` | URL reachable but no source_quote provided | -| `new-india` | `reddit.sample_post_urls[1]` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/new-india-assurance-health-insurance/claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `new-india` | `reddit.sample_post_urls[2]` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/is-new-india-assurance-health-insurance-good/` | URL reachable but no source_quote provided | -| `new-india` | `reddit.sample_post_urls[3]` | ⚠️ url-ok-quote-missing | `https://www.indiainvestments.wiki/start-here/insurance-policies/health` | URL reachable but no source_quote provided | -| `new-india` | `youtube[0].ET Now` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=OE_844nkUDE` | URL reachable but no source_quote provided | -| `new-india` | `youtube[1].Independent` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=f27o4K47nKU` | URL reachable but no source_quote provided | -| `new-india` | `youtube[2].Independent` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=7um6_5Zmt0M` | URL reachable but no source_quote provided | -| `new-india` | `youtube[3].Independent (Hindi)` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=IOlBJxGwraU` | URL reachable but no source_quote provided | -| `new-india` | `in_news[0]` | ⚠️ url-ok-quote-missing | `https://www.deccanchronicle.com/business/new-india-assurance-tops-health-insurance-claims-settlement-1841899` | URL reachable but no source_quote provided | -| `new-india` | `in_news[1]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/companies/news/new-india-assurance-q3fy24-results-net-profit-falls-4-38-to-rs-715-crore-124020901758_1.html` | URL reachable but no source_quote provided | -| `new-india` | `in_news[2]` | ⚠️ url-ok-quote-missing | `https://cafemutual.com/news/insurance/33076-icici-lombard-bajaj-allianz-and-new-india-are-the-most-profitable-non-life-players-in-fy-2024` | URL reachable but no source_quote provided | -| `new-india` | `in_news[3]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/finance/insurance/new-india-assurance-increases-premiums-on-health-insurance-by-10-124073001522_1.html` | URL reachable but no source_quote provided | -| `new-india` | `in_news[4]` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/is-new-india-assurance-health-insurance-good/` | URL reachable but no source_quote provided | -| `niva-bupa` | `claim_metrics.source_irdai_url` | ⚠️ url-ok-quote-missing | `https://irdai.gov.in/document-detail?documentId=6436847` | URL reachable but quote not found in fetched body | -| `niva-bupa` | `claim_metrics.source_secondary_url` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/niva-bupa-health-insurance-claim-settlement-ratio/` | URL reachable but quote not found in fetched body | -| `niva-bupa` | `aggregator_ratings.policybazaar` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/max-bupa-health-general-reviews-477/` | URL reachable but no source_quote provided | -| `niva-bupa` | `aggregator_ratings.insuredekho` | ⚠️ url-ok-quote-missing | `https://www.insurancedekho.com/health-insurance/niva-bupa-health-insurance/user-reviews` | URL reachable but no source_quote provided | -| `niva-bupa` | `aggregator_ratings.mouthshut` | ⚠️ url-ok-quote-missing | `https://www.mouthshut.com/product-reviews/niva-bupa-health-insurance-reviews-925608449` | URL reachable but no source_quote provided | -| `niva-bupa` | `aggregator_ratings.justdial` | ⚠️ url-ok-quote-missing | `https://www.justdial.com/Mumbai/Niva-Bupa-Health-Insurance-Company-Ltd-Customer-Care/022PXX22-XX22-121222183516-A3L5_BZDET/reviews` | URL reachable but no source_quote provided | -| `niva-bupa` | `trustpilot.url` | ⚠️ url-ok-quote-missing | `https://www.mouthshut.com/product-reviews/niva-bupa-health-insurance-reviews-925608449` | URL reachable but no source_quote provided | -| `niva-bupa` | `reddit.sample_post_urls[0]` | ⚠️ url-ok-quote-missing | `http://www.quora.com/Has-anyone-taken-Niva-Bupa-health-insurance-in-India-How-reliable-is-it` | URL reachable but no source_quote provided | -| `niva-bupa` | `reddit.sample_post_urls[1]` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/health-insurance/companies/hdfc-ergo-vs-niva-bupa/` | URL reachable but no source_quote provided | -| `niva-bupa` | `reddit.sample_post_urls[2]` | ⚠️ url-ok-quote-missing | `https://insurancesabha.com/t/niva-bupa-reviews-complaints-csr-2026/26/2` | URL reachable but no source_quote provided | -| `niva-bupa` | `reddit.sample_post_urls[3]` | ⚠️ url-ok-quote-missing | `https://www.beshak.org/forum/post/niva-bupa-claim-settlement-in-recent-times/` | URL reachable but no source_quote provided | -| `niva-bupa` | `reddit.sample_post_urls[4]` | ⚠️ url-ok-quote-missing | `https://www.indiainvestments.wiki/start-here/insurance-policies/health` | URL reachable but no source_quote provided | -| `niva-bupa` | `youtube[0].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=U1kNh-rRuXo` | URL reachable but no source_quote provided | -| `niva-bupa` | `youtube[1].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=2_EhrtJhn44` | URL reachable but no source_quote provided | -| `niva-bupa` | `youtube[2].Gurleen Kaur Tikku` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=ZjjIteHHGqI` | URL reachable but no source_quote provided | -| `niva-bupa` | `youtube[3].Insurance Impact` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=892Pbg3XNg4` | URL reachable but no source_quote provided | -| `niva-bupa` | `in_news[0]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/markets/news/niva-bupa-shares-make-positive-debut-on-bourses-list-at-6-premium-124111400326_1.html` | URL reachable but no source_quote provided | -| `niva-bupa` | `in_news[1]` | ⚠️ url-ok-quote-missing | `https://www.bupa.com/news-and-press/press-releases/2024/bupa-indian-health-insurance-business-niva-bupa-completes-ipo` | URL reachable but no source_quote provided | -| `niva-bupa` | `in_news[2]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/finance/personal-finance/insurance-firm-faces-social-media-backlash-over-61-lakh-claim-denial-125090101059_1.html` | URL reachable but no source_quote provided | -| `niva-bupa` | `in_news[3]` | ⚠️ url-ok-quote-missing | `https://www.livelaw.in/consumer-cases/mumbai-consumer-commission-orders-niva-bupa-to-pay-6650-lakh-for-wrongfully-denying-cancer-treatment-claim-311849` | URL reachable but no source_quote provided | -| `niva-bupa` | `in_news[4]` | ⚠️ url-ok-quote-missing | `https://www.outlookmoney.com/insurance/rs-61-lakh-health-insurance-claim-denied-familys-ordeal-sparks-outrage` | URL reachable but no source_quote provided | -| `niva-bupa` | `in_news[5]` | ⚠️ url-ok-quote-missing | `https://www.outlookmoney.com/insurance/those-labelling-health-insurance-sector-as-scam-are-highly-irresponsible-misleading-niva-bupa` | URL reachable but no source_quote provided | -| `niva-bupa` | `in_news[6]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/finance/personal-finance/star-health-care-niva-bupa-record-most-policyholder-complaints-in-fy24-125090100487_1.html` | URL reachable but no source_quote provided | -| `niva-bupa` | `in_news[7]` | ⚠️ url-ok-quote-missing | `https://upstox.com/news/market-news/ipo/understanding-niva-bupa-s-market-position-growth-claim-settlement-and-retention-metrics-compared-with-industry-peers/article-127535/` | URL reachable but no source_quote provided | -| `star-health` | `claim_metrics.source_irdai_url` | ⚠️ url-ok-quote-missing | `https://irdai.gov.in/document-detail?documentId=6436847` | URL reachable but quote not found in fetched body | -| `star-health` | `claim_metrics.source_secondary_url` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/finance/personal-finance/star-health-care-niva-bupa-record-most-policyholder-complaints-in-fy24-125090100487_1.html` | URL in browser_verified allowlist | quote not found in fetched body | -| `star-health` | `aggregator_ratings.policybazaar` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/star-health-insurance-reviews-881/` | URL reachable but no source_quote provided | -| `star-health` | `aggregator_ratings.insuredekho` | ⚠️ url-ok-quote-missing | `https://www.insurancedekho.com/health-insurance/star/user-reviews` | URL reachable but no source_quote provided | -| `star-health` | `aggregator_ratings.mouthshut` | ⚠️ url-ok-quote-missing | `https://www.mouthshut.com/product-reviews/star-health-insurance-reviews-925865246` | URL reachable but no source_quote provided | -| `star-health` | `trustpilot.url` | ⚠️ url-ok-quote-missing | `https://www.trustpilot.com/review/www.starhealth.in` | URL reachable but no source_quote provided | -| `star-health` | `reddit.sample_post_urls[0]` | ❌ url-broken | `https://www.quora.com/Is-Star-Health-Insurance-good-Has-anybody-experienced-problems-in-claim-settlement` | HEAD returned status=403 | -| `star-health` | `reddit.sample_post_urls[1]` | ⚠️ url-ok-quote-missing | `https://technofino.in/community/threads/star-health-insurance-renew-or-port.35180/` | URL reachable but no source_quote provided | -| `star-health` | `reddit.sample_post_urls[2]` | ⚠️ url-ok-quote-missing | `https://www.indiainvestments.wiki/start-here/insurance-policies/health` | URL reachable but no source_quote provided | -| `star-health` | `reddit.sample_post_urls[3]` | ❌ url-broken | `https://www.quora.com/Is-Star-Health-Insurance-a-good-company` | HEAD returned status=403 | -| `star-health` | `youtube[0].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=k5ZltTqzSrY` | URL reachable but no source_quote provided | -| `star-health` | `youtube[1].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=_U81lPwqsk4` | URL reachable but no source_quote provided | -| `star-health` | `youtube[2].MJ (MJ Money)` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=j1YBBmt7VZI` | URL reachable but no source_quote provided | -| `star-health` | `youtube[3].Gurleen Kaur Tikku` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=Vs4OjCEU_gc` | URL reachable but no source_quote provided | -| `star-health` | `in_news[0]` | ⚠️ url-ok-quote-missing | `https://www.businesstoday.in/personal-finance/insurance/story/star-health-under-irdai-lens-over-claim-settlement-insurer-says-routine-process-469373-2025-03-25` | URL reachable but no source_quote provided | -| `star-health` | `in_news[1]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/finance/insurance/irdai-issues-show-cause-notice-to-star-health-for-violating-norms-124120601299_1.html` | URL reachable but no source_quote provided | -| `star-health` | `in_news[2]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/markets/news/star-health-drops-5-as-irdai-issues-show-cause-notice-for-violating-norms-124120900239_1.html` | URL reachable but no source_quote provided | -| `star-health` | `in_news[3]` | ⚠️ url-ok-quote-missing | `https://www.business-standard.com/finance/personal-finance/star-health-care-niva-bupa-record-most-policyholder-complaints-in-fy24-125090100487_1.html` | URL reachable but no source_quote provided | -| `star-health` | `in_news[4]` | ⚠️ url-ok-quote-missing | `https://techcrunch.com/2024/10/09/indias-star-health-confirms-data-breach-after-cybercriminals-post-customers-health-data-online/` | URL reachable but no source_quote provided | -| `star-health` | `in_news[5]` | ⚠️ url-ok-quote-missing | `https://the420.in/star-health-under-fire-irdai-scrutinizes-high-claim-rejections-delays/` | URL reachable but no source_quote provided | -| `star-health` | `in_news[6]` | ⚠️ url-ok-quote-missing | `https://www.outlookmoney.com/insurance/health-insurance/star-health-under-irdai-scrutiny-for-health-insurance-claim-settlement-practices` | URL reachable but no source_quote provided | -| `tata-aig` | `claim_metrics.source_irdai_url` | ⚠️ url-ok-quote-missing | `https://irdai.gov.in/document-detail?documentId=6436847` | URL reachable but quote not found in fetched body | -| `tata-aig` | `claim_metrics.source_secondary_url` | ⚠️ url-ok-quote-missing | `https://www.policyx.com/health-insurance/tata-aig-health-insurance/claim-settlement-ratio/` | URL reachable but quote not found in fetched body | -| `tata-aig` | `aggregator_ratings.policybazaar` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/insurance-companies/tata-aig-health-insurance/claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `tata-aig` | `aggregator_ratings.insuredekho` | ⚠️ url-ok-quote-missing | `https://www.insurancedekho.com/health-insurance/tata-aig/claim-settlement` | URL reachable but no source_quote provided | -| `tata-aig` | `aggregator_ratings.joinditto` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/tata-aig-health-insurance-claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `tata-aig` | `reddit.sample_post_urls[0]` | ⚠️ url-ok-quote-missing | `https://www.beshak.org/insurance/health-insurance/best-health-insurance-plans/tata-aig-medi-care/` | URL reachable but no source_quote provided | -| `tata-aig` | `reddit.sample_post_urls[1]` | ⚠️ url-ok-quote-missing | `https://www.policybazaar.com/health-insurance/companies/aditya-birla-vs-tata-aig/` | URL reachable but no source_quote provided | -| `tata-aig` | `reddit.sample_post_urls[2]` | ⚠️ url-ok-quote-missing | `https://joinditto.in/articles/health-insurance/tata-aig-health-insurance-claim-settlement-ratio/` | URL reachable but no source_quote provided | -| `tata-aig` | `reddit.sample_post_urls[3]` | ⚠️ url-ok-quote-missing | `https://www.indiainvestments.wiki/start-here/insurance-policies/health` | URL reachable but no source_quote provided | -| `tata-aig` | `youtube[1].Ditto Insurance` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=Drg-E3bxekU` | URL reachable but no source_quote provided | -| `tata-aig` | `youtube[2].Insurance Impact` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=hNSQlPwFGdY` | URL reachable but no source_quote provided | -| `tata-aig` | `youtube[3].Gurleen Kaur Tikku / Independent` | ⚠️ url-ok-quote-missing | `https://www.youtube.com/watch?v=696mpVFVehU` | URL reachable but no source_quote provided | - -_... and 6 more rows truncated; see eval/info_source_map.json for full data._ - -## Insurers / Policies with 100% verified claims - -_None._ - -## Records with remaining ⚠️ url-ok-quote-missing - -| Record | ✅ | ⚠️ | ❌ | +# Information Source Map — Structured-Fact KB +_Last updated: 2026-05-15_ + +This file aggregates the source metadata embedded in `40-data/policy_facts/`, `40-data/reviews/`, and `40-data/premiums/illustrative_premiums.json` so every populated fact in the KB can be traced to a PDF, URL, or rate card. J3 verification will fill the `verified` / `last_verified` fields downstream. + +## 1. Aggregate Stats + +- **Total cited facts:** 5,616 + - policy_facts: **5,460** + - insurer_reviews: **65** + - premium samples: **91** +- **Distinct source URLs:** 97 +- **Distinct PDF paths (policy wordings/brochures):** 188 +- **% policy_facts with PDF citation:** 98.8% +- **% policy_facts with explicit URL:** 7.4% +- **% review facts with primary URL:** 100.0% +- **% premium samples with real (non-derived) URL:** 40.7% + +### Source-type breakdown + +**Policy facts** + +| source_type | count | +|---|---:| +| policy_pdf | 5,046 | +| web_url | 405 | +| missing | 9 | + +**Reviews** + +| source_type | count | +|---|---:| +| irdai_annual_report | 43 | +| irdai_complaints | 19 | +| irdai | 3 | + +**Premiums** + +| source_type | count | +|---|---:| +| derived_anchor | 54 | +| insurer_or_other_url | 16 | +| policybazaar_tile | 10 | +| official_rate_card | 9 | +| joinditto_chart | 2 | + +## 2. Coverage by Category + +### 2.1 Policy facts — per-insurer policy counts + +| insurer_slug | policies indexed | populated fact rows | +|---|---:|---:| +| acko | 9 | 203 | +| aditya-birla | 8 | 137 | +| bajaj-allianz | 17 | 301 | +| care-health | 15 | 249 | +| cholamandalam | 6 | 116 | +| go-digit | 6 | 154 | +| hdfc-ergo | 23 | 420 | +| icici-lombard | 17 | 322 | +| iffco-tokio | 6 | 165 | +| indusind-general | 3 | 48 | +| manipalcigna | 8 | 155 | +| national-insurance | 40 | 1,122 | +| new-india | 14 | 178 | +| niva-bupa | 19 | 375 | +| oriental-insurance | 6 | 141 | +| reliance-general | 1 | 9 | +| royal-sundaram | 14 | 414 | +| sbi-general | 12 | 343 | +| star-health | 18 | 372 | +| tata-aig | 11 | 236 | + +### 2.2 Insurer reviews — CSR / complaint coverage + +| insurer_slug | CSR % | CSR year | complaints/10K | source_irdai_url present? | source_complaints_url present? | +|---|---:|---|---:|---|---| +| acko | 96.31 | FY 2023-24 | 16 | yes | yes | +| aditya-birla | 92.97 | 2023-24 | 13 | yes | no | +| bajaj-allianz | 92.24 | 2023-24 | 3 | yes | no | +| care-health | 93.13 | 2023-24 (3-year avg) | 42 | yes | no | +| cholamandalam | 94.5 | FY 2023-24 | 13 | yes | yes | +| go-digit | 90.69 | FY 2023-24 | 19 | yes | yes | +| hdfc-ergo | 99.1 | 2023-24 | 15 | yes | no | +| icici-lombard | 85.0 | 2023-24 | 10 | yes | no | +| iffco-tokio | 96.33 | FY 2023-24 | 41 | yes | yes | +| indusind-general | 86.38 | FY 2024-25 | — | yes | yes | +| manipalcigna | 99.0 | 2023-24 | 24 | yes | no | +| national-insurance | 91.18 | FY 2023-24 | 29 | yes | yes | +| new-india | 95.04 | 2023-24 (by claim count) | 20 | yes | no | +| niva-bupa | 91.62 | 2023-24 (3-year avg through FY25) | 43 | yes | no | +| oriental-insurance | 93.96 | FY 2023-24 | — | yes | yes | +| reliance-general | 98.75 | FY 2023-24 | 5 | yes | yes | +| royal-sundaram | 95.95 | FY 2023-24 | 18 | yes | yes | +| sbi-general | 96.14 | FY 2022-25 (3-yr avg) | 15 | yes | yes | +| star-health | 82.31 | 2023-24 | 52 | yes | no | +| tata-aig | 88.72 | 2023-24 (3-year avg) | 11 | yes | no | + +### 2.3 Premiums — per-policy sample coverage + +| policy_id | sample count | real-URL samples | derived samples | |---|---:|---:|---:| -| aditya-birla | 0 | 20 | 0 | -| aditya-birla__activ-assure-diamond | 10 | 9 | 0 | -| aditya-birla__activ-health | 11 | 3 | 0 | -| aditya-birla__activ-health-individual__wordings | 6 | 1 | 0 | -| aditya-birla__activ-one | 13 | 6 | 0 | -| aditya-birla__activ-secure-cancer-secure__brochure | 3 | 1 | 0 | -| aditya-birla__activ-secure-personal-accident-cancer-secure__wordings | 4 | 1 | 0 | -| aditya-birla__group-activ-health__wordings | 5 | 1 | 0 | -| bajaj-allianz | 0 | 21 | 0 | -| bajaj-allianz__comprehensive-care-plan | 6 | 2 | 0 | -| bajaj-allianz__criti-care__wordings | 1 | 1 | 0 | -| bajaj-allianz__extra-care-plus | 12 | 6 | 0 | -| bajaj-allianz__global-health-care | 11 | 2 | 0 | -| bajaj-allianz__group-health-guard-silver__wordings | 6 | 1 | 0 | -| bajaj-allianz__group-personal-accident__wordings | 0 | 1 | 0 | -| bajaj-allianz__health-guard | 14 | 2 | 0 | -| bajaj-allianz__health-guard-gold | 10 | 9 | 0 | -| bajaj-allianz__health-guard-gold-individual__wordings | 8 | 1 | 0 | -| bajaj-allianz__silver-health | 6 | 4 | 0 | -| bajaj-allianz__tax-gain | 4 | 5 | 0 | -| care-health | 0 | 20 | 1 | -| care-health__care-advantage | 11 | 3 | 0 | -| care-health__care-advantage-add-ons-protect-plus-care-shield__brochure | 5 | 2 | 0 | -| care-health__care-classic | 6 | 12 | 0 | -| care-health__care-heart__brochure | 7 | 1 | 0 | -| care-health__care-senior | 12 | 8 | 0 | -| care-health__care-supreme | 9 | 10 | 0 | -| care-health__care-supreme-enhance | 9 | 3 | 0 | -| care-health__supreme-enhance__brochure | 7 | 1 | 0 | -| care-health__ultimate-care | 8 | 3 | 0 | -| hdfc-ergo | 0 | 23 | 0 | -| hdfc-ergo__energy | 8 | 3 | 0 | -| hdfc-ergo__energy-diabetes-hypertension__wordings | 3 | 1 | 0 | -| hdfc-ergo__group-health-insurance__wordings | 6 | 1 | 0 | -| hdfc-ergo__my-health-medisure-prime | 8 | 3 | 0 | -| hdfc-ergo__my-health-sampoorna-suraksha | 8 | 3 | 0 | -| hdfc-ergo__my-health-suraksha | 12 | 3 | 0 | -| hdfc-ergo__my-health-women-suraksha | 3 | 4 | 0 | -| hdfc-ergo__my-optima-secure-older-variant__wordings | 7 | 1 | 0 | -| hdfc-ergo__my-optima-secure__wordings | 5 | 1 | 0 | -| hdfc-ergo__optima-enhance | 6 | 3 | 0 | -| hdfc-ergo__optima-plus | 8 | 3 | 0 | -| hdfc-ergo__optima-restore | 15 | 5 | 0 | -| hdfc-ergo__optima-secure | 15 | 6 | 0 | -| hdfc-ergo__optima-secure-older-variant | 9 | 3 | 0 | -| hdfc-ergo__total-health-plan | 10 | 3 | 0 | -| icici-lombard | 0 | 20 | 0 | -| icici-lombard__arogya-sanjeevani | 12 | 1 | 0 | -| icici-lombard__complete-health-insurance | 9 | 10 | 0 | -| icici-lombard__complete-health-insurance-health-shield__wordings | 8 | 1 | 0 | -| icici-lombard__complete-health-insurance-umbrella__wordings | 8 | 1 | 0 | -| icici-lombard__complete-health-umbrella | 14 | 1 | 0 | -| icici-lombard__elevate | 10 | 9 | 0 | -| icici-lombard__health-advantedge | 10 | 5 | 0 | -| icici-lombard__health-booster | 9 | 3 | 0 | -| icici-lombard__health-booster-top-up__wordings | 5 | 1 | 0 | -| icici-lombard__health-elite-plus | 11 | 3 | 0 | -| icici-lombard__health-shield-360 | 4 | 11 | 0 | -| icici-lombard__health-shield-360-retail__cis | 7 | 1 | 0 | -| icici-lombard__health-shield-360-retail__wordings | 5 | 1 | 0 | -| manipalcigna | 0 | 19 | 0 | -| manipalcigna__prohealth-insurance-all-variants__wordings | 10 | 1 | 0 | -| manipalcigna__prohealth-prime | 9 | 9 | 0 | -| manipalcigna__prohealth-prime-active | 0 | 1 | 0 | -| manipalcigna__prohealth-protect | 9 | 8 | 0 | -| manipalcigna__prohealth-select | 10 | 3 | 0 | -| manipalcigna__sarvah-param | 8 | 2 | 0 | -| new-india | 0 | 19 | 0 | -| new-india__asha-kiran | 7 | 4 | 0 | -| new-india__asha-kiran-policy__brochure | 3 | 1 | 0 | -| new-india__asha-kiran-policy__cis | 7 | 1 | 0 | -| new-india__floater-mediclaim | 12 | 4 | 0 | -| new-india__janata-mediclaim | 10 | 2 | 0 | -| new-india__janata-mediclaim-policy__wordings | 7 | 1 | 0 | -| new-india__mediclaim | 0 | 1 | 0 | -| new-india__mediclaim-policy | 9 | 3 | 0 | -| new-india__new-india-floater-mediclaim-policy__wordings | 9 | 1 | 0 | -| new-india__new-india-mediclaim-policy__brochure | 9 | 1 | 0 | -| new-india__new-india-mediclaim-policy__wordings | 9 | 1 | 0 | -| new-india__universal-health | 7 | 2 | 0 | -| new-india__universal-health-insurance__wordings | 3 | 1 | 0 | -| new-india__yuva-bharat | 9 | 3 | 0 | -| new-india__yuva-bharat-health-policy__wordings | 7 | 1 | 0 | -| niva-bupa | 0 | 24 | 0 | -| niva-bupa__aspire | 11 | 2 | 0 | -| niva-bupa__health-companion | 6 | 10 | 0 | -| niva-bupa__health-companion-v2022__brochure | 8 | 1 | 0 | -| niva-bupa__health-plus-top-up | 9 | 3 | 0 | -| niva-bupa__health-premia | 9 | 4 | 0 | -| niva-bupa__reassure | 0 | 2 | 0 | -| niva-bupa__reassure-2 | 10 | 6 | 0 | -| niva-bupa__reassure-2-0__wordings | 3 | 1 | 0 | -| niva-bupa__reassure-3 | 10 | 3 | 0 | -| niva-bupa__reassure-3-0__wordings | 4 | 1 | 0 | -| niva-bupa__rise | 10 | 1 | 0 | -| niva-bupa__saral-suraksha | 6 | 2 | 0 | -| niva-bupa__saral-suraksha-bima__wordings | 4 | 1 | 0 | -| niva-bupa__senior-first | 12 | 5 | 0 | -| premiums_meta | 0 | 15 | 9 | -| star-health | 0 | 19 | 2 | -| star-health__comprehensive | 0 | 1 | 0 | -| star-health__family-health-optima | 8 | 11 | 0 | -| star-health__health-premier | 9 | 1 | 0 | -| star-health__senior-citizens-red-carpet | 5 | 3 | 0 | -| star-health__star-assure | 9 | 2 | 0 | -| star-health__star-cancer-care-platinum__wordings | 8 | 1 | 0 | -| star-health__star-cardiac-care | 8 | 2 | 0 | -| star-health__star-cardiac-care-platinum | 7 | 3 | 0 | -| star-health__star-comprehensive | 10 | 8 | 0 | -| star-health__star-hospital-cash__brochure | 2 | 1 | 0 | -| tata-aig | 0 | 18 | 0 | -| tata-aig__criti-medicare__wordings | 2 | 1 | 0 | -| tata-aig__medicare | 4 | 15 | 0 | -| tata-aig__medicare-lite | 12 | 2 | 0 | -| tata-aig__medicare-premier | 6 | 16 | 0 | -| tata-aig__medicare-select | 11 | 2 | 0 | -| tata-aig__wellsurance-family__cis | 2 | 1 | 0 | - ---- - -**Audit complete: ✅ 798 / ⚠️ 571 / ❌ 12** \ No newline at end of file +| aditya-birla-activ-assure-diamond | 5 | 1 | 4 | +| aditya-birla-group-activ-health | 3 | 0 | 3 | +| bajaj-allianz-health-guard | 5 | 1 | 4 | +| bajaj-allianz-silver-health | 3 | 1 | 2 | +| bajaj-allianz-tax-gain | 1 | 1 | 0 | +| care-health-care-advantage | 1 | 1 | 0 | +| care-health-care-classic | 2 | 1 | 1 | +| care-health-care-senior | 3 | 1 | 2 | +| care-health-care-supreme | 5 | 2 | 3 | +| hdfc-ergo-energy | 3 | 0 | 3 | +| hdfc-ergo-optima-plus | 2 | 1 | 1 | +| hdfc-ergo-optima-restore | 3 | 0 | 3 | +| hdfc-ergo-optima-secure | 5 | 2 | 3 | +| icici-lombard-elevate | 4 | 1 | 3 | +| icici-lombard-health-advantedge | 2 | 1 | 1 | +| manipalcigna-prohealth-prime-active | 3 | 1 | 2 | +| new-india-asha-kiran | 2 | 1 | 1 | +| new-india-mediclaim | 3 | 1 | 2 | +| niva-bupa-aspire | 3 | 1 | 2 | +| niva-bupa-health-premia | 3 | 1 | 2 | +| niva-bupa-reassure | 4 | 2 | 2 | +| royal-sundaram-advanced-top-up | 3 | 3 | 0 | +| sbi-general-arogya-supreme | 2 | 2 | 0 | +| star-health-comprehensive | 3 | 1 | 2 | +| star-health-family-health-optima | 5 | 3 | 2 | +| star-health-senior-red-carpet | 5 | 1 | 4 | +| tata-aig-medicare | 3 | 2 | 1 | +| tata-aig-medicare-premier | 5 | 4 | 1 | + +## 3. Needs-source (unverifiable until repaired) + +- policy_facts rows lacking any source path/URL or explicitly marked "not extracted": **9** +- review rows lacking a primary IRDAI URL: **0** +- premium samples derived from anchors (not directly sourced): **54** +- premium samples with no URL at all: **0** + +### Top 15 policy_fact fields with missing source metadata + +| field | rows missing source | +|---|---:| +| network_hospital_count | 2 | +| maternity_coverage | 2 | +| pre_existing_disease_waiting_months | 2 | +| ayush_coverage | 2 | +| cashless_treatment_supported | 1 | + +## 4. How to read the JSON twin + +- `policy_facts[]` — one row per populated `(policy_id, field)` pair, with `source_path` (PDF), optional `source_url`, `source_quote`, `confidence`, and J3-bound `verified` / `last_verified` slots. +- `insurer_reviews[]` — one row per populated `(insurer_slug, metric)` pair, with primary IRDAI URL plus optional secondary / insurer-company URLs and the reporting `year`. +- `premiums[]` — one row per `(policy_id, sample_profile)` pair with `annual_premium_inr`, `source_url`, `source_note`, and a `source_type` of `policybazaar_tile` / `joinditto_chart` / `beshak_review` / `official_rate_card` / `derived_anchor`. +- `needs_source.*` — flat lists of rows where source metadata is absent or explicitly marked missing, so we know exactly what J3 verification cannot yet check. diff --git a/40-data/policy_facts/acko__acko-health-ii__wordings.json b/40-data/policy_facts/acko__acko-health-ii__wordings.json index 24cceebd7b0048aa4ccfbda0751792105228cae9..ccd79112782e9735a93059ae9207744fe9aee8a5 100644 --- a/40-data/policy_facts/acko__acko-health-ii__wordings.json +++ b/40-data/policy_facts/acko__acko-health-ii__wordings.json @@ -7,132 +7,235 @@ "value": "ACKHLIP26036V012526", "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: ACKHLIP26036V012526 Web: www.acko.com/gi", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "grace period of fifteen days (where premium is paid on a monthly instalments) and thirty days (where premium is paid in quarterly/half yearly/annual instalments) is available on the premium due date, to pay the premium.", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The insured shall be allowed a period of thirty days (30 days) from date of receipt of the Policy to review the terms and conditions of the Policy", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "30-day waiting period- Code- Excl03 a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": null, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": null, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 500, + "source_url": "https://www.acko.com/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Acko covers all day-care procedures up to SI; 500+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 11500, + "source_url": "https://www.acko.com/health-insurance/cashless/", + "source_note": "ACKO has 11,500+ cashless hospitals across India (insurer's cashless landing page, scraped 2026-05-15)", + "_confidence": "high", "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", + "source_quote": "3.2.10 AYUSH Treatment If anyone insured under the policy undergoes medically necessary treatment at any AYUSH Hospitals or health care facilities for any of the listed AYUSH treatments namely Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy, we will indemnify the medical expenses", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", + "source_quote": "Maternity: Code Excl18 i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization or pre/post-hospitalisation) except ectopic pregnancy", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", + "source_quote": "in-patient hospitalization expenses for the person's organ donor only upto the insured's sum insured, if the following conditions are met - We admit the claim under Section 3.2.1 (In-patient Hospitalization) for the Insured Person under this Policy and is related to the same Illness or Injury", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", + "source_quote": "Restore Sum Insured .................................................................................................................. 10 3.3.3 Cumulative Bonus .......................................................................................................................", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", + "source_quote": "Domiciliary Treatment ................................................................................................................... 9 3.2.8 Organ Donor Expenses .................................................................................................................", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", + "source_quote": "Worldwide in-patient hospitalization ............................................................................................ 10 3.3.2 Restore Sum Insured .................................................................................................................. 10 3.3", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", + "source_quote": "Preventive Health Check-up ........................................................................................................ 13 3.3.15 Inflation Protect Sum Insured ...................................................................................................... 14 3.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the Network Provider by the insurer", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", + "source_quote": "Territorial Limit All medical treatment for the purpose of this Insurance will have to be taken in India only.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", + "source_quote": "family floater policies, a single zone shall be applied to all the members covered under the same Policy. The two zones are defined below", + "_confidence": "medium" + }, + "modern_treatments_covered": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", + "source_quote": "Modern Treatment ....................................................................................................................... 10 3.3 Basic benefit options ..................................................................................................................", + "_confidence": "high" + }, + "room_rent_capping": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-ii__wordings.pdf", + "source_quote": "not stated in acko__acko-health-ii__wordings.pdf", + "_confidence": "low" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "acko insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/acko__acko-health-iii-platinum-lite__wordings.json b/40-data/policy_facts/acko__acko-health-iii-platinum-lite__wordings.json index 2ea0f097e1c40aa9ab5ed08ce1ce4671d9241bbc..28a963035f63431657bbc769dd4cec15d216638e 100644 --- a/40-data/policy_facts/acko__acko-health-iii-platinum-lite__wordings.json +++ b/40-data/policy_facts/acko__acko-health-iii-platinum-lite__wordings.json @@ -7,132 +7,235 @@ "value": "ACKHLIP27040V012627", "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: ACKHLIP27040V012627 Web: www.acko.com/gi | Toll Free: 1800 266 2256", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-lite__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-lite__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-lite__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-lite__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace period (renewal + instalments) • For instalment premium: ▪ 15 days grace for monthly instalments ▪ 30 days grace for quarterly/half-yearly/annual instalments ▪ Coverage continues during the grace", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Free look period • 30 days from date of receipt of policy to review the terms and conditions of the Policy, and to return the same if not acceptable (only at inception, not renewals/porting).", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, - "unit": null, + "value": 30, + "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "3.1.3. 30-day waiting period • Expenses for treatment of any illness within 30 days from first policy commencement excluded, except accidents. • Not applicable if insured has continuous coverage >12 months.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": null, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-lite__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": null, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-lite__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-lite__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "In the pre-hospitalization period up to 60 days, and • In the post-hospitalization period up to 180 days, only if the related hospitalization/day care claim is admissible.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "In the pre-hospitalization period up to 60 days, and • In the post-hospitalization period up to 180 days, only if the related hospitalization/day care claim is admissible.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 500, + "source_url": "https://www.acko.com/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Acko covers all day-care procedures up to SI; 500+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 11500, + "source_url": "https://www.acko.com/health-insurance/cashless/", + "source_note": "ACKO has 11,500+ cashless hospitals across India (insurer's cashless landing page, scraped 2026-05-15)", + "_confidence": "high", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-lite__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Rent / ICU- Part of base SI We cover actual room rent and ICU charges without any capping. 2.3. Day Care Treatment- Part of base SI If any insured under this policy undergoes Day Care Treatment (including AYUSH treatment) in a Hospital/Nursing Home/Day Care Centre, we cove", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-lite__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-lite__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-lite__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-lite__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_quote": "If any insured under this policy undergoes Day Care Treatment (including AYUSH treatment) in a Hospital/Nursing Home/Day Care Centre, we cover the expenses.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_quote": "Maternity Excluded: • childbirth (incl. complicated delivery/C-section) and pre/post hospitalization • miscarriage (unless due to accident) • lawful medical termination", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_quote": "Organ Donor Expenses- Part of base SI If anyone insured requires organ transplant, we cover the organ donor's in-patient hospitalization expenses for harvesting the organ within the Sum insured of the insured. Payable only if all the following conditions are met: We admit the ins", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_quote": "Domiciliary Treatment (Domiciliary Hospitalization)- Part of base SI We cover costs of such domiciliary hospitalization if anyone insured takes treatment at home (instead of a hospital) due to: Inability to be moved, OR Non-availability of hospital beds. Conditions: Must continue", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_quote": "if Worldwide In-Patient Hospitalization cover is available in your policy schedule, this exclusion shall be waived off. OPD consultations/diagnostics/pharmacy/procedure, unless covered by OPD add-on cover opted or as part of Pre/Post hospitalization of admitted in-patient/day car", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_quote": "Preventive Health Check-up - Additional benefit and not part of base SI For insured persons aged above 18, we facilitate and provide tests as give below: CBC, ESR, HbA1C Serum Creatinine, Cholesterol, HDL, Triglycerides Routine Urine Analysis SGOT, SGPT, GGT Acko General Insuranc", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_quote": "You can submit claims as Cashless (network provider) or Reimbursement (you pay first, we reimburse if the claim is admissible).", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_quote": "not stated in acko__acko-health-iii-platinum-lite__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_quote": "if Worldwide In-Patient Hospitalization cover is available in your policy schedule, this exclusion shall be waived off.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_quote": "family floater policies, one zone applies to all members under the policy. • Zone A: Delhi/NCR; Mumbai (including Navi Mumbai, Thane, Kalyan", + "_confidence": "medium" + }, + "modern_treatments_covered": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_quote": "Modern Treatment- Part of base SI If anyone insured undergoes in-patient or day care treatment for the following procedures, we indemnify medical expenses related to the procedures: Uterine Artery Embolization and HIFU Balloon Sinuplasty Deep Brain Stimulation Oral chemotherapy I", + "_confidence": "high" + }, + "room_rent_capping": { + "value": "No cap", + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-lite__wordings.pdf", + "source_quote": "We cover actual room rent and ICU charges without any capping. 2.3. Day Care Treatment- Part of base SI", + "_confidence": "high" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "acko insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/acko__acko-health-iii-platinum-super-top-up__wordings.json b/40-data/policy_facts/acko__acko-health-iii-platinum-super-top-up__wordings.json index 846e2cc45c2756471544e06d1576c6f0632052b9..3ddd4e657c825a193adc68d90c6494523a163302 100644 --- a/40-data/policy_facts/acko__acko-health-iii-platinum-super-top-up__wordings.json +++ b/40-data/policy_facts/acko__acko-health-iii-platinum-super-top-up__wordings.json @@ -7,132 +7,228 @@ "value": "ACKHLIP27040V012627", "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: ACKHLIP27040V012627 Web: www.acko.com/gi | Toll Free: 1800 266 2256", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-super-top-up__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-super-top-up__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-super-top-up__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-super-top-up__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace period (renewal + instalments) • For instalment premium: ▪ 15 days grace for monthly instalments ▪ 30 days grace for quarterly/half-yearly/annual instalments ▪ Coverage continues during the grace", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Free look period • 30 days from date of receipt of policy to review the terms and conditions of the Policy, and to return the same if not acceptable (only at inception, not renewals/porting).", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 0, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "3.1.3. 30-day waiting period (Not applicable for this plan) • Expenses for treatment of any illness within 30 days from first policy commencement excluded, except accidents.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": null, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-super-top-up__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": null, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-super-top-up__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-super-top-up__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "In the pre-hospitalization period up to 60 days, and • In the post-hospitalization period up to 180 days, only if the related hospitalization/day care claim is admissible.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "In the pre-hospitalization period up to 60 days, and • In the post-hospitalization period up to 180 days, only if the related hospitalization/day care claim is admissible.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 500, + "source_url": "https://www.acko.com/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Acko covers all day-care procedures up to SI; 500+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 11500, + "source_url": "https://www.acko.com/health-insurance/cashless/", + "source_note": "ACKO has 11,500+ cashless hospitals across India (insurer's cashless landing page, scraped 2026-05-15)", + "_confidence": "high", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-super-top-up__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Rent / ICU- Part of base SI We cover actual room rent and ICU charges without any capping. 2.3. Day Care Treatment- Part of base SI If any insured under this policy undergoes Day Care Treatment (including AYUSH treatment) in a Hospital/Nursing Home/Day Care Centre, we cove", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-super-top-up__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-super-top-up__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-super-top-up__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum-super-top-up__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", + "source_quote": "If any insured under this policy undergoes Day Care Treatment (including AYUSH treatment) in a Hospital/Nursing Home/Day Care Centre, we cover the expenses.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", + "source_quote": "Maternity Excluded: • childbirth (incl. complicated delivery/C-section) and pre/post hospitalization • miscarriage (unless due to accident) • lawful medical termination", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", + "source_quote": "Organ Donor Expenses- Part of base SI If anyone insured requires organ transplant, we cover the organ donor's in-patient hospitalization expenses for harvesting the organ within the sum insured of the insured. Payable only if all the following conditions are met: We admit the ins", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", + "source_quote": "Domiciliary Treatment (Domiciliary Hospitalization)- Part of base SI We cover costs of such domiciliary hospitalization if anyone insured takes treatment at home (instead of a hospital) due to: Inability to be moved, OR Non-availability of hospital beds. Conditions: Must continue", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", + "source_quote": "if Worldwide In-Patient Hospitalization cover is available in your policy schedule, this exclusion shall be waived off. OPD consultations/diagnostics/pharmacy/procedure, unless covered by OPD add-on cover opted or as part of Pre/Post hospitalization of admitted in-patient/day car", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", + "source_quote": "You can submit claims as Cashless (network provider) or Reimbursement (you pay first, we reimburse if the claim is admissible).", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", + "source_quote": "not stated in acko__acko-health-iii-platinum-super-top-up__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", + "source_quote": "if Worldwide In-Patient Hospitalization cover is available in your policy schedule, this exclusion shall be waived off.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", + "source_quote": "ACKO Health III (Platinum Super Top-up) – Policy Wordings 1. Introduction & How the Policy Works", + "_confidence": "high" + }, + "modern_treatments_covered": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", + "source_quote": "Modern Treatment- Part of base SI If anyone insured undergoes in-patient or day care treatment for the following procedures, we indemnify medical expenses related to the procedures: Uterine Artery Embolization and HIFU Balloon Sinuplasty Deep Brain Stimulation Oral chemotherapy I", + "_confidence": "high" + }, + "room_rent_capping": { + "value": "No cap", + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum-super-top-up__wordings.pdf", + "source_quote": "We cover actual room rent and ICU charges without any capping. 2.3. Day Care Treatment- Part of base SI", + "_confidence": "high" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "acko insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/acko__acko-health-iii-platinum__brochure.json b/40-data/policy_facts/acko__acko-health-iii-platinum__brochure.json index 47cd39f3821b83d5748aecb1a3bfe0950553d353..25931c32309e5ec9b7184f8865bd0839da94c0e9 100644 --- a/40-data/policy_facts/acko__acko-health-iii-platinum__brochure.json +++ b/40-data/policy_facts/acko__acko-health-iii-platinum__brochure.json @@ -7,132 +7,245 @@ "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__brochure.pdf", + "_confidence": "low" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__brochure.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__brochure.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__brochure.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "source document is an image-only scan; not text-extractable (no OCR available)", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", - "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "Grace period (renewal + instalments) • For instalment premium: ▪ 15 days grace for monthly instalments ▪ 30 days grace for quarterly/half-yearly/annual instalments ▪ Coverage continues during the grace", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 30, "unit": "days", - "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "Free look period • 30 days from date of receipt of policy to review the terms and conditions of the Policy, and to return the same if not acceptable (only at inception, not renewals/porting).", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 0, + "unit": "days", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "3.1.3. 30-day waiting period (Not applicable for this plan) • Expenses for treatment of any illness within 30 days from first policy commencement excluded, except accidents.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__brochure.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__brochure.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 60, + "unit": "days", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "In the pre-hospitalization period up to 60 days, and • In the post-hospitalization period up to 180 days, only if the related hospitalization/day care claim is admissible.", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 180, + "unit": "days", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "In the pre-hospitalization period up to 60 days, and • In the post-hospitalization period up to 180 days, only if the related hospitalization/day care claim is admissible.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 500, + "source_url": "https://www.acko.com/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Acko covers all day-care procedures up to SI; 500+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf" }, "network_hospital_count": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "source document is an image-only scan; not text-extractable (no OCR available)", + "_confidence": "low" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__brochure.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", - "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "Rent / ICU- Part of base SI We cover actual room rent and ICU charges without any capping. 2.3. Day Care Treatment- Part of base SI If any insured under this policy undergoes Day Care Treatment (including AYUSH treatment) in a Hospital/Nursing Home/Day Care Centre, we cove", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__brochure.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "source document is an image-only scan; not text-extractable (no OCR available)", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "If any insured under this policy undergoes Day Care Treatment (including AYUSH treatment) in a Hospital/Nursing Home/Day Care Centre, we cover the expenses.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "Maternity Excluded: • childbirth (incl. complicated delivery/C-section) and pre/post hospitalization • miscarriage (unless due to accident) • lawful medical termination", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "2.8. Organ Donor Expenses- Part of base SI If anyone insured requires organ transplant, we cover the organ donor’s in-patient hospitalization expenses for harvesting the organ within the Sum insured of the insured.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "2.7. Domiciliary Treatment (Domiciliary Hospitalization)- Part of base SI We cover costs of such domiciliary hospitalization if anyone insured takes treatment at home (instead of a hospital)", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "if Worldwide In-Patient Hospitalization cover is available in your policy schedule, this exclusion shall be waived off.", + "_confidence": "medium" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "2.14. Preventive Health Check-up - Additional benefit and not part of base SI For insured persons aged above 18, we facilitate and provide tests as given below: • CBC, ESR, HbA1C", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "You can submit claims as Cashless (network provider) or Reimbursement (you pay first, we reimburse if the claim is admissible).", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", + "source_quote": "source document is an image-only scan; not text-extractable (no OCR available)", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", + "source_quote": "source document is an image-only scan; not text-extractable (no OCR available)", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "if Worldwide In-Patient Hospitalization cover is available in your policy schedule, this exclusion shall be waived off.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "family floater policies, one zone applies to all members under the policy. • Zone A: Delhi/NCR; Mumbai (including Navi Mumbai, Thane, Kalyan", + "_confidence": "medium" + }, + "modern_treatments_covered": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "2.11. Modern Treatment- Part of base SI If anyone insured undergoes in-patient or day care treatment for the following procedures, we indemnify medical expenses related to the procedures: • Uterine Artery Embolization and HIFU • Balloon Sinuplasty", + "_confidence": "high" + }, + "room_rent_capping": { + "value": "No room rent limit", + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "We cover actual room rent and ICU charges without any capping. 2.3. Day Care Treatment- Part of base SI", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__brochure.pdf", + "source_quote": "source document is an image-only scan; not text-extractable (no OCR available)", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/acko__acko-health-iii-platinum__wordings.json b/40-data/policy_facts/acko__acko-health-iii-platinum__wordings.json index e6cf91e4ad8b0ea3ae46bcb2c33cf5b6d9e53df6..1a29cb7c291a56219f1afcbbdd786705e55cda48 100644 --- a/40-data/policy_facts/acko__acko-health-iii-platinum__wordings.json +++ b/40-data/policy_facts/acko__acko-health-iii-platinum__wordings.json @@ -7,132 +7,249 @@ "value": "ACKHLIP27040V012627", "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: ACKHLIP27040V012627 Web: www.acko.com/gi | Toll Free: 1800 266 2256", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace period (renewal + instalments) • For instalment premium: ▪ 15 days grace for monthly instalments ▪ 30 days grace for quarterly/half-yearly/annual instalments ▪ Coverage continues during the grace", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Free look period • 30 days from date of receipt of policy to review the terms and conditions of the Policy, and to return the same if not acceptable (only at inception, not renewals/porting).", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 0, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "3.1.3. 30-day waiting period (Not applicable for this plan) • Expenses for treatment of any illness within 30 days from first policy commencement excluded, except accidents.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": null, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "In the pre-hospitalization period up to 60 days, and • In the post-hospitalization period up to 180 days, only if the related hospitalization/day care claim is admissible.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "In the pre-hospitalization period up to 60 days, and • In the post-hospitalization period up to 180 days, only if the related hospitalization/day care claim is admissible.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 500, + "source_url": "https://www.acko.com/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Acko covers all day-care procedures up to SI; 500+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 11500, + "source_url": "https://www.acko.com/health-insurance/cashless/", + "source_note": "ACKO has 11,500+ cashless hospitals across India (insurer's cashless landing page, scraped 2026-05-15)", + "_confidence": "high", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Rent / ICU- Part of base SI We cover actual room rent and ICU charges without any capping. 2.3. Day Care Treatment- Part of base SI If any insured under this policy undergoes Day Care Treatment (including AYUSH treatment) in a Hospital/Nursing Home/Day Care Centre, we cove", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "If any insured under this policy undergoes Day Care Treatment (including AYUSH treatment) in a Hospital/Nursing Home/Day Care Centre, we cover the expenses.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "Maternity Excluded: • childbirth (incl. complicated delivery/C-section) and pre/post hospitalization • miscarriage (unless due to accident) • lawful medical termination", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "Organ Donor Expenses- Part of base SI If anyone insured requires organ transplant, we cover the organ donor's in-patient hospitalization expenses for harvesting the organ within the Sum insured of the insured. Payable only if all the following conditions are met: We admit the ins", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "Domiciliary Treatment (Domiciliary Hospitalization)- Part of base SI We cover costs of such domiciliary hospitalization if anyone insured takes treatment at home (instead of a hospital) due to: Inability to be moved, OR Non-availability of hospital beds. Conditions: Must continue", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "if Worldwide In-Patient Hospitalization cover is available in your policy schedule, this exclusion shall be waived off. OPD consultations/diagnostics/pharmacy/procedure, unless covered by OPD add-on cover opted or as part of Pre/Post hospitalization of admitted in-patient/day car", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "Preventive Health Check-up - Additional benefit and not part of base SI For insured persons aged above 18, we facilitate and provide tests as given below: CBC, ESR, HbA1C Serum Creatinine, Cholesterol, HDL, Triglycerides Routine Urine Analysis SGOT, SGPT, GGT Uric Acid How it's p", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "You can submit claims as Cashless (network provider) or Reimbursement (you pay first, we reimburse if the claim is admissible).", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "if Worldwide In-Patient Hospitalization cover is available in your policy schedule, this exclusion shall be waived off.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "family floater policies, one zone applies to all members under the policy. • Zone A: Delhi/NCR; Mumbai (including Navi Mumbai, Thane, Kalyan", + "_confidence": "medium" + }, + "modern_treatments_covered": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "Modern Treatment- Part of base SI If anyone insured undergoes in-patient or day care treatment for the following procedures, we indemnify medical expenses related to the procedures: Uterine Artery Embolization and HIFU Balloon Sinuplasty Deep Brain Stimulation Oral chemotherapy I", + "_confidence": "high" + }, + "room_rent_capping": { + "value": "No cap", + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "We cover actual room rent and ICU charges without any capping. 2.3. Day Care Treatment- Part of base SI", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/acko/acko-health-iii-platinum__wordings.pdf", + "source_quote": "not stated in acko__acko-health-iii-platinum__wordings.pdf", + "_confidence": "low" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "acko insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/acko__acko-health-iii__cis.json b/40-data/policy_facts/acko__acko-health-iii__cis.json index b8d4fd113dc21d28e31da6f633e166b0258323e8..3ed1219f64a106d47929faad3a3c4e6b96b03c3a 100644 --- a/40-data/policy_facts/acko__acko-health-iii__cis.json +++ b/40-data/policy_facts/acko__acko-health-iii__cis.json @@ -7,132 +7,235 @@ "value": "ACKHLIP27040V012627", "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: ACKHLIP27040V012627| Mail: hello@acko.com Page 1 of 7 CUSTOMER INFORMATION SHEET", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Free Look cancellation: You may cancel the insurance policy if you do not want it, within 30 days from the receipt of the policy.", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": null, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": null, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 500, + "source_url": "https://www.acko.com/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Acko covers all day-care procedures up to SI; 500+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 11500, + "source_url": "https://www.acko.com/health-insurance/cashless/", + "source_note": "ACKO has 11,500+ cashless hospitals across India (insurer's cashless landing page, scraped 2026-05-15)", + "_confidence": "high", "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", + "source_quote": "2.8 Second Opinion for alternate evaluation 2.9 Ayush Treatment 2.10 Modern Treatment 2.11 Basic Benefit Options", + "_confidence": "medium" + }, + "maternity_coverage": { + "value": false, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", + "source_quote": "Medical treatment expenses related to Maternity 31.16 Expenses for Non-Payable Medical for any hospitalization, day care or domiciliary treatment Permanent Exclusions", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", + "source_quote": "2.7 Organ Donor expenses 2.8 Second Opinion for alternate evaluation 2.9 Ayush Treatment 2.10 Modern Treatment", + "_confidence": "medium" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", + "source_quote": "Restore Sum Insured 2.12.11 First Notification of Claim 2.12.12 Preferred Providers Network 2.12.13 Co-Pay 2.12.14 Floater Deductible 2.12.15 Individual Deductible 2.12.16 All medically necessary hospitalization 2.12.17 Add-on Benefits: 2.13 Access to a doctor or a general medica", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", + "source_quote": "domiciliary treatment Permanent Exclusions 3.2.1 Named Ailment waiting period or exclusion 3.2.2 Medical Practitioner Exclusion 3.2.3 For detailed exclusions please refer the policy wordings 7 Waiting Period Initial waiting Period: As per Policy Schedule 3.1.3 Specific Illness (S", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", + "source_quote": "Worldwide In-Patient Hospitalization 2.12.7 Cumulative Bonus 2.12.8 No Claim Bonus Sum Insured 2.12.9 No Claim Discount 2.12.10 Restore Sum Insured 2.12.11 First Notification of Claim 2.12.12 Preferred Providers Network 2.12.13 Co-Pay 2.12.14 Floater Deductible 2.12.15 Individual", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", + "source_quote": "2.12.3 Preventive Health Check-up 2.12.4 Inflation Protect Sum Insured 2.12.5 Initial 30 Days Waiting Period Waiver", + "_confidence": "medium" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", + "source_quote": "Cashless claim facility can be availed in all network hospitals. The list of network hospitals are available on our website or can be checked at the customer care center.", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", + "source_quote": "TAT for preauthorization of cashless facility: 1 hour ii. TAT for cashless final bill authorization: 3 hours", + "_confidence": "high" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", + "source_quote": "not stated in acko__acko-health-iii__cis.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", + "source_quote": "Type of Insurance Product Indemnity and Benefit 4 Sum Insured (Basis) Individual / Floater (Amount will be mentioned here)", + "_confidence": "medium" + }, + "modern_treatments_covered": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__cis.pdf", + "source_quote": "2.9 Ayush Treatment 2.10 Modern Treatment 2.11 Basic Benefit Options 2.12 Waiver of non-payable medical expenses", + "_confidence": "medium" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "acko insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/acko__acko-health-iii__wordings.json b/40-data/policy_facts/acko__acko-health-iii__wordings.json index 0b1c624e1d35cc8a36feaa9ee2285b2c1fe32a5b..9dbae708a1b5612166a3fdbffe4eb2e22e644e9a 100644 --- a/40-data/policy_facts/acko__acko-health-iii__wordings.json +++ b/40-data/policy_facts/acko__acko-health-iii__wordings.json @@ -7,132 +7,242 @@ "value": "ACKHLIP27040V012627", "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: ACKHLIP27040V012627 Web: www.acko.com/gi", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace period (renewal + instalments) • For instalment premium: ▪ 15 days grace for monthly instalments ▪ 30 days grace for quarterly/half-yearly/annual instalments ▪ Coverage continues during the grace", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Free look period • 30 days from date of receipt of policy to review the terms and conditions of the Policy, and to return the same if not acceptable (only at inception, not renewals/porting).", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "3.1.3. 30-day waiting period • Expenses for treatment of any illness within 30 days from first policy commencement excluded, except accidents. • Not applicable if insured has continuous coverage >12 months.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": null, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": null, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, - "unit": null, + "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, - "unit": null, + "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 500, + "source_url": "https://www.acko.com/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Acko covers all day-care procedures up to SI; 500+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 11500, + "source_url": "https://www.acko.com/health-insurance/cashless/", + "source_note": "ACKO has 11,500+ cashless hospitals across India (insurer's cashless landing page, scraped 2026-05-15)", + "_confidence": "high", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", + "source_quote": "If any insured under this policy undergoes Day Care Treatment (including AYUSH treatment) in a Hospital/Nursing Home/Day Care Centre, we cover the expenses.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", + "source_quote": "Maternity Excluded: • childbirth (incl. complicated delivery/C-section) and pre/post hospitalization • miscarriage (unless due to accident) • lawful medical termination", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", + "source_quote": "Organ Donor Expenses- Part of base SI If anyone insured requires organ transplant, we cover the organ donor's in-patient hospitalization expenses for harvesting the organ within the inpatient Sum insured of the insured. Payable only if all the following conditions are met: We adm", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", + "source_quote": "Restore Sum Insured If you exhaust your total Sum Insured in a Policy Year, we automatically refill (restore) it. How It Works: Restoration happens only: Not applicable for the first claim in the Policy Year. Available for related/unrelated illnesses as specified in Schedule. In", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", + "source_quote": "Domiciliary Treatment (Domiciliary Hospitalization)- Part of base SI We cover costs of such domiciliary hospitalization if anyone insured takes treatment at home (instead of a hospital) due to: Inability to be moved, OR Non-availability of hospital beds. Conditions: Must continue", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", + "source_quote": "if Worldwide In-Patient Hospitalization cover is available in your policy schedule, this exclusion shall be waived off. OPD consultations/diagnostics/pharmacy/procedure, unless covered by OPD add-on cover opted or as part of Pre/Post hospitalization of admitted in-patient/day car", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", + "source_quote": "Preventive Health Check-up - Additional benefit and not part of base SI For insured persons aged above 18, we facilitate and provide tests as per Schedule: CBC, ESR, HbA1C Serum Creatinine, Cholesterol, HDL, Triglycerides Routine Urine Analysis SGOT, SGPT, GGT Uric Acid How it's", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", + "source_quote": "You can submit claims as Cashless (network provider) or Reimbursement (you pay first, we reimburse if the claim is admissible).", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", + "source_quote": "Worldwide In-Patient Hospitalization- Part of base SI If opted, this benefit extends your in-patient hospitalization cover outside India.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", + "source_quote": "family floater policies, one zone applies to all members under the policy. • Zone A: Delhi/NCR; Mumbai (including Navi Mumbai, Thane, Kalyan", + "_confidence": "medium" + }, + "modern_treatments_covered": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", + "source_quote": "Modern Treatment- Part of base SI If anyone insured undergoes in-patient or day care treatment for the following procedures, we indemnify medical expenses related to the procedures: Uterine Artery Embolization and HIFU Balloon Sinuplasty Deep Brain Stimulation Oral chemotherapy I", + "_confidence": "high" + }, + "room_rent_capping": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-health-iii__wordings.pdf", + "source_quote": "not stated in acko__acko-health-iii__wordings.pdf", + "_confidence": "low" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "acko insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/acko__acko-personal-health__wordings.json b/40-data/policy_facts/acko__acko-personal-health__wordings.json index 83eb2f42aec2286468e632438ebc920150dcb640..e9c06bf28cac5c6dedf65bbd6ffe7e270eae1565 100644 --- a/40-data/policy_facts/acko__acko-personal-health__wordings.json +++ b/40-data/policy_facts/acko__acko-personal-health__wordings.json @@ -7,132 +7,235 @@ "value": "ACKHLIP25035V022425", "unit": null, "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: ACKHLIP25035V022425 Web: www.acko.com/gi | Toll Free: 1800 266 2256 | Mail: hello@acko.com Page 1 of 59 Acko Personal Health Policy", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period of fifteen days (where premium is paid on a monthly instalments) and thirty days (where premium is paid in quarterly/half yearly/annual instalments) is available on the premium due date, to pay the premium.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured shall be allowed a period of thirty days (30 days) from date of receipt of the Policy to review the terms and conditions of the Policy", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "30-day waiting period- Code- Excl03 a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 36, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 500, + "source_url": "https://www.acko.com/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Acko covers all day-care procedures up to SI; 500+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 11500, + "source_url": "https://www.acko.com/health-insurance/cashless/", + "source_note": "ACKO has 11,500+ cashless hospitals across India (insurer's cashless landing page, scraped 2026-05-15)", + "_confidence": "high", "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", + "source_quote": "AYUSH Treatment If anyone insured under the policy undergoes medical treatment at any AYUSH Hospitals or health care facilities for any of the listed AYUSH treatments namely Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy, we will indemnify the medical expenses", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", + "source_quote": "Maternity: Code Excl18 i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", + "source_quote": "Organ Donor Expenses ............................................................................................ 16 3.2.9 Second Opinion ....................................................................................................... 17 3.2.10 AYUSH Treatment ............", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", + "source_quote": "Restore Sum Insured ............................................................................................... 18 3.3.3 No Claim Bonus Sum Insured .................................................................................. 19 3.3.4 First Notification of Claim ........", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", + "source_quote": "Domiciliary Treatment .............................................................................................. 16 3.2.8 Organ Donor Expenses ............................................................................................ 16 3.2.9 Second Opinion ................", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", + "source_quote": "Worldwide in-patient hospitalization .......................................................................... 17 3.3.2 Restore Sum Insured ............................................................................................... 18 3.3.3 No Claim Bonus Sum Insured .......", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", + "source_quote": "Preventive Health Check-up ..................................................................................... 21 3.3.12 Inflation Protect Sum Insured ................................................................................... 22 3.3.13 Initial 30 days waiting period wa", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the Network Provider by the insurer", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", + "source_quote": "Territorial Limit All medical treatment for the purpose of this Insurance will have to be taken in India only.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", + "source_quote": "family floater policies, a single zone shall be applied to all the members covered under the same Policy. The two zones are defined below: Zone A: Delhi/NCR, Mumbai including (Navi Mumbai, Thane and Kalyan)", + "_confidence": "medium" + }, + "modern_treatments_covered": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", + "source_quote": "Modern Treatment ................................................................................................... 17 3.3 Basic benefit options ...................................................................................................... 17 3.3.1 Worldwide in-patient h", + "_confidence": "high" + }, + "room_rent_capping": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/acko/acko-personal-health__wordings.pdf", + "source_quote": "not stated in acko__acko-personal-health__wordings.pdf", + "_confidence": "low" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "acko insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/acko__arogya-sanjeevani__wordings.json b/40-data/policy_facts/acko__arogya-sanjeevani__wordings.json index da9e08790999ed07e1f60b698448902ec13e160a..32fc32cf08ee9c6c2ddf7d6ca793e0208e23d5ed 100644 --- a/40-data/policy_facts/acko__arogya-sanjeevani__wordings.json +++ b/40-data/policy_facts/acko__arogya-sanjeevani__wordings.json @@ -7,138 +7,244 @@ "value": "ACKHLIP20183V011920", "unit": null, "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: ACKHLIP20183V011920 HSN: 9971 | Mail: hello@acko.com Page 1 of 33 Arogya Sanjeevani Policy - Acko General Insurance Limited Policy Wordings", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Eligibility Policy can be availed by persons between the age of 18 years and 65years, as Proposer.", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Eligibility Policy can be availed by persons between the age of 18 years and 65years, as Proposer.", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "dependent Children (i.e. natural or legally adopted) between the age 3 months to 25 years. If the child above 18 years of age is financially independent, he or she shall be ineligible for coverage in the subsequent renewals. 3.19 Grace Peri", + "_confidence": "medium" }, "sum_insured_options": { - "value": [ - 100000, - 200000, - 300000, - 500000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in acko__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases.", + "_confidence": "high" }, "free_look_period": { - "value": 15, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Free Look Period A period of 30 days (from the date of receipt of the policy document) is available to the policyholder to review the terms and conditions of the policy.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. b. This exclusion shall not, however, apply if the Insured Person has Continuous Coverage for more than twelve months.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 48, - "unit": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with us.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Specific Waiting Period (Code- Excl02) a. Expenses related to the treatment of the following listed conditions, surgeries/treatments shall be excluded until the expiry of24/36 months of continuous coverage, as may be the case after the date of inception of the first policy with the insurer.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "period of 30 days prior to the date of admissible hospitalization covered under the policy.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "a fixed period of 60 days from the date of discharge from the hospital, following an admissible hospitalization covered under the policy.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 500, + "source_url": "https://www.acko.com/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Acko covers all day-care procedures up to SI; 500+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 11500, + "source_url": "https://www.acko.com/health-insurance/cashless/", + "source_note": "ACKO has 11,500+ cashless hospitals across India (insurer's cashless landing page, scraped 2026-05-15)", + "_confidence": "high", "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { - "value": null, + "value": 5, "unit": "percent", "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Co-payment Each and every claim under the Policy shall be subject to a Co-payment of 5% applicable to claim amount admissible and payable as per the terms and conditions of the Policy.", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 2, + "unit": "%", "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home up to 2% of the sum insured subject to maximum of Rs.5000 /-, per day. ii. Intensive Care Unit (ICU)/ Intensive Cardiac Care Unit (ICCU) expenses up to 5% of s", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy period means period of one policy year as mentioned in the schedule for which the Policy is issued", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in acko__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_quote": "AYUSH Treatment The Company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the limit of sum insured as specified in the policy schedule", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": null, + "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_quote": "Maternity Expenses (Code - Exel18): i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in acko__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in acko__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_quote": "7.18 Any expenses incurred on Domiciliary Hospitalization and OPD treatment 7.19 Treatment taken outside the geographical limits of India", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_quote": "Treatment taken outside the geographical limits of India 7.20 In respect of the existing diseases, disclosed by the insured and mentioned in the policy schedule(based on insured's consent), policyholder is not entitled t", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in acko__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured person in accordance with the Policy terms and conditions, are directly mad e to the network provider by the insurer to the extent pr", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_quote": "increased by 5% in respect of each claim free policy year (where no claims are reported), provided the policy is renewed with the company without a break subject to maximum of 50% of the sum insured under the current policy year.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_quote": "Territorial Limit All medical treatment for the purpose of this insurance will have to be taken in India only.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_quote": "in respect of that Insured Person (on Individual basis) or all Insured Persons (on Floater basis)", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "2% of Sum Insured", + "unit": null, + "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_quote": "Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home up to 2% of the sum insured subject to maximum of Rs.5000 /-, per day.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/acko/arogya-sanjeevani__wordings.pdf", + "source_quote": "increased by 5% in respect of each claim free policy year (where no claims are reported), provided the policy is renewed with the company without a break subject to maximum of 50% of the sum insured under the current policy year.", + "_confidence": "high" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "acko insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/aditya-birla__activ-assure-diamond.json b/40-data/policy_facts/aditya-birla__activ-assure-diamond.json index 4abbb8ab67e1f8fd8e5da5e3f18152de77a5d14e..23a9b2fe358bf08763b63ace6b5dc0fc7e6b1a52 100644 --- a/40-data/policy_facts/aditya-birla__activ-assure-diamond.json +++ b/40-data/policy_facts/aditya-birla__activ-assure-diamond.json @@ -8,27 +8,25 @@ "source_quote": "Product Name: Activ Assure, Product UIN: ADIHLIP18077V011718" }, "min_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "Dependent Children ... between the age 91 days to 25 years (standard ABHI Activ family entry; child entry 91 days)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "Adult entry age 18-65 years (standard Activ Assure entry per Policy Schedule)" - }, - "max_renewal_age": { "value": null, + "unit": "years", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "Lifelong renewability provided under standard Renewal clause" + "source_quote": "not stated in aditya-birla__activ-assure-diamond.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "Sum Insured ... up to 75 Lakh rupees ... Sum Insured above 75 Lakh rupees (range up to and above 75 Lakh referenced; full option list per Product Benefit Table)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -36,9 +34,11 @@ "source_quote": "i. First 30 days waiting period We shall not be liable for any claim arising due to any condition ... commencing within 30 days from Policy Commencement Date" }, "pre_existing_disease_waiting_months": { - "value": 36, + "value": 24, + "unit": "months", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "Pre-Existing Diseases shall not be covered until the time period specified in the Policy Schedule (standard ABHI 36-month PED, optional 24-month buy-down per 'applicable Pre Existing Disease waiting period for claims related to Pre-Existing Diseases to 24 months')" + "source_quote": "for Hospitalization in respect of diagnosis/treatment of any Pre-Existing Disease after 24 months, as applicable and mentioned in the Policy Schedule, if continuous coverage has elapsed, since the inception of the first Policy with Us.", + "_confidence": "medium" }, "specific_disease_waiting_months": { "value": 24, @@ -48,7 +48,8 @@ "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "maternity or birth (including caesarean section) except in the case of ectopic pregnancy for in-patient only. (Maternity excluded in base)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, @@ -56,19 +57,24 @@ "source_quote": "Pre-hospitalization Medical Expenses ... up to the Sum Insured for the number of days in accordance with the limit as specified in the Policy Schedule (standard ABHI Activ Assure Diamond: 60 days)" }, "post_hospitalization_days": { - "value": 180, + "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "Post-hospitalization Medical Expenses ... up to the Sum Insured for the number of days specified in the Policy Schedule (standard ABHI Activ Assure Diamond: 180 days post-hospitalization)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "Day Care Treatment ... list of such Day Care Treatment is mentioned in Annexure II" + "value": 586, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/activ-one-plan", + "source_note": "Per insurer baseline (Aditya Birla Activ One MAX / Activ Care: 586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf" }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "AYUSH Hospitals having registration with a Government authority under appropriate Act ... (covered under AYUSH Treatment benefit; though pre/post hospitalization for AYUSH not covered)" + "source_quote": "given under ‘Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.", + "_confidence": "high" }, "maternity_coverage": { "value": false, @@ -76,9 +82,10 @@ "source_quote": "maternity or birth (including caesarean section) except in the case of ectopic pregnancy for in-patient only. (Excluded under permanent exclusions in base policy)" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "New Born Baby means baby born during the Policy Period and is aged upto 90 days (definition only; base policy does not include newborn cover without maternity)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, @@ -96,49 +103,83 @@ "source_quote": "(h) Reload of Sum Insured: ... Once in the Policy Year, We shall provide for a reload of the Sum Insured up to the limits as specified in the Policy Schedule" }, "room_rent_capping": { - "value": "Single Private A/C Room (subject to Product Benefit Table limits per SI slab)", + "value": "Single Private A/C Room", + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "Single Private A/C Room is not available (proportionate deduction clause applies if higher category room is opted)" + "source_quote": "the room type is “Single Private A/C Room (upgradable to next level, only if Single Private A/C Room is not available)”", + "_confidence": "medium" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "payment per claim (over and above any other Co-payment, if any) as specified in Product Benefit Table/Policy Schedule (no mandatory base copay — depends on SI slab/zone for higher entry-age plans)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible in Activ Assure Diamond" + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "not stated in aditya-birla__activ-assure-diamond.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; Aditya Birla Health advertises 10,000+ network hospitals on its website (not extracted in this pass)" + "value": 10051, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/health-insurance-plans", + "source_note": "Cashless facility available at 10051+ network hospitals (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "Cashless facility extended via PPN/Network Provider (standard ABHI clause; cashless settlement defined in policy)" + "source_quote": "Cashless Facilities can be availed only at Our Network Providers / Empanelled Service Providers.", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in aditya-birla__activ-assure-diamond.pdf", + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, + "value": 24, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "We shall settle or repudiate a claim within 30 days of the receipt of the last necessary information (claim settlement TAT; cashless authorization TAT governed by IRDAI Master Circular)" + "source_quote": "easons for the rejection. (iv) The Authorization letter shall be issued to the Network Provider within 24 hours of receiving the complete information. c. Process to b", + "_confidence": "medium" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "In-patient Hospitalization ... reimbursement basis ... up to the Sum Insured (indemnity-based)" + "source_quote": "Where the Policyholder/Insured Person has policies from more than one insurer to cover the same risk on indemnity basis, the Policyholder/Insured Person shall only be indemnified the Hospitalization", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", "completeness_pct": 82, - "notes": "Most benefit limits reference Product Benefit Table (variant-driven). SI options + day-care count not explicit in wording body." + "notes": "Most benefit limits reference Product Benefit Table (variant-driven). SI options + day-care count not explicit in wording body. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "Road Ambulance Cover: What is covered We shall cover the costs incurred up to the limits as specified in the Policy Schedule / Product Benefit Table o", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "Domiciliary Hospitalization (Home Care): What is covered We shall cover the Medical Expenses incurred for the Insured Pe", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "Annual Health Check up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/aditya-birla__activ-assure-diamond__wordings.json b/40-data/policy_facts/aditya-birla__activ-assure-diamond__wordings.json index 967f54b2fe8db92bb2ac6244910446f4eeb3d839..a38623b0df9c409065144aaa32397558c5310694 100644 --- a/40-data/policy_facts/aditya-birla__activ-assure-diamond__wordings.json +++ b/40-data/policy_facts/aditya-birla__activ-assure-diamond__wordings.json @@ -7,132 +7,251 @@ "value": "ADIHLIP18077V011718", "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Product UIN: ADIHLIP18077V011718", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in aditya-birla__activ-assure-diamond__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "in no case later than the Grace Period of 30 days from the expiry date.", + "_confidence": "high" }, "free_look_period": { "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "We shall provide You a period of 15 days (30 days in case of contracts with a term of 3 years, offered over distance marketing mode) from the date of receipt of the Policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period We shall not be liable for any claim arising due to any condition for which appearance of signs/symptoms, consultation, investigation, treatment or admission commencing within 30 days from Policy Commencement Date", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 48, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in activ-assure-diamond__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Two Year waiting periods The conditions listed below, whether medical or surgical and of the Illness/conditions and their complications mentioned below, will be subject to a waiting period of 24 months from the commencement of the 1st Policy Year", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in activ-assure-diamond__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 180, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in activ-assure-diamond__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, + "value": 586, + "unit": "count", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "585 Chalazion Surgery 586 Circumcision Surgery", + "_confidence": "high" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 10051, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/health-insurance-plans", + "source_note": "Cashless facility available at 10051+ network hospitals (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in aditya-birla__activ-assure-diamond__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "given under ‘Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "not stated in aditya-birla__activ-assure-diamond.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "(g) Organ Donor Expenses: What is covered We shall cover the Medical Expenses, up to the limits as specified in the Policy Schedule / Product Benefit Table of this Policy, incurred in respect of the organ donor, for organ transplant Surgery towards the harvesting of the organ donated.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "(h) Reload of Sum Insured: What is covered Once in the Policy Year, We shall provide for a reload of the Sum Insured up to the limits as specified in the Policy Schedule / Product Benefit Table of this Policy", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "(e) Domiciliary Hospitalization (Home Care): What is covered We shall cover the Medical Expenses incurred for the Insured Person’s Domiciliary Hospitalization, up to the limits as specified in the Policy Schedule / Product Benefit Table of this Policy, during the Policy Period following an Illness or Injury that occurs during the Policy Period.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "(p) International Emergency Assistance Services (including Air Ambulance) What is covered We will provide the Emergency medical assistance outside India as described below when an Insured Person is travelling 150 (one hundred and fifty) kilometres or more away from his/her residential address as mentioned in the Policy Schedule for a period of less than 90(ninety) days.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "(m) Health Check-up Program What is covered All Insured Persons in the Policy may avail a comprehensive health check-up once in a Policy Year in accordance with the table below:", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "Cashless Facilities can be availed only at Our Network Providers / Empanelled Service Providers.", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "The accumulated No Claim Bonus shall not exceed 50% of the Sum Insured on the Renewed Policy.", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": 24, + "unit": "hours", + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "pre-authorise Cashless Facility within 24 hours of the Insured Person’s Hospitalization if the Insured Person has been Hospitalized in an Emergency.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "All benefits are available in India only (except section B.II.p), and all claims shall be payable in India in Indian Rupees only.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "In case of a Family Floater Policy, the reload of Sum Insured shall be available on a floater basis", + "_confidence": "medium" + }, + "modern_treatments_covered": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "45. Robotic surgery (whether invasive or non-invasive) unless specifically approved by Us. 46. All forms of Bariatric surgery. 47. Use of Radio Frequency (RF) probe for", + "_confidence": "high" + }, + "room_rent_capping": { + "value": "Single Private A/C Room", + "unit": null, + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "the room type is “Single Private A/C Room (upgradable to next level, only if Single Private A/C Room is not available)”", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/aditya-birla/activ-assure-diamond__wordings.pdf", + "source_quote": "not stated in activ-assure-diamond__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/aditya-birla__activ-health-individual__wordings.json b/40-data/policy_facts/aditya-birla__activ-health-individual__wordings.json index 7cefb03b83407ed4e73c79ef61bfa8478ca23b77..3e8eb6736c465f38880d97d613c1e8b232a70c14 100644 --- a/40-data/policy_facts/aditya-birla__activ-health-individual__wordings.json +++ b/40-data/policy_facts/aditya-birla__activ-health-individual__wordings.json @@ -10,52 +10,60 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-health-individual__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-health-individual__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in activ-health-individual__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "maternity_coverage": { - "value": null, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" + "source_quote": "Where Maternity Expenses is opted as an Optional Cover under this Policy, We will cover Maternity Expenses up to the Maternity Sum Insured specified in the Policy Schedule", + "_confidence": "medium" }, "maternity_waiting_months": { - "value": null, + "value": 48, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" + "source_quote": "Maternity Waiting Period Any treatment arising from or traceable to pregnancy, childbirth including caesarean section will not be covered until 48 months of continuous coverage has elapsed for that particular Insured Person since the inception of the Maternity Expenses Benefit under the Policy for that Insured Person.", + "_confidence": "high" }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Ayush Cover:\nWhat is covered" + "source_quote": "given under ‘Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Cashless Facility" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured", + "_confidence": "high" }, "copayment_pct": { - "value": 10, + "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Co-payment applicable\nZone II Zone I 10%" + "source_quote": "not stated in aditya-birla__activ-health-individual.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 100, @@ -63,59 +71,78 @@ "source_quote": "Cumulative Bonus shall not exceed 100%" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" + "source_quote": "Once in the Policy Year, We shall provide for a reload of the Sum Insured up to the limits as specified in the Policy Schedule / Product Benefit Table of this Policy, in case the available Sum Insured which shall be considered to be inclusive of accumulated Cumulative Bonus (if any), is insufficient for covering a claim under the Policy as a result of previous claims in that Policy Year.", + "_confidence": "high" }, "room_rent_capping": { - "value": "Room Rent for accommodation in Hospital room and other boarding charges up to", + "value": "Single Private A/C Room", + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Room Rent for accommodation in Hospital room and other boarding charges up to" + "source_quote": "Single Private A/C Room means a basic (most economical of all accommodation) category of single room in a Hospital with air-conditioning facility", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-health-individual__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-health-individual__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" + "value": 586, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/activ-one-plan", + "source_note": "Per insurer baseline (Aditya Birla Activ One MAX / Activ Care: 586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" + "value": 10051, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/health-insurance-plans", + "source_note": "Cashless facility available at 10051+ network hospitals (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-health-individual__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-health-individual__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, + "value": 24, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "" + "source_quote": "The Authorization letter shall be issued to the Network Provider within 24 hours of receiving the complete information.", + "_confidence": "high" }, "policy_type": { "value": "hospital_cash", "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "classified as hospital_cash from PDF heuristics" + "source_quote": "Where an insured person has policies from more than one insurer to cover the same risk on indemnity basis, the insured person shall only be indemnified the treatment costs in accordance with the terms and conditions of the chosen policy.", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", "completeness_pct": 32, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" + }, + "co_payment_pct": { + "value": 10, + "unit": "percent", + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_quote": "Co-payment applicable 10% 15% 25%", + "_confidence": "medium" } } \ No newline at end of file diff --git a/40-data/policy_facts/aditya-birla__activ-health.json b/40-data/policy_facts/aditya-birla__activ-health.json index eb66b7bfa0470f5dbe5bf3e044023671df9756af..fcc064054f25a96928c67610379eb93fee53f256 100644 --- a/40-data/policy_facts/aditya-birla__activ-health.json +++ b/40-data/policy_facts/aditya-birla__activ-health.json @@ -11,18 +11,15 @@ "value": null, "unit": "days", "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in aditya-birla__activ-health.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in aditya-birla__activ-health.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -38,47 +35,59 @@ "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "reimbursement basis, for upto 30 days from the date of discharge from Hospitals and up to the limits specified against Benefit C.IV.(31) in the Policy Schedule / Product Benefit Table of this Policy. " + "source_quote": "The symptoms of the Major Illness first occur or manifest itself during the Policy Period and after completion of the initial waiting period of 30 days, subject to applicability of any waiting periods specified in the Policy Schedule.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "not stated in aditya-birla__activ-health.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "Expenses related to the treatment of the listed Conditions, surgeries / treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with Us. This exclusion shall not be applicable for claims arising due to an accident.", + "_confidence": "high" }, "maternity_waiting_months": { - "value": null, + "value": 48, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "Cover under this Policy, We will cover Maternity Expenses up to the Maternity Sum Insured specified in the Policy Schedule after a waiting period of 48 months from the inception of the 1st Policy where Maternity Ex", + "_confidence": "high" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "not stated in aditya-birla__activ-health.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "not stated in aditya-birla__activ-health.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 527, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/activ-health", + "source_note": "Aditya Birla Activ Health policy lists 527 day care procedures", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf" }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "visible and violent means. 2. AYUSH Hospital is a healthcare facility wherein medical / surgical / para-surgical treatment procedures and interventions are carried out by AYUSH Medical Practitioner(s)" + "source_quote": "given under ‘Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.", + "_confidence": "high" }, "maternity_coverage": { - "value": false, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "8. Maternity Expenses (Code - Excl18): i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic" + "source_quote": "Where Maternity Expenses is opted as an Optional Cover under this Policy, We will cover Maternity Expenses up to the Maternity Sum Insured specified in the Policy Schedule", + "_confidence": "medium" }, "newborn_coverage": { "value": true, @@ -88,7 +97,8 @@ "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Organ Donor Expenses: What is covered We shall cover the Medical Expenses, up to the limits as specified in the Policy Schedule / Product Benefit Table of this Policy, incurred by or in respect of the" + "source_quote": "(7) Organ Donor Expenses: What is covered We shall cover the Medical Expenses, up to the limits as specified in the Policy Schedule / Product Benefit Table of this Policy, incurred by or in respect of the organ donor, for an organ transplant Surgery accepted by Us under Section C.I.(1) solely towards the harvesting of the organ donated.", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": 100, @@ -101,50 +111,91 @@ "source_quote": "reinstatement" }, "room_rent_capping": { - "value": "room category / limit that is higher than the one that is specified in the Policy Schedule / Product", + "value": "Single Private A/C Room", + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "room category / limit that is higher than the one that is specified in the Policy Schedule / Product" + "source_quote": "Single Private A/C Room means a basic (most economical of all accommodation) category of single room in a Hospital with air-conditioning facility", + "_confidence": "medium" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in aditya-birla__activ-health-individual.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in aditya-birla__activ-health.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 10051, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/health-insurance-plans", + "source_note": "Cashless facility available at 10051+ network hospitals (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "UIN: ADIHLIP24102V052324. 4. Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the pol" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in aditya-birla__activ-health.pdf", + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "value": 24, + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_quote": "asons for the rejection. (iv) The Authorization letter shall be issued to the Network Provider within 24 hours of receiving the complete information. c. Process to be", + "_confidence": "medium" }, "policy_type": { "value": "hospital-cash", "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "Where an insured person has policies from more than one insurer to cover the same risk on indemnity basis, the insured person shall only be indemnified the treatment costs in accordance with the terms and conditions of the chosen policy.", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 70, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_quote": "Ambulance means a road vehicle or aircraft operated by a licenced / authorised service provider and equipped for the transport and paramedical treatme", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness / disease / injury which in the normal course would r", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_quote": "Annual Health Check up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "co_payment_pct": { + "value": 10, + "unit": "percent", + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_quote": "Co-payment applicable 10% 15% 25%", + "_confidence": "medium" } } \ No newline at end of file diff --git a/40-data/policy_facts/aditya-birla__activ-one.json b/40-data/policy_facts/aditya-birla__activ-one.json index ebfe9e9dd89839bb6e60593e01f33dce694c7cd6..a0cb5a55ddb9e0e5e3e20a109396666be23b8917 100644 --- a/40-data/policy_facts/aditya-birla__activ-one.json +++ b/40-data/policy_facts/aditya-birla__activ-one.json @@ -14,36 +14,36 @@ "source_quote": "Dependent Children (upto 3) (i.e. natural or legally adopted) between the age 3 months to 25 years." }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Adult entry age 18-65 years (standard ABHI Activ Health/Activ One; per Product Benefit Table)" - }, - "max_renewal_age": { "value": null, + "unit": "years", "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Lifelong renewability provided under Renewal clause" + "source_quote": "not stated in aditya-birla__activ-health-individual.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Sum Insured up to 75 Lakh ... above 75 Lakh (range observed; full option list per Product Benefit Table — typically 2L to 2Cr)" + "source_quote": "not stated in aditya-birla__activ-one.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "3. 30-day waiting period (Code- Excl03) ... i. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded" + "source_quote": "The symptoms of the Major Illness first occur or manifest itself during the Policy Period and after completion of the initial waiting period of 30 days, subject to applicability of any waiting periods specified in the Policy Schedule.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 36, + "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Pre-Existing Diseases (Code- Excl01) ... excluded until the expiry of the number of months of continuous coverage after the date of inception ... as specified in the Policy Schedule (standard ABHI Activ One: 36 months; optional buy-down to 24 months)" + "source_quote": "not stated in aditya-birla__activ-health-individual.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "2. Specified disease / procedure waiting period: (Code- Excl02) ... excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy" + "source_quote": "Expenses related to the treatment of the listed Conditions, surgeries / treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with Us. This exclusion shall not be applicable for claims arising due to an accident.", + "_confidence": "high" }, "maternity_waiting_months": { "value": 48, @@ -51,39 +51,49 @@ "source_quote": "Insured specified in the Policy Schedule after a waiting period of 48 months from the inception of the 1st Policy where Maternity ... (48-month maternity waiting under optional Maternity cover)" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Pre-hospitalization Medical Expenses means medical expenses incurred during pre-defined number of days preceding the hospitalization ... (Activ One/Activ Health Diamond+: 60 days)" + "source_quote": "not stated in aditya-birla__activ-health-individual.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 180, + "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Post-hospitalization Medical Expenses means medical expenses incurred during pre-defined number of days immediately after the hospitalization ... (Activ One/Activ Health Diamond+: 180 days)" + "source_quote": "not stated in aditya-birla__activ-health-individual.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Day Care Treatment ... list of such Day Care Treatment is mentioned in Annexure II (586 day-care procedures cited in ABHI product brochures)" + "value": 586, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/activ-one-plan", + "source_note": "Aditya Birla Activ One (incl. MAX/NXT) covers 586 day care procedures", + "_confidence": "high", + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf" }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "AYUSH Hospital is a healthcare facility wherein medical / surgical / para-surgical treatment procedures and interventions are carried out by AYUSH Medical Practitioner(s) ... (covered)" + "source_quote": "given under ‘Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.", + "_confidence": "high" }, "maternity_coverage": { - "value": false, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "18. Maternity Expenses (Code - Excl18): i. Medical treatment expenses traceable to childbirth ... (excluded in base; optional Maternity/Parenthood cover available with 48-month waiting)" + "source_quote": "Where Maternity Expenses is opted as an Optional Cover under this Policy, We will cover Maternity Expenses up to the Maternity Sum Insured specified in the Policy Schedule", + "_confidence": "medium" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Newborn cover linked to Maternity cover (base policy does not include newborn baby cover; available via optional Maternity add-on)" + "source_quote": "not stated in aditya-birla__activ-health-individual.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Organ Donor expenses ... incurred in respect of the organ donor, for organ transplant Surgery towards the harvesting of the organ donated (covered)" + "source_quote": "(7) Organ Donor Expenses: What is covered We shall cover the Medical Expenses, up to the limits as specified in the Policy Schedule / Product Benefit Table of this Policy, incurred by or in respect of the organ donor, for an organ transplant Surgery accepted by Us under Section C.I.(1) solely towards the harvesting of the organ donated.", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": 100, @@ -93,52 +103,94 @@ "restoration_benefit": { "value": "Reload of Sum Insured (once per policy year) + Super Reload (unlimited subsequent claims for any illness)", "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "(8) Reload of Sum Insured: ... insufficient for covering a claim ... Reload of Sum Insured shall be available only [once]. Super Reload of Sum Insured shall apply to the first claim in the Policy Year" + "source_quote": "(8) Reload of Sum Insured: What is covered Table of this Policy, in case the available Sum Insured which shall be considered to be inclusive of accumulated Cumulative Bonus (if any), is", + "_confidence": "high" }, "room_rent_capping": { - "value": "Single Private A/C Room (no rent cap on higher plan variants; proportionate deduction if higher category opted)", + "value": "Single Private A/C Room", + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Proportionate deductions are not applicable for ICU charges. Such proportionate deductions ... will not be applied in respect of the Hospitals which do not follow differential billing" + "source_quote": "Single Private A/C Room means a basic (most economical of all accommodation) category of single room in a Hospital with air-conditioning facility", + "_confidence": "medium" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "No mandatory base copayment (zone-based or senior-entry copays apply only per Product Benefit Table)" + "source_quote": "not stated in aditya-birla__activ-health-individual.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible in Activ One/Activ Health" + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_quote": "not stated in aditya-birla__activ-one.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; Aditya Birla Health advertises 10,000+ network hospitals on its website" + "value": 10051, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/health-insurance-plans", + "source_note": "Cashless facility available at 10051+ network hospitals (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "Network Provider means hospitals enlisted by an insurer, TPA or jointly by an Insurer and TPA to provide medical services to an insured by a cashless facility." + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in aditya-birla__activ-one.pdf", + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "value": 24, + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_quote": "asons for the rejection. (iv) The Authorization letter shall be issued to the Network Provider within 24 hours of receiving the complete information. c. Process to be", + "_confidence": "medium" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", - "source_quote": "In-patient Hospitalization ... reimbursement basis ... up to the Sum Insured (indemnity-based)" + "source_quote": "Where an insured person has policies from more than one insurer to cover the same risk on indemnity basis, the insured person shall only be indemnified the treatment costs in accordance with the terms and conditions of the chosen policy.", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", "completeness_pct": 78, - "notes": "Activ One brochure is image-only (no extractable text); curated from activ-health-individual wordings PDF which is the underlying UIN. Activ One is the current commercial flagship variant of Activ Health." + "notes": "Activ One brochure is image-only (no extractable text); curated from activ-health-individual wordings PDF which is the underlying UIN. Activ One is the current commercial flagship variant of Activ Health. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_quote": "Ambulance means a road vehicle or aircraft operated by a licenced / authorised service provider and equipped for the transport and paramedical treatme", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness / disease / injury which in the normal course would r", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_quote": "Annual Health Check up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "co_payment_pct": { + "value": 10, + "unit": "percent", + "source_pdf_path": "rag/corpus/aditya-birla/activ-health-individual__wordings.pdf", + "source_quote": "Co-payment applicable 10% 15% 25%", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/aditya-birla__activ-secure-cancer-secure__brochure.json b/40-data/policy_facts/aditya-birla__activ-secure-cancer-secure__brochure.json index f5e98cf7aef79f8c4e4e6a519a688d62515889ce..baf24489f7ade999cc8c04e109ba36ff0afb1b7f 100644 --- a/40-data/policy_facts/aditya-birla__activ-secure-cancer-secure__brochure.json +++ b/40-data/policy_facts/aditya-birla__activ-secure-cancer-secure__brochure.json @@ -8,24 +8,23 @@ "source_quote": "UIN: ADIHLIP18076V011718" }, "min_entry_age": { - "value": null, + "value": 18, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "source_quote": "Eligibility Criteria Minimum entry age - 18 years i. Age Maximum entry age - 65 years ii. 1,2,3 years Tenure", + "_confidence": "high" }, "max_entry_age": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, + "value": 65, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "source_quote": "Eligibility Criteria Minimum entry age - 18 years i. Age Maximum entry age - 65 years ii. 1,2,3 years Tenure", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in activ-secure-cancer-secure__brochure.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 90, @@ -34,28 +33,36 @@ }, "maternity_coverage": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in activ-secure-cancer-secure__brochure.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-cancer-secure__brochure.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in activ-secure-cancer-secure__brochure.pdf", + "_confidence": "low" }, "cashless_treatment_supported": { - "value": null, + "value": false, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "source_quote": "Payout Option: Lump sum payout", + "_confidence": "high" }, "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-cancer-secure__brochure.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 10, @@ -65,57 +72,69 @@ "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-cancer-secure__brochure.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in activ-secure-cancer-secure__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-cancer-secure__brochure.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-cancer-secure__brochure.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "value": 586, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/activ-one-plan", + "source_note": "Per insurer baseline (Aditya Birla Activ One MAX / Activ Care: 586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "value": 10051, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/health-insurance-plans", + "source_note": "Cashless facility available at 10051+ network hospitals (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "Sum Insured Options " + "source_quote": "not stated in aditya-birla__activ-secure-cancer-secure__brochure.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-cancer-secure__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-cancer-secure__brochure.pdf", + "_confidence": "low" }, "policy_type": { - "value": "hospital_cash", + "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", - "source_quote": "classified as hospital_cash from PDF heuristics" + "source_quote": "not stated in aditya-birla__activ-secure-cancer-secure.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/aditya-birla/activ-secure-cancer-secure__brochure.pdf", "completeness_pct": 18, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } } \ No newline at end of file diff --git a/40-data/policy_facts/aditya-birla__activ-secure-personal-accident-cancer-secure__wordings.json b/40-data/policy_facts/aditya-birla__activ-secure-personal-accident-cancer-secure__wordings.json index c64d7091a96b36f5d5153741dbc984ed883de14f..d55ee0e97f20e1a7a8860326957083c0fa0d52bd 100644 --- a/40-data/policy_facts/aditya-birla__activ-secure-personal-accident-cancer-secure__wordings.json +++ b/40-data/policy_facts/aditya-birla__activ-secure-personal-accident-cancer-secure__wordings.json @@ -10,52 +10,60 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-personal-accident-cancer-secure__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-personal-accident-cancer-secure__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of the 36 months" + "source_quote": "Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of the 36 months of continuous coverage after the date of inception of the first policy with Us.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-personal-accident-cancer-secure__wordings.pdf", + "_confidence": "low" }, "maternity_coverage": { - "value": null, + "value": false, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "source_quote": "miscarriage (except as a result of an Accident or Illness), maternity or birth (including caesarean section) except in the case of ectopic pregnancy for In-patient only.", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-personal-accident-cancer-secure__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in activ-secure-personal-accident-cancer-secure__wordings.pdf", + "_confidence": "low" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "Cashless facility" + "source_quote": "Cashless facilities can be availed only at Our Network Providers.", + "_confidence": "medium" }, "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-personal-accident-cancer-secure__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 5, @@ -65,57 +73,69 @@ "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-personal-accident-cancer-secure__wordings.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in activ-secure-personal-accident-cancer-secure__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-personal-accident-cancer-secure__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-personal-accident-cancer-secure__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "value": 586, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/activ-one-plan", + "source_note": "Per insurer baseline (Aditya Birla Activ One MAX / Activ Care: 586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "value": 10051, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/health-insurance-plans", + "source_note": "Cashless facility available at 10051+ network hospitals (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-personal-accident-cancer-secure__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__activ-secure-personal-accident-cancer-secure__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, + "value": 24, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "" + "source_quote": "facilities in Emergencies (i) We must be contacted to pre-authorize Cashless facility within 24 hours of the Insured Person’s Hospitalization if the Insured Pers", + "_confidence": "medium" }, "policy_type": { - "value": "hospital_cash", + "value": null, "source_pdf_path": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", - "source_quote": "classified as hospital_cash from PDF heuristics" + "source_quote": "not stated in aditya-birla__activ-secure-personal-accident-cancer-secure.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/aditya-birla/activ-secure-personal-accident-cancer-secure__wordings.pdf", "completeness_pct": 23, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } } \ No newline at end of file diff --git a/40-data/policy_facts/aditya-birla__group-activ-health__wordings.json b/40-data/policy_facts/aditya-birla__group-activ-health__wordings.json index 63cb4386a2b2591f194e238f1d80f08c7477fb85..2dd1359227de51f2c7d50702b7b4f4a32df8415a 100644 --- a/40-data/policy_facts/aditya-birla__group-activ-health__wordings.json +++ b/40-data/policy_facts/aditya-birla__group-activ-health__wordings.json @@ -8,34 +8,36 @@ "source_quote": "UIN: ADIHLGP26041V052526" }, "min_entry_age": { - "value": null, + "value": 1, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "source_quote": "18. Eligibility Minimum Entry Age 1 day Maximum Entry Age No Limit", + "_confidence": "high" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__group-activ-health__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in group-activ-health__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "source_quote": "30-day waiting period (Code- Excl03) a) Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "maternity_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "maternity\n(including but not limited to medical complications arising out of such delivery).\n(iii) Claim in respect of a" + "source_quote": "Maternity Benefit – Comprehensive (Over and above Base Cover In-patient Hospitalisation Sum Insured) i. We shall cover below benefits under this section without any selection upto Maternity Benefit limit chosen", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 18, @@ -43,79 +45,97 @@ "source_quote": "maternity\n(including but not limited to medical complications arising out of such delivery).\n(iii) Claim in respect of a" }, "ayush_coverage": { - "value": null, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "source_quote": "AYUSH Treatment We will cover the Medical Expenses for medically required AYUSH Treatments undergone as an In-patient Treatment", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "Cashless Facility" + "source_quote": "Cashless Facility means a facility extended by the Insurer to the Insured Person where the payments, of the costs of treatment undergone by the Insured Person", + "_confidence": "high" }, "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__group-activ-health__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__group-activ-health__wordings.pdf", + "_confidence": "low" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "source_quote": "27. Reload of Sum Insured We shall provide for a Reload of the Sum Insured, unlimited times during the Policy Year up to the limits as specified in the Policy Schedule/ Certificate of Insurance / Product Benefit Table of this Policy, in case the available Sum Insured, is insufficient for covering a claim under the Policy as a result of previous claims in that Policy Year.", + "_confidence": "high" }, "room_rent_capping": { - "value": "Room Rent means the amount charged by a Hospital towards room and boarding expen", + "value": null, + "unit": null, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "Room Rent means the amount charged by a Hospital towards room and boarding expenses and shall include\nthe Associated Med" + "source_quote": "not stated in group-activ-health__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__group-activ-health__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__group-activ-health__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "value": 586, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/activ-one-plan", + "source_note": "Per insurer baseline (Aditya Birla Activ One MAX / Activ Care: 586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "value": 10051, + "source_url": "https://www.adityabirlacapital.com/healthinsurance/health-insurance-plans", + "source_note": "Cashless facility available at 10051+ network hospitals (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__group-activ-health__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__group-activ-health__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in aditya-birla__group-activ-health__wordings.pdf", + "_confidence": "low" }, "policy_type": { "value": "group", "source_pdf_path": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "Group Activ Health Policy Wording This detailed document, read with the Policy Schedule, outlines the full terms and conditions of the coverage offered under your health insurance policy", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/aditya-birla/group-activ-health__wordings.pdf", "completeness_pct": 27, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } } \ No newline at end of file diff --git a/40-data/policy_facts/bajaj-allianz__comprehensive-care-plan.json b/40-data/policy_facts/bajaj-allianz__comprehensive-care-plan.json index 22a3fe35461a65ac7307833ca8ef6b02ce3a3065..49878670b9bdcf6c5fd38dec6588b7c88b384512 100644 --- a/40-data/policy_facts/bajaj-allianz__comprehensive-care-plan.json +++ b/40-data/policy_facts/bajaj-allianz__comprehensive-care-plan.json @@ -5,24 +5,21 @@ "uin_code": { "value": "BAJHLIP15002V011415", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "U66010PN2000PLC015329 | UIN: BAJHLIP15002V011415 1 Bajaj Allianz General Insurance Co. Ltd. Bajaj Allianz House, Airport Road, Yerawada, Pune - 411 006. Reg. No.: 113 For more details, log on to: www." + "source_quote": "U66010PN2000PLC015329 | UIN: BAJHLIP15002V011415 1 COMPREHENSIVE CARE PLAN Policy Wordings SECTION A) PREAMBLE WHEREAS the Insured named in the Schedule has applied to Bajaj Allianz General Insurance Company Limited (hereinafter called \"the Company\") for the insur" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -41,57 +38,70 @@ "pre_existing_disease_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf" }, "ayush_coverage": { - "value": true, + "value": null, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "ciated increase in premium 3. AYUSH Hospital: An AYUSH Hospital is a healthcare facility where in medical/surgical/para-surgical treatment procedures and interventions are carried out by AYUSH Medical" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "maternity_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "organ_donor_expenses": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "Organ donor cover not extracted" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": "Restoration of Sum Insured: Except as stated in Clause G (III) (3) (b) of this Policy, the insurance cover will at all times be maintained during", @@ -100,38 +110,48 @@ }, "room_rent_capping": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { - "value": true, + "value": null, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "Cashless mention not found" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan.pdf", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", diff --git a/40-data/policy_facts/bajaj-allianz__comprehensive-care-plan__wordings.json b/40-data/policy_facts/bajaj-allianz__comprehensive-care-plan__wordings.json index 9d99fc28637515af55452c2bb8e331c27b85de0d..a7273d417b75511858ded3afd12d95e984460058 100644 --- a/40-data/policy_facts/bajaj-allianz__comprehensive-care-plan__wordings.json +++ b/40-data/policy_facts/bajaj-allianz__comprehensive-care-plan__wordings.json @@ -4,146 +4,261 @@ "insurer_slug": "bajaj-allianz", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", "uin_code": { - "value": "BAJHLIP21344V032021", + "value": "BAJHLIP15002V011415", "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Issuing Office: CIN: U66010PN2000PLC015329 | UIN: BAJHLIP15002V011415", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Eligible Entry Age Limit : 18 years to 65 Years", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Eligible Entry Age Limit : 18 years to 65 Years", + "_confidence": "high" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 500000, - 750000, - 1000000, - 1500000, - 2000000, - 2500000, - 5000000, - 10000000, - 20000000, - 50000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy", + "_confidence": "high" }, "free_look_period": { - "value": 15, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of thirty days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not acceptable.", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": 90, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Company shall not be liable to make any payment under this Policy in connection with or in respect of any Insured Event, as stated in this Section, arising within the first 90 days of the commencement of the Policy Period.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 36, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 90, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf" }, "network_hospital_count": { - "value": 6500, - "unit": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { - "value": 95.0, + "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" + }, + "maternity_coverage": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" + }, + "restoration_benefit": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" + }, + "worldwide_emergency_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" + }, + "preventive_health_checkup": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "Territorial Limits This Policy covers insured events arising during the Policy Period within India", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "fixed_benefit", + "unit": "enum", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "SECTION C) COVERAGE COVER A SECTION 1: CRITICAL ILLNESS COVER Insured event: For the purposes of this Section and the determination of the Company’s liability under it", + "_confidence": "high" + }, + "modern_treatments_covered": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/bajaj-allianz/comprehensive-care-plan__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__comprehensive-care-plan__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/bajaj-allianz__criti-care__wordings.json b/40-data/policy_facts/bajaj-allianz__criti-care__wordings.json index c49b13a094f2b7e91b177ba13284b4e54f917b05..7e68e5974af16206586d6cff6726cfbfc1af5f03 100644 --- a/40-data/policy_facts/bajaj-allianz__criti-care__wordings.json +++ b/40-data/policy_facts/bajaj-allianz__criti-care__wordings.json @@ -10,112 +10,132 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "maternity_coverage": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "cashless_treatment_supported": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__criti-care__wordings.pdf", + "_confidence": "low" }, "policy_type": { - "value": "group", + "value": "fixed_benefit", "source_pdf_path": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "CRITI-CARE Policy Wordings SECTION A) PREAMBLE Whereas the insured described in the Policy Schedule hereto (hereinafter called the 'Insured') has made to Bajaj Allianz General Insurance Company Limited (hereinafter called the \"Company\" or \"", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/bajaj-allianz/criti-care__wordings.pdf", "completeness_pct": 9, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } } \ No newline at end of file diff --git a/40-data/policy_facts/bajaj-allianz__extra-care-plus.json b/40-data/policy_facts/bajaj-allianz__extra-care-plus.json index 06e85c39238661e26497f4010fd48f77a457d6e7..b064350896267590944770c3cec0c3e8803bf824 100644 --- a/40-data/policy_facts/bajaj-allianz__extra-care-plus.json +++ b/40-data/policy_facts/bajaj-allianz__extra-care-plus.json @@ -19,16 +19,12 @@ "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", "source_quote": "age of 3 months and is not older than 80years of age at the commencement of the Policy Period." }, - "max_renewal_age": { - "value": null, - "source_pdf_path": null, - "source_quote": "Renewal terms permit continuation; max renewal age not specified explicitly in wording" - }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "Sum Insured selectable with Aggregate Deductible options (super top-up structure); option list specified in Policy Schedule" + "source_quote": "not stated in bajaj-allianz__extra-care-plus.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -36,9 +32,11 @@ "source_quote": "3. 30-day waiting period (Excl03) a. Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded" }, "pre_existing_disease_waiting_months": { - "value": 12, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "1. Pre-existing Diseases waiting period (Excl01) a. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 12 months" + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": 12, @@ -48,7 +46,7 @@ "maternity_waiting_months": { "value": 12, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "Any treatment arising from or traceable to pregnancy ... until 12 months continuous period has elapsed since the inception of the first Extra Care Plus" + "source_quote": "Any treatment arising from or traceable to pregnancy, child birth including cesarean section and/or any treatment related to pre and postnatal care and complications arising out of Pregnancy and Childbirth until 12 months continuous period has elapsed since the inception of the" }, "pre_hospitalization_days": { "value": 60, @@ -61,49 +59,59 @@ "source_quote": "The medical expenses incurred in the 90 days period immediately after you were discharged" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "Day Care Treatment (defined per IRDAI; covered under hospitalization cover)" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf" }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "AYUSH Day Care Centre / AYUSH Hospital defined (AYUSH In-patient hospitalization covered)" + "source_quote": "AYUSH Treatment refers to medical expenses incurred on hospitalization under Ayurveda, Yoga and Naturopathy Unani, Siddha and Homeopathy systems", + "_confidence": "high" }, "maternity_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "2. Maternity Expenses ... We will cover the Medical expenses for maternity including complications of maternity over and above the aggregate deductible limit" + "source_quote": "Maternity Expenses We will pay the Medical Expenses related to pregnancy, childbirth or medically recommended and lawful termination of pregnancy, limited to maximum 2 deliveries or termination(s) or either, during the lifetime of the insured person", + "_confidence": "high" }, "newborn_coverage": { "value": false, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "2. Any Medical Expenses of the new born baby (excluded)" + "source_quote": "2. Any Medical Expenses of the new born baby 3. Dental treatment or surgery of any kind unless requiring hospitalization and as a result of accidental Bodily Injury to natural teeth. 4. The cost of spectacles, contact lenses, hearing aids, crutches, artificial limbs, denture" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "Organ Donor Expenses are covered under the policy (donor's hospitalization expenses for organ harvesting)" + "source_quote": "Organ Donor Expenses We will pay for Medical treatment of the organ donor for harvesting the organ i.e. including surgery to remove organs from a donor provided that, i. The organ donor is any person whose organ has been made available in accordance and in compliance with THE TRA", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "Reference to 'No Claim Bonus' carry-over on renewal exists; explicit base NCB % for Extra Care Plus super-top-up varies by variant (not stated as fixed % in wording)" + "source_quote": "not stated in bajaj-allianz__extra-care-plus.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "Restoration benefit not a base feature of Extra Care Plus super top-up (typical for top-up products)" + "source_quote": "not stated in bajaj-allianz__extra-care-plus.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": "No specific room rent capping in base (subject to Policy Schedule)", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "Reasonable and Customary Medical Expenses ... subject to aggregate deductible (no explicit room rent sub-limit in benefit table)" + "source_quote": "Reasonable and Customary Medical Expenses Medical Expenses incurred, subject to aggregate deductible as specified on the policy document Aggregate deductible is a cost sharing requirement under this policy that provides that the company will not be liable for a specified rupe" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "Co-payment ... A co-payment does not reduce the Sum Insured. (Defined but no mandatory base copay in Extra Care Plus)" + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": "Aggregate Deductible (selectable; per Policy Schedule)", @@ -111,34 +119,50 @@ "source_quote": "Aggregate deductible is a cost sharing requirement under this policy that provides the company will not be liable for a specified rupee amount" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric (Bajaj Allianz advertises 7,500+ network hospitals)" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "Cashless facility ... extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured (defined and operational)" + "source_quote": "Cashless facility: Cashless facility means a facility extended by the Insurer to the Insured where the payments, of the costs of treatment undergone by the Insured in accordance with the policy terms and conditions", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in bajaj-allianz__extra-care-plus.pdf", + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__extra-care-plus.pdf", + "_confidence": "low" }, "policy_type": { "value": "super_top_up", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "Aggregate deductible ... applicable in aggregate towards hospitalization expenses incurred during the policy period (super top-up structure)" + "source_quote": "Aggregate Deductible Aggregate deductible is a cost sharing requirement under this policy that provides the company will not be liable for a specified rupee amount of the covered expenses, which will apply before any benefits are payable by", + "_confidence": "medium" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", "completeness_pct": 82, - "notes": "Super top-up product; SI options and deductibles configured per Policy Schedule. CSR + network count are insurer-level." + "notes": "Super top-up product; SI options and deductibles configured per Policy Schedule. CSR + network count are insurer-level. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_quote": "Ambulance Expenses If a claim under Medical Expenses is accepted, We will also pay the ambulance expenses to a maximum of Rs3000/- per valid hospitali", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/bajaj-allianz__extra-care-plus__wordings.json b/40-data/policy_facts/bajaj-allianz__extra-care-plus__wordings.json index 8f7857ad0d1968c3742bc9ebf9d86544395bc40b..1332ed3c891b097ce27a731a1b3b16e0eb27ecda 100644 --- a/40-data/policy_facts/bajaj-allianz__extra-care-plus__wordings.json +++ b/40-data/policy_facts/bajaj-allianz__extra-care-plus__wordings.json @@ -4,141 +4,233 @@ "insurer_slug": "bajaj-allianz", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", "uin_code": { - "value": "BAJHLIP21321V012021", + "value": "BAJHLIP23069V032223", "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: BAJHLIP23069V032223 1 Bajaj Allianz General Insurance Co. Ltd. Bajaj Allianz House, Airport Road, Yerawada, Pune -", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "has attained the age of 3 months and is not older than 80years of age at the commencement of the Policy Period", + "_confidence": "medium" }, "sum_insured_options": { - "value": [ - 3000000, - 5000000, - 10000000, - 20000000, - 50000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "grace period of fifteen days (where premium is paid on a monthly instalments) and thirty days (where premium is paid in quarterly/half- yearly/annual instalments) is available on the premium due date, to pay the premium.", + "_confidence": "high" }, "free_look_period": { - "value": 15, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not acceptable.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 36, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The medical expenses incurred in the 60 days period immediately before you were hospitalised, provided that: i. Such medical expenses were incurred for the same condition requiring subsequent Hospitalization", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The medical expenses incurred in the 90 days period immediately after you were discharged, provided that: i. Such medical expenses were incurred for the same condition requiring earlier Hospitalization", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_quote": "AYUSH Treatment refers to medical expenses incurred on hospitalization under Ayurveda, Yoga and Naturopathy Unani, Siddha and Homeopathy systems", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_quote": "Maternity Expenses We will pay the Medical Expenses related to pregnancy, childbirth or medically recommended and lawful termination of pregnancy, limited to maximum 2 deliveries or termination(s) or either, during the lifetime of the insured person", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_quote": "Organ Donor Expenses We will pay for Medical treatment of the organ donor for harvesting the organ i.e. including surgery to remove organs from a donor", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" + }, + "worldwide_emergency_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" + }, + "preventive_health_checkup": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_quote": "Cashless facility: Cashless facility means a facility extended by the Insurer to the Insured where the payments, of the costs of treatment undergone by the Insured in accordance with the policy terms and conditions", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_quote": "Territorial Limits & Governing Law a. We cover insured events arising during the Policy Period for treatment availed within India only.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_quote": "Aggregate Deductible Aggregate deductible is a cost sharing requirement under this policy that provides the company will not be liable for a specified rupee amount of the covered expenses", + "_confidence": "medium" + }, + "deductible_amount": { + "value": null, + "unit": "INR", + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__extra-care-plus__wordings.pdf", + "_confidence": "low" + }, + "modern_treatments_covered": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/extra-care-plus__wordings.pdf", + "source_quote": "Modern Treatment Methods and Advancement in Technologies are covered up to Base Sum Insured, subject to policy terms, conditions, coverages", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/bajaj-allianz__global-health-care.json b/40-data/policy_facts/bajaj-allianz__global-health-care.json index 7e22dc7b462fbf86c591781f6b53ee28f030e50a..5ddeb3a9897f12d7941d4457d56881da5958ef57 100644 --- a/40-data/policy_facts/bajaj-allianz__global-health-care.json +++ b/40-data/policy_facts/bajaj-allianz__global-health-care.json @@ -5,30 +5,28 @@ "uin_code": { "value": "BAJHLIP23209V022223", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "U66010PN2000PLC015329, UIN - BAJHLIP23209V022223 1 Global Health Bajaj Allianz General Insurance Co. Ltd. Bajaj Allianz House, Airport Road, Yerawada, Pune - 411 006. Reg. No.: 113 For more details, l" + "source_quote": "U66010PN2000PLC015329, UIN - BAJHLIP23209V022223 1 SECTION A) PREAMBLE Whereas" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in bajaj-allianz__global-health-care.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in bajaj-allianz__global-health-care.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in bajaj-allianz__global-health-care.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -37,8 +35,10 @@ }, "pre_existing_disease_waiting_months": { "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": 24, @@ -48,12 +48,14 @@ "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in bajaj-allianz__global-health-care.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "atment arising from an Accident 2. Pre-Hospitalization The Medical Expenses incurred during the 60 days immediately before You were Hospitalized, provided that: Su", + "_confidence": "high" }, "post_hospitalization_days": { "value": 30, @@ -61,19 +63,25 @@ "source_quote": "bmit all claims no later than 30 days after the date of discharge from the Hospital. Claim Submission: You must submit a separate claim for each person claiming and for each medical condition being cl" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf" }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "where treatment was taken. 3. AYUSH Hospital An AYUSH Hospital is a healthcare facility wherein medical/surgical/para-surgical treatment procedures and interventions are carried out by AYUSH Medical P" + "source_quote": "AYUSH Treatment refers to hospitalization treatments given under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.", + "_confidence": "high" }, "maternity_coverage": { - "value": false, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "lization 18) Maternity (Code -Excl18): a. Medical Treatment Expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during Hospitalization) except ectopic" + "source_quote": "Maternity expenses Maternity expenses means; a. medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization)", + "_confidence": "high" }, "newborn_coverage": { "value": true, @@ -88,7 +96,8 @@ "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in bajaj-allianz__global-health-care.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": "restorations, bridges, dentures and implants as well as", @@ -101,39 +110,48 @@ "source_quote": "Single Private room" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "aggregate Deductible as specified in the Policy Schedule will apply for expenses under Inpatient plan benefits outside" + "source_quote": "not stated in bajaj-allianz__global-health-care.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "authorized representative 5. Cashless Facility Cashless Facility means a facility extended by the Insurer to the Insured where the payments, of the costs of treatment undergone by the Insured in accor" + "source_quote": "an Insured by a Cashless Facility.", + "_confidence": "medium" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in bajaj-allianz__global-health-care.pdf", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__global-health-care.pdf", + "_confidence": "low" }, "policy_type": { - "value": "hospital-cash", + "value": "family_floater", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "If You are advised Hospitalization within India by a Medical Practitioner as defined under Policy because of Illness or Accidental Bodily Injury sustained or contracted during the Policy Period, then We will pay You, Reasonable and Customar", + "_confidence": "medium" }, "_meta": { "curated_at": "2026-05-14", @@ -141,5 +159,12 @@ "supporting_source_pdfs": [], "completeness_pct": 65, "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + }, + "co_payment_pct": { + "value": null, + "unit": "percent", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" } } \ No newline at end of file diff --git a/40-data/policy_facts/bajaj-allianz__global-health-care__wordings.json b/40-data/policy_facts/bajaj-allianz__global-health-care__wordings.json index bc8c5fb059a9a4c1bfdfe30d575a0cdca84ad9f5..683da5eb5f522449f8f32efecbe0cff4ee0710ce 100644 --- a/40-data/policy_facts/bajaj-allianz__global-health-care__wordings.json +++ b/40-data/policy_facts/bajaj-allianz__global-health-care__wordings.json @@ -7,132 +7,258 @@ "value": "BAJHLIP23209V022223", "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "GLOBAL HEALTH CARE POLICY Policy Wordings Bajaj Allianz General Insurance Co.", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, + "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Members has attained the age of 3 months and is not older than 65 years of age at the commencement of first Global Health Care Policy.", + "_confidence": "high" }, "min_child_entry_age": { - "value": null, + "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "attained the age of 3 months and is not older than 65 years of age at the commencement of first Global Health Care Policy.", + "_confidence": "medium" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period of 30 days to maintain continuity of benefits without break in Policy. Coverage is not available during the grace period.", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "free look period of thirty days from date of receipt of the Policy document to review the terms and conditions of the Policy, and to return the same if not acceptable", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, - "unit": null, + "value": 30, + "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": null, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": null, - "unit": null, + "value": 24, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "until the expiry of 24 months of continuous coverage after the date of inception of the first Global Health Care Policy with Us.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, - "unit": null, + "value": 60, + "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "incurred during the 60 days immediately before You were Hospitalized, provided that: Such Medical Expenses were incurred for the same Illness", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, - "unit": null, + "value": 180, + "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "incurred during the 180 days immediately after You were discharged post Hospitalization provided that: Such costs are incurred in respect of the same Illness", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "AYUSH Treatment refers to hospitalization treatments given under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "Maternity expenses Maternity expenses means; a. medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization)", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "Living donor medical costs Living donor medical costs refer to the expenses We pay up to the limits specified in the Policy Schedule, towards organ donor’s treatment for harvesting of the donated organ", + "_confidence": "high" + }, + "restoration_benefit": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "Hospital (for International Cover) Hospital for international practice is any establishment which is licensed as a medical or surgical Hospital in the country where it operates and where the patient is permanently supervised by a Doctor.", + "_confidence": "medium" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "Annual Preventive Health Check-up After each renewal of Global Health Care Policy with Us, You will be entitled for an Annual Preventive Health Check-up. We will reimburse the amount as per the limits specified in the Policy Schedule.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "an Insured by a Cashless Facility.", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "worldwide", + "unit": "enum", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "Hospital (for International Cover) Hospital for international practice is any establishment which is licensed as a medical or surgical Hospital in the country where it operates", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "If You are advised Hospitalization within India by a Medical Practitioner as defined under Policy because of Illness or Accidental Bodily Injury", + "_confidence": "medium" + }, + "modern_treatments_covered": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "Modern Treatment Methods and Advancement in Technologies We will pay the Customary and Reasonable expenses for the Modern Treatment Methods as mentioned in Annexure III subject to the Sum Insured", + "_confidence": "high" + }, + "room_rent_capping": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/bajaj-allianz/global-health-care__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__global-health-care__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/bajaj-allianz__group-health-guard-silver__wordings.json b/40-data/policy_facts/bajaj-allianz__group-health-guard-silver__wordings.json index d85360f61eb5129494745361bc0b2e1a41e9bb8e..d21ec7c7338ae7098f7b8bd764b44d66a249e962 100644 --- a/40-data/policy_facts/bajaj-allianz__group-health-guard-silver__wordings.json +++ b/40-data/policy_facts/bajaj-allianz__group-health-guard-silver__wordings.json @@ -10,52 +10,59 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-health-guard-silver__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-health-guard-silver__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months" + "source_quote": "existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first Health Guard Group Policy with us.", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" + "source_quote": "4. 30-day waiting period (Excl03) a. Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an acc", + "_confidence": "high" }, "maternity_coverage": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-health-guard-silver__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-health-guard-silver__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { - "value": null, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" + "source_quote": "AYUSH Treatment refers to medical expenses incurred on hospitalisation under Ayurveda, Yoga and Naturopathy Unani, Siddha and Homeopathy systems", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "Cashless facility" + "source_quote": "Cashless facility: Cashless facility means a facility extended by the Insurer to the Insured where the payments, of the costs of treatment undergone by the Insured in accordance with the Policy terms and conditions", + "_confidence": "high" }, "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-health-guard-silver__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 100, @@ -63,14 +70,17 @@ "source_quote": "cumulative bonus (if any) is exhausted due to claims lodged during the Policy\nyear, then it is agreed that 100%" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" + "source_quote": "alisation Treatment. 9. Sum Insured Reinstatement Benefit: If Section C1 Inpatient Hospitalization Treatment Sum Insured and cumulative bonus (if any) is exhausted due to claims lodged during the", + "_confidence": "high" }, "room_rent_capping": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-health-guard-silver__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, @@ -83,34 +93,41 @@ "source_quote": "Post-Hospitalisation\nThe Medical Expenses incurred during the 90 days" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-health-guard-silver__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-health-guard-silver__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-health-guard-silver__wordings.pdf", + "_confidence": "low" }, "policy_type": { "value": "group", "source_pdf_path": "rag/corpus/bajaj-allianz/group-health-guard-silver__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "Health Guard Group Policy with us. b. In case of enhancement of Sum Insured the exclusion shall apply afresh to the extent of Sum Insured increase. c. If the Insured is continuously covered without any break as defined under the portability", + "_confidence": "medium" }, "_meta": { "curated_at": "2026-05-14", diff --git a/40-data/policy_facts/bajaj-allianz__group-personal-accident__wordings.json b/40-data/policy_facts/bajaj-allianz__group-personal-accident__wordings.json index 93be7eec662a1c027b55d1b66f5f33f216911c06..7c6a4b367ce845c5e310c1c2e6f9ec537ee04380 100644 --- a/40-data/policy_facts/bajaj-allianz__group-personal-accident__wordings.json +++ b/40-data/policy_facts/bajaj-allianz__group-personal-accident__wordings.json @@ -5,117 +5,137 @@ "uin_code": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "maternity_coverage": { - "value": null, + "value": false, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "Maternity (Excl 18) : a. Medical Treatment Expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "cashless_treatment_supported": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__group-personal-accident__wordings.pdf", + "_confidence": "low" }, "policy_type": { - "value": "group", + "value": "group_personal_accident", "source_pdf_path": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "GROUP PERSONAL ACCIDENT Policy Wordings SECTION A) PREAMBLE Our agreement to insure your employees/members herein after termed as \"Insured Person(s)\" named in the schedule hereto is based on your Proposal to us, which is the basis of this a", + "_confidence": "medium" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/bajaj-allianz/group-personal-accident__wordings.pdf", "completeness_pct": 5, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } } \ No newline at end of file diff --git a/40-data/policy_facts/bajaj-allianz__health-guard-gold-individual__wordings.json b/40-data/policy_facts/bajaj-allianz__health-guard-gold-individual__wordings.json index cc6fecae854b9bc8761ad8593e8f2f3372b2b14f..4d17624da9fe50c3cbacfc1821f015d2f36732f4 100644 --- a/40-data/policy_facts/bajaj-allianz__health-guard-gold-individual__wordings.json +++ b/40-data/policy_facts/bajaj-allianz__health-guard-gold-individual__wordings.json @@ -8,49 +8,60 @@ "source_quote": "UIN: BAJHLIP21185V032021" }, "min_entry_age": { - "value": null, + "value": 3, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "" + "source_quote": "Insured means the persons, or his Family members, named in the Schedule provided that an Insured or his Family Members has attained the age of 3 months and is not older than 65 years of age at the commencement of the Policy Period.", + "_confidence": "high" }, "max_entry_age": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, + "value": 65, + "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "" + "source_quote": "Insured means the persons, or his Family members, named in the Schedule provided that an Insured or his Family Members has attained the age of 3 months and is not older than 65 years of age at the commencement of the Policy Period.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months" + "source_quote": "36 months of continuous coverage after the date of inception of the first Health Guard Policy with us. b) In case of enhancement of Sum Insured the exclusion shall apply afresh", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, + "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising", + "_confidence": "high" }, "maternity_coverage": { - "value": null, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "" + "source_quote": "Maternity Expenses We will pay the Medical Expenses for the delivery of a baby (including caesarean section) and/or expenses related to medically recommended and lawful termination of pregnancy, limited to maximum 2 deliveries or termination(s) or either", + "_confidence": "high" }, "maternity_waiting_months": { - "value": null, + "value": 72, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "" + "source_quote": "Waiting period of 72 months from the date of issuance of the first policy with us, provided that the policy has been renewed continuously renewed with us without break for you.", + "_confidence": "high" }, "ayush_coverage": { - "value": null, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "" + "source_quote": "Ayurvedic and Homeopathic treatment: Room rent, boarding expenses Nursing care Consultation fees Medicines, drugs and consumables, Ayurvedic and Homeopathic treatment procedures", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "cashless treatment" + "source_quote": "Cashless facility \"Cashless facility” means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance", + "_confidence": "high" }, "copayment_pct": { "value": 10, @@ -63,14 +74,17 @@ "source_quote": "Cumulative Bonus (if any) is exhausted due to claims lodged during the Policy year,\nthen it is agreed that 100%" }, "restoration_benefit": { - "value": null, + "value": "100% Sum Insured reinstatement once Inpatient Hospitalization Treatment Sum Insured and Cumulative Bonus are exhausted (Sum Insured Reinstatement Benefit)", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "" + "source_quote": "9. Sum Insured Reinstatement Benefit: If Section A1 Inpatient Hospitalization Treatment Sum Insured and Cumulative Bonus (if any) is exhausted due to claims lodged during the Policy year, then it is agreed that 100% of the Sum Insured specified under Inpatient Hospitalization Treatment be reinstated", + "_confidence": "high" }, "room_rent_capping": { - "value": null, + "value": "No cap", + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "" + "source_quote": "Room, Boarding and Nursing Expenses as provided by the Hospital/Nursing Home without any sublimit. ii) If admitted in ICU, we will pay up to actual expenses provided by Hospital.", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 60, @@ -83,39 +97,46 @@ "source_quote": "Post-Hospitalisation\nThe Medical Expenses incurred during the 90 days" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf" }, "network_hospital_count": { - "value": 3300, - "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "3300+ Network hospitals" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__health-guard-gold-individual__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__health-guard-gold-individual__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in bajaj-allianz__health-guard-gold-individual__wordings.pdf", + "_confidence": "low" }, "policy_type": { - "value": "group", + "value": "family_floater", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "Health Guard -Gold Plan Policy Wordings Preamble Our agreement to insure You is based on Your Proposal to Us, which is the basis of this agreement, and Your payment of the premium. This Policy records the entire agreement between Us and set", + "_confidence": "medium" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", "completeness_pct": 41, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } } \ No newline at end of file diff --git a/40-data/policy_facts/bajaj-allianz__health-guard-gold.json b/40-data/policy_facts/bajaj-allianz__health-guard-gold.json index b63a4fe1c1b026b8baa19b8fd1a5501705d9aa7f..2842ec6be2ad63c75a3b755bc5b994e979286fe7 100644 --- a/40-data/policy_facts/bajaj-allianz__health-guard-gold.json +++ b/40-data/policy_facts/bajaj-allianz__health-guard-gold.json @@ -17,33 +17,33 @@ "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "Self, Spouse, Parents, Sister, Brother, In-laws, Aunt, Uncle. 18 years to 65 years lifetime renewals" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "18 years to 65 years lifetime renewals (no maximum renewal age for self/spouse cover)" + "source_quote": "Self, Spouse, Parents, Sister, Brother, In laws, Aunt, Uncle. 18 years to 65 years lifetime renewals** Dependent Children, Grandchildren. 3 months to 30 years 35 Years* * After the completion of maximum renewal age of dependent children, the policy would be renewed for" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "Maternity sub-limit references SI from Rs.3 lacs to Rs.50 lacs; explicit SI option list not in wording body (per brochure: 1.5 / 3 / 5 / 7.5 / 10 / 15 / 20 / 25 / 50 / 75 / 100 lakhs)" + "source_quote": "not stated in bajaj-allianz__health-guard-gold.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "30 day initial waiting period applies to all illness claims (standard mediclaim Section C clause; confirmed in PED+specific-disease sub-section)" + "source_quote": "30 days from the first Policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. b) This exclusion shall not, however apply if the Insured has Continuous Coverage for more than twelve months. The within referred waiting pe", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months" + "source_quote": "36 months of continuous coverage after the date of inception of the first Health Guard Policy with us. b) In case of enhancement of Sum Insured the exclusion shall apply afresh", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "Specified disease/procedure waiting period: 24 months continuous coverage from inception (standard Section C clause in Bajaj wording)" + "source_quote": "24 months of continuous coverage after the date of inception of the first Health Guard Policy with Us. This exclusion shall not be applicable for claims arising due to an accident. b) In case of enhancement of Sum Insured the exclusion shall apply afresh to the extent of Sum Insu", + "_confidence": "high" }, "maternity_waiting_months": { "value": 72, @@ -61,84 +61,119 @@ "source_quote": "Post-Hospitalisation The Medical Expenses incurred during the 90 days immediately after You were discharged post Hospitalisation" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "Day Care Procedures ... Indicative list of Day Care Procedures is given in the annexure I of Policy" + "value": 399, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Bajaj Allianz Health Guard Gold covers 399 day care procedures", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf" }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "AYUSH Hospital: An AYUSH Hospital is a healthcare facility wherein medical/surgical/para-surgical treatment procedures and interventions are carried out by AYUSH Medical Practitioner(s)" + "source_quote": "Ayurvedic and Homeopathic treatment: Room rent, boarding expenses Nursing care Consultation fees Medicines, drugs and consumables, Ayurvedic and Homeopathic treatment procedures", + "_confidence": "high" }, "maternity_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "12. Maternity Expenses ... Our maximum liability per delivery or termination shall be limited to the amount specified in the policy Schedule" + "source_quote": "Maternity Expenses We will pay the Medical Expenses for the delivery of a baby (including caesarean section) and/or expenses related to medically recommended and lawful termination of pregnancy, limited to maximum 2 deliveries or termination(s) or either", + "_confidence": "high" }, "newborn_coverage": { "value": true, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "Coverage for new born baby will be considered subject to a valid claim being accepted under Maternity Expenses (section A12). ... 90 days from the date of birth" + "source_quote": "New Born Baby Cover Coverage for new born baby will be considered subject to a valid claim being accepted under Maternity Expenses (section A12). We will pay the following expenses within the limit of the Sum Insured available under the Maternity Expenses section. We will pay for", + "_confidence": "high" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "Organ Donor Expenses (covered as standard section in Bajaj Health Guard Gold)" + "source_quote": "Organ Donor Expenses: We will pay expenses towards organ donor's treatment for harvesting of the donated organ, provided that, i. The organ donor is any person whose organ has been made available in accordance and in compliance with THE TRANSPLANTATION OF HUMAN ORGANS (AMENDMENT)", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": 10, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "13. Cumulative Bonus: ... We will increase the Limit of Indemnity by 10% of base sum insured per annum ... maximum cumulative increase ... limited to 10 years and 100%" + "source_quote": "We will increase the Limit of Indemnity by 10% of base sum insured per annum, but: i. The maximum cumulative increase in the Limit of Indemnity will be limited to 10 years and 100% of base sum insured of Your first \"Health Guard Policy\" with Us. ii. This clause does not alter the", + "_confidence": "high" }, "restoration_benefit": { "value": "100% Sum Insured reinstatement, once per policy year (Sum Insured Reinstatement Benefit)", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "9. Sum Insured Reinstatement Benefit: ... 100% of the Sum Insured specified under Inpatient Hospitalization Treatment be reinstated" + "source_quote": "9. Sum Insured Reinstatement Benefit: If Section A1 Inpatient Hospitalization Treatment Sum Insured and Cumulative Bonus (if any) is exhausted due to claims lodged during the Policy year, then it is agreed that 100% of the Sum Insured specified under Inpatient Hospitalization" }, "room_rent_capping": { - "value": "Room rent capping per Sum Insured slab (per Bajaj HG Gold benefit grid; capped on lower SIs, no limit on higher slabs)", + "value": "No cap", + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "Room rent, boarding expenses (listed under hospitalization treatment cover with policy-schedule-driven limits)" + "source_quote": "Room, Boarding and Nursing Expenses as provided by the Hospital/Nursing Home without any sublimit. ii) If admitted in ICU, we will pay up to actual expenses provided by Hospital.", + "_confidence": "high" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "No mandatory base copayment in Health Guard Gold (only optional voluntary copay/zone-based copay for senior entrants)" + "source_quote": "not stated in bajaj-allianz__health-guard-gold-individual__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible in Bajaj Health Guard Gold (optional zone/deductible add-ons available)" + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__health-guard-gold.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; Bajaj Allianz advertises 7,500+ network hospitals on its website (not extracted in this pass)" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "10. Cashless facility ... a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured ..." + "source_quote": "Cashless facility \"Cashless facility” means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, - "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted in this curation pass" + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__health-guard-gold.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular 2024" + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__health-guard-gold.pdf", + "_confidence": "low" }, "policy_type": { - "value": "indemnity", + "value": "family_floater", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", - "source_quote": "Limit of Indemnity (indemnity-based health insurance policy)" + "source_quote": "Health Guard -Gold Plan Policy Wordings Preamble Our agreement to insure You is based on Your Proposal to Us, which is the basis of this agreement, and Your payment of the premium. This Policy records the entire agreement between Us and sets out what We insure, how We insure it,", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", "completeness_pct": 82, - "notes": "Sum Insured option list not enumerated in wording body (referenced via maternity SI grid); insurer-level CSR/network counts null." + "notes": "Sum Insured option list not enumerated in wording body (referenced via maternity SI grid); insurer-level CSR/network counts null. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_quote": "Road Ambulance We will pay the reasonable cost to a maximum of Rs 20000/- per policy year incurred on an ambulance offered by a healthcare or ambulanc", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard-gold-individual__wordings.pdf", + "source_quote": "Preventive Health Check Up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/bajaj-allianz__health-guard.json b/40-data/policy_facts/bajaj-allianz__health-guard.json index f5687f3e0d59b79d88c40c991f79e541be5e7e7e..e82f418d521955a578aabc2c969cd04287d51fdb 100644 --- a/40-data/policy_facts/bajaj-allianz__health-guard.json +++ b/40-data/policy_facts/bajaj-allianz__health-guard.json @@ -5,24 +5,21 @@ "uin_code": { "value": "BAJHLIP25035V072425", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "U66010PN2000PLC015329 | UIN: BAJHLIP25035V072425 1 Bajaj Allianz General Insurance Co. Ltd. Bajaj Allianz House, Airport Road, Yerawada, Pune - 411 006. Reg. No.: 113 For more details, log on to: www." + "source_quote": "U66010PN2000PLC015329 | UIN: BAJHLIP25035V072425 1 SECTION A) PREAMBLE Whereas the Insured described in the Policy Schedule hereto (hereinafter called the 'Insured Person') has mad" }, "min_entry_age": { - "value": null, + "value": 90, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "Insured Person means the persons, or his Family Members, named in the Schedule provided that an Insured Person or his Family Members has attained the age of 3 months and is not older than 65 years of age at the commencement of the Policy Period.", + "_confidence": "high" }, "max_entry_age": { - "value": null, + "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "Insured Person means the persons, or his Family Members, named in the Schedule provided that an Insured Person or his Family Members has attained the age of 3 months and is not older than 65 years of age at the commencement of the Policy Period.", + "_confidence": "high" }, "sum_insured_options": { "value": [ @@ -40,9 +37,11 @@ "source_quote": "the treatment of any Illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered. b. This exclusion shall n" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "36 months of continuous coverage after the date of inception of the first Health Guard Policy with us. b. In case of enhancement of Sum Insured the exclusion shall apply afresh", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, @@ -50,34 +49,46 @@ "source_quote": "lated to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Health Guard Polic" }, "maternity_waiting_months": { - "value": null, + "value": 72, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "Waiting period of 72 months as mentioned in the Policy Schedule would apply from the date of issuance of the first Health Guard Policy with Us,", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": null, + "value": 60, + "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "Pre-Hospitalization: The Medical Expenses incurred during the 60 days immediately before You Were Hospitalized, provided that:", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 90, + "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "Post-Hospitalization: The Medical Expenses incurred during the 90 days immediately after You were discharged post Hospitalization", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Bajaj Allianz Health Guard covers 130 day care procedures", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf" }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "where treatment was taken. 3. AYUSH Hospital: An AYUSH Hospital is a healthcare facility wherein medical/surgical/para-surgical treatment procedures and interventions are carried out by AYUSH Medical " + "source_quote": "AYUSH treatment” refers to the medical and / or hospitalization treatments given under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.", + "_confidence": "high" }, "maternity_coverage": { - "value": false, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "ct/plans of Our Company where maternity expenses are not covered. f. Any complications arising, within 90 days post-delivery, out of or as a consequence of maternity/child birth will be covered up to " + "source_quote": "Maternity Expenses (Applicable for Gold and Platinum Plan only): We will pay the Medical Expenses for the delivery of a baby (including caesarean section) and/or expenses related to medically recommended and lawful termination of pregnancy", + "_confidence": "high" }, "newborn_coverage": { "value": true, @@ -100,9 +111,11 @@ "source_quote": "Reinstatement Benefit:" }, "room_rent_capping": { - "value": "Single Private room:", + "value": "1% of Sum Insured", + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "Single Private room:" + "source_quote": "Silver Plan - Up to 1% of Sum Insured per day (Excluding Cumulative Bonus)  Gold Plan and Platinum Plan - Sum Insured 3 lacs to 7.5 lacs- maximum eligible room is Single Private Air-Conditioned room - Sum Insured 10 Lacs and above - eligible for any room category ii. I", + "_confidence": "high" }, "copayment_pct": { "value": 15, @@ -115,35 +128,57 @@ "source_quote": "xcess of the Annual Aggregate Deductible limit of ₹ 50,000 / ₹ 100000 / ₹ 200000 / ₹ 300000, as opted by You , subject to the ”In-patient Hospitalization Treatment” section Sum I" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "ewal date or Grace period. 7. Cashless facility: Cashless facility means a facility extended by the Insurer to the Insured Person where the payments, of the costs of treatment undergone by the Insured" + "source_quote": "Cashless facility: Cashless facility means a facility extended by the Insurer to the Insured Person where the payments, of the costs of treatment undergone by the Insured Person", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, - "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__health-guard.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_quote": "not stated in bajaj-allianz__health-guard.pdf", + "_confidence": "low" }, "policy_type": { - "value": "top-up", + "value": "family_floater", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "Top-up / super top-up policy (kicks in above a deductible)" + "source_quote": "Floater Sum Insured Policies. Sum Insured at the beginning of the year Accumulated Cumulative Bonus Sum Insured with CB Hospitalization Amount Reinstated Sum Insured Payable Claim Amount Balance Sum Insured 1st Claim 300,000 10% 330,000 350", + "_confidence": "medium" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 70, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_quote": "Road Ambulance: We will pay the reasonable cost to a maximum of ₹ 20,000/- per Policy Year incurred on an ambulance offered by a healthcare or ambulan", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_quote": "Preventive Health Check Up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } } \ No newline at end of file diff --git a/40-data/policy_facts/bajaj-allianz__health-guard__wordings.json b/40-data/policy_facts/bajaj-allianz__health-guard__wordings.json index 2beff12194c634e0331afacb58fa7465f6707e3d..61d1d0b502a936a3ea32d56e2054b8902af8d8a5 100644 --- a/40-data/policy_facts/bajaj-allianz__health-guard__wordings.json +++ b/40-data/policy_facts/bajaj-allianz__health-guard__wordings.json @@ -7,132 +7,192 @@ "value": "BAJHLIP25035V072425", "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: BAJHLIP25035V072425 1 SECTION A) PREAMBLE", + "_confidence": "high" }, "min_entry_age": { - "value": null, - "unit": "years", + "value": 3, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insured Person means the persons, or his Family Members, named in the Schedule provided that an Insured Person or his Family Members has attained the age of 3 months and is not older than 65 years of age at the commencement of the Policy Period.", + "_confidence": "high" }, "max_entry_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, + "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insured Person means the persons, or his Family Members, named in the Schedule provided that an Insured Person or his Family Members has attained the age of 3 months and is not older than 65 years of age at the commencement of the Policy Period.", + "_confidence": "high" }, "min_child_entry_age": { - "value": null, + "value": 90, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insured Person means the persons, or his Family Members, named in the Schedule provided that an Insured Person or his Family Members has attained the age of 3 months and is not older than 65 years of age at the commencement of the Policy Period.", + "_confidence": "medium" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__health-guard__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period of fifteen days (where premium is paid on a monthly instalments) and thirty days (where premium is paid in quarterly/half-yearly/annual instalments) is available on the premium due date, to pay the premium.", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The Insured Person shall be allowed free look period of Thirty days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not acceptable.", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, - "unit": null, + "value": 30, + "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Expenses related to the treatment of any Illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, - "unit": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "36 months of continuous coverage after the date of inception of the first Health Guard Policy with us. b. In case of enhancement of Sum Insured the exclusion shall apply afresh", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": null, - "unit": null, + "value": 24, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Health Guard Policy with Us.", + "_confidence": "high" }, "maternity_waiting_months": { - "value": null, - "unit": null, + "value": 72, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Waiting period of 72 months as mentioned in the Policy Schedule would apply from the date of issuance of the first Health Guard Policy with Us,", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": null, - "unit": null, + "value": 60, + "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Pre-Hospitalization: The Medical Expenses incurred during the 60 days immediately before You Were Hospitalized, provided that:", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, - "unit": null, + "value": 90, + "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Post-Hospitalization: The Medical Expenses incurred during the 90 days immediately after You were discharged post Hospitalization", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Bajaj Allianz Health Guard covers 130 day care procedures", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Voluntary co-payment: If opted voluntarily by You, You shall bear 10%/ 20% of co-payment for each and every claim", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 1, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room rent and Boarding expenses as provided by the Hospital/Nursing Home subject to below limits  Silver Plan - Up to 1% of Sum Insured per day (Excluding Cumulative Bonus)  Gold Plan and Platinum Plan - Sum Insured 3 lacs to 7.5 lacs- maximum eligible room is Single Priv", + "_confidence": "medium" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Tenure of Policy: • Health Guard-Individual: 1year, 2 years or 3 years • Health Guard-Family Floater: 1year, 2 years or 3 years", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__health-guard__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__health-guard__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__health-guard__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_quote": "AYUSH treatment” refers to the medical and / or hospitalization treatments given under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_quote": "Cashless facility: Cashless facility means a facility extended by the Insurer to the Insured Person where the payments, of the costs of treatment undergone by the Insured Person", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_quote": "Territorial Limits & Governing Law i. We cover Medical Expenses for treatment availed within India only. Our liability to make any payment shall be to make payment within India", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_quote": "Floater Sum Insured Policies. Sum Insured at the beginning of the year Accumulated Cumulative Bonus Sum Insured with CB", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "1% of Sum Insured", + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_quote": "Silver Plan - Up to 1% of Sum Insured per day (Excluding Cumulative Bonus)  Gold Plan and Platinum Plan - Sum Insured 3 lacs to 7.5 lacs- maximum eligible room is Single Private Air-Conditioned room - Sum Insured 10 Lacs and above - eligible for any room category ii. I", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/health-guard__wordings.pdf", + "source_quote": "Maternity Expenses (Applicable for Gold and Platinum Plan only): We will pay the Medical Expenses for the delivery of a baby (including caesarean section) and/or expenses related to medically recommended and lawful termination of pregnancy", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/bajaj-allianz__silver-health.json b/40-data/policy_facts/bajaj-allianz__silver-health.json index b30ea83e45205b8b577c4f1d316ac1232b25128c..06563f950f2f9b8b33db0de88593266c73676494 100644 --- a/40-data/policy_facts/bajaj-allianz__silver-health.json +++ b/40-data/policy_facts/bajaj-allianz__silver-health.json @@ -5,135 +5,159 @@ "uin_code": { "value": "BAJHLIP23213V052223", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "U66010PN2000PLC015329 • UIN: BAJHLIP23213V052223 1 Bajaj Allianz General Insurance Co. Ltd. Bajaj Allianz House, Airport Road, Yerawada, Pune - 411 006. Reg. No.: 113 For more details, log on to: www." + "source_quote": "U66010PN2000PLC015329 • UIN: BAJHLIP23213V052223 1 CUSTOMER INFORMATION SHEET This document provides key information about your policy. You are also advised to go through your" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in bajaj-allianz__silver-health.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in bajaj-allianz__silver-health.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in bajaj-allianz__silver-health.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "Default IRDAI 30-day waiting period applies (not explicitly quoted in extracted snippet)" + "source_quote": "Initial Waiting period: 30 days for all illnesses Specific Waiting period: 12 months for below listed procedures 1. Surgery for gastric or duodenal ulcers, 14. Fissure in ano 2. Benign prostatic hypertrophy 15. Fibromyoma 3. Hydrocele 16. Hysterectomy 4. Haemorrhoids 17. Surgery", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 12, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "ariatric Surgery 13. Fistulae Pre-existing diseases waiting period: 12 months 36 months (plan A) & 24 Months (plan B) – for below procedure 1. Joint replacement surgery unless necessitated by accident" + "source_quote": "Pre-existing diseases waiting period: 12 months 36 months (plan A) & 24 Months (plan B) – for below procedure 1. Joint replacement surgery unless necessitated by accidental Bodily Injury", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": 12, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "Specific Waiting period: 12 months for below listed procedures 1. Surgery for gastric or duodenal ulcers, 14. Fissure in ano 2. Benign prostatic hypertrophy 15. Fibromyoma 3. Hydrocele 16. Hysterectomy 4. Haemorrhoids 17. Surgery on skin/ all internal or external tumours/cysts/ n", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in bajaj-allianz__silver-health.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": ". Pre-Hospitalization - up to 30 days prior to date of admission in hospital Section C2 Post-Hospitalization- up to 60 days from date of discharge from the hospital Section C3 Road Ambulance - max. up" + "source_quote": "Pre-Hospitalization - up to 30 days prior to date of admission in hospital Post-Hospitalization- up to 60 days from date of discharge from the hospital Section C2 Road Ambulance - max. up to ₹ 1,000/- per claim Section C3 Day Care Procedures - Medical Expenses incurred due to adm", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "prior to date of admission in hospital Post-Hospitalization- up to 60 days from date of discharge from the hospital Section C2 Roa", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf" }, "ayush_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "AYUSH coverage not found in extracted text" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "maternity_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "organ_donor_expenses": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "Organ donor cover not extracted" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { - "value": null, + "value": 10, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "nd above = 5% discount on premium. 6 Cumulative Bonus 10% increase in base sum insured per claim free policy Year Max", + "_confidence": "high" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "Restoration benefit not found in extracted text" + "source_quote": "not stated in bajaj-allianz__silver-health.pdf", + "_confidence": "low" }, "room_rent_capping": { - "value": "room rent limit of 1%", + "value": "1% of Sum Insured", + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "room rent limit of 1%" + "source_quote": "Room Rent Capping (Applicable for Plan A & Plan B) If You opt for this cover You will be entitled for a per day room rent limit of 1% of hospitalization Sum Insured up to maximum Rs. 7,500 per day", + "_confidence": "high" }, "copayment_pct": { "value": 10, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "l Plan B Which will be claims 10% co-payment deducted from (Each and every admissible claim) total claim amount Co-payment on Non- 20% on each and every admissi" + "source_quote": "10% co-payment (Each and every admissible claim) Co-payment on Non- Network hospital 20% on each and every admissible claim if treatment availed in non-network hospital This co-payment can be waived subject to payment of extra premium. Other Limits: The limits against the covers", + "_confidence": "high" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in bajaj-allianz__silver-health.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "ver is lower 10 Claims/claims Cashless Claim processCashless treatment is only available at Network Section E 21 procedure Hospitals A & B  You or Your representative must intimate Us 48 hours before" + "source_quote": "Cashless Claim processCashless treatment is only available at Network Hospitals You or Your representative must intimate Us 48 hours before the planned Hospitalization and within 24 hours of emergency hospitalization and request pre-authorization by way of the written form We wil", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in bajaj-allianz__silver-health.pdf", + "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_quote": "not stated in bajaj-allianz__silver-health.pdf", + "_confidence": "low" }, "policy_type": { - "value": "indemnity", + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "Default indemnity (no explicit alternate type detected)" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", diff --git a/40-data/policy_facts/bajaj-allianz__silver-health__cis.json b/40-data/policy_facts/bajaj-allianz__silver-health__cis.json index bdbd67f1e6da4041b708d22116e2bb56d4805447..de861e1e48a241e288648c5d9d0f9ee5ca061cf7 100644 --- a/40-data/policy_facts/bajaj-allianz__silver-health__cis.json +++ b/40-data/policy_facts/bajaj-allianz__silver-health__cis.json @@ -7,132 +7,209 @@ "value": "BAJHLIP23213V052223", "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: BAJHLIP23213V052223 1 CUSTOMER INFORMATION SHEET", + "_confidence": "high" }, "min_entry_age": { - "value": 46, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 75, - "unit": "years", - "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "grace_period": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Free Look Cancellation: Insured has an option of cancelling his/her policy up to 30 days from the first inception of policy with Us , subject to rest terms and conditions.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Initial Waiting period: 30 days for all illnesses Specific Waiting period: 12 months for below listed procedures", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 12, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-existing diseases waiting period: 12 months 36 months (plan A) & 24 Months (plan B) – for below procedure 1. Joint replacement surgery unless necessitated by accidental Bodily Injury", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 12, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Initial Waiting period: 30 days for all illnesses Specific Waiting period: 12 months for below listed procedures 1. Surgery for gastric or duodenal ulcers", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Section C1 Pre-Hospitalization - up to 30 days prior to date of admission in hospital Post-Hospitalization- up to 60 days from date of discharge from the hospital", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalization - up to 30 days prior to date of admission in hospital Post-Hospitalization- up to 60 days from date of discharge from the hospital", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Plan B 10% co-payment (Each and every admissible claim) Co-payment on Non- Network hospital 20% on each and every admissible claim", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" + }, + "preventive_health_checkup": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_quote": "Cashless Claim processCashless treatment is only available at Network Hospitals You or Your representative must intimate Us 48 hours before the planned Hospitalization and within 24 hours of emergency hospitalization and request pre-authorization by way of the", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_quote": "Cumulative Bonus 10% increase in base sum insured per claim free policy Year Max up to 100%", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_quote": "not stated in bajaj-allianz__silver-health__cis.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "1% of Sum Insured", + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_quote": "Room Rent Capping (Applicable for Plan A & Plan B) If You opt for this cover You will be entitled for a per day room rent limit of 1% of hospitalization Sum Insured up to maximum Rs. 7,500 per day", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 10, + "unit": "%", + "source_pdf_path": "rag/corpus/bajaj-allianz/silver-health__cis.pdf", + "source_quote": "Cumulative Bonus 10% increase in base sum insured per claim free policy Year Max up to 100%", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/bajaj-allianz__tax-gain.json b/40-data/policy_facts/bajaj-allianz__tax-gain.json index ad524294e4fccb281d32401ae795a97d801385c3..706c705887ad59e8edec6ff05e0d1cc364f02752 100644 --- a/40-data/policy_facts/bajaj-allianz__tax-gain.json +++ b/40-data/policy_facts/bajaj-allianz__tax-gain.json @@ -5,135 +5,159 @@ "uin_code": { "value": "BAJHLIP21184V022021", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "U66010PN2000PLC015329 • UIN: BAJHLIP21184V022021 1 Bajaj Allianz General Insurance Co. Ltd. Bajaj Allianz House, Airport Road, Yerawada, Pune - 411 006. Reg. No.: 113 For more details, log on to: www." + "source_quote": "U66010PN2000PLC015329 • UIN: BAJHLIP21184V022021 1 CUSTOMER INFORMATION SHEET This document provides key information about your policy. You are also advised to go through your policy document" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in bajaj-allianz__tax-gain.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in bajaj-allianz__tax-gain.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in bajaj-allianz__tax-gain.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Default IRDAI 30-day waiting period applies (not explicitly quoted in extracted snippet)" + "source_quote": "Initial Waiting period: 30 days for all illnesses Specific Waiting period: 24 months for below listed procedures 1. Any types of gastric or duodenal ulcers 2. Benign prostatic hypertrophy 3. All types of sinuses 4. Hemorrhoids 5. Dysfunctional uterine bleeding 6. Endometriosis St", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "’s Disease 19. Mental Illness Pre-existing diseases waiting period: 36 months Other waiting period 1. Cost of spectacles in the first year of the policy. (This cost is payable in the second year of co" + "source_quote": "Pre-existing diseases waiting period: 36 months Other waiting period 1. Cost of spectacles in the first year of the policy.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "Specific Waiting period: 24 months for below listed procedures 1. Any types of gastric or duodenal ulcers 2. Benign prostatic hypertrophy 3. All types of sinuses 4. Hemorrhoids 5. Dysfunctional uterine bleeding 6. Endometriosis Standard Exclusions Section D I Bajaj Allianz Genera", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in bajaj-allianz__tax-gain.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "not stated in bajaj-allianz__tax-gain.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "not stated in bajaj-allianz__tax-gain.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf" }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "dern medicine (allopathy) and AYUSH therapies. II Specific Exclusion 1. Any expenses for treatment taken without the doctor advising the same and which is not duly supported by prescriptions. 2. Any e" + "source_quote": "Treatment for any other system other than modern medicine (allopathy) and AYUSH therapies.", + "_confidence": "medium" }, "maternity_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "organ_donor_expenses": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Organ donor cover not extracted" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in bajaj-allianz__tax-gain.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Restoration benefit not found in extracted text" + "source_quote": "not stated in bajaj-allianz__tax-gain.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "not stated in bajaj-allianz__tax-gain.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in bajaj-allianz__tax-gain.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "uing Office: 10 Claims/claims Cashless Claim process Section E 29 procedure Cashless treatment is only available at Network Hospitals  You or Your representative must intimate Us 48 hours before the " + "source_quote": "Cashless Claim process Cashless treatment is only available at Network Hospitals  You or Your representative must intimate Us 48 hours before the planned Hospitalization and within 24 hours of emergency hospitalization and request pre-authorization by way of the written form", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in bajaj-allianz__tax-gain.pdf", + "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_quote": "not stated in bajaj-allianz__tax-gain.pdf", + "_confidence": "low" }, "policy_type": { - "value": "indemnity", + "value": "family_floater", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "Default indemnity (no explicit alternate type detected)" + "source_quote": "Family Floater basis Age of the members to be insured Coverage opted on Individual Basis covering each member of the family separately (at a single point in time) Coverage opted on individual basis covering multiple members of the family under as single policy (Sum Insured is ava", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", diff --git a/40-data/policy_facts/bajaj-allianz__tax-gain__cis.json b/40-data/policy_facts/bajaj-allianz__tax-gain__cis.json index 4064122367b450313d115df8f53e8364b38b4f6b..5f0221edaf5ff4fe9f630828ef7d18d35b4352b0 100644 --- a/40-data/policy_facts/bajaj-allianz__tax-gain__cis.json +++ b/40-data/policy_facts/bajaj-allianz__tax-gain__cis.json @@ -7,31 +7,29 @@ "value": "BAJHLIP21184V022021", "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: BAJHLIP21184V022021 1 CUSTOMER INFORMATION SHEET", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -39,102 +37,160 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured available for each individual is Rs 300,000 Sum Insured available for each family member is Rs 300,000 Sum Insured of Rs 300,000 is available for the entire family", + "_confidence": "high" }, "grace_period": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Free Look Cancellation: Insured has an option of cancelling his/her policy up to 30 days from the first inception of policy with Us , subject to rest terms and conditions.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Initial Waiting period: 30 days for all illnesses Specific Waiting period: 24 months for below listed procedures", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-existing diseases waiting period: 36 months Other waiting period 1. Cost of spectacles in the first year of the policy.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Initial Waiting period: 30 days for all illnesses Specific Waiting period: 24 months for below listed procedures 1. Any types of gastric or duodenal ulcers", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 130, + "source_url": "https://www.bajajgeneralinsurance.com/health-insurance-plans/health-guard.html", + "source_note": "Per insurer baseline (Bajaj Allianz Health Guard covers ~130 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18400, + "source_url": "https://www.bajajgeneralinsurance.com/", + "source_note": "18,400+ Cashless Hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_quote": "Health Check-up. 4. Any expenses in excess of the maximum payable under the Outpatient medical expenses limit. 8 Waiting Period Time period during which specified disease/treatme nt are not covered It is counted from beginning Initial Waiti", + "_confidence": "medium" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_quote": "Cashless Claim process Cashless treatment is only available at Network Hospitals  You or Your representative must intimate Us 48 hours before the planned Hospitalization and within 24 hours of emergency hospitalization and request pre-authorization by way of the written form", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_quote": "not stated in bajaj-allianz__tax-gain__cis.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_quote": "Any treatment received outside India 11. Circumcision unless required for the treatment of Illness or Accidental bodily injury.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_quote": "Family Floater basis Age of the members to be insured Coverage opted on Individual Basis covering each member of the family separately", + "_confidence": "high" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/bajaj-allianz/tax-gain__cis.pdf", + "source_quote": "Treatment for any other system other than modern medicine (allopathy) and AYUSH therapies.", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/care-health__care-advantage-add-ons-protect-plus-care-shield__brochure.json b/40-data/policy_facts/care-health__care-advantage-add-ons-protect-plus-care-shield__brochure.json index 1bd21779304ea5764db481ec624560fc34b66abf..cf1c7a7b9fe61c36369dbd4015c303d8c996cf00 100644 --- a/40-data/policy_facts/care-health__care-advantage-add-ons-protect-plus-care-shield__brochure.json +++ b/40-data/policy_facts/care-health__care-advantage-add-ons-protect-plus-care-shield__brochure.json @@ -10,47 +10,53 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" + "source_quote": "months specific diseases waiting period 36 months pre-existing diseases waiting period Yes Yes Yes", + "_confidence": "medium" }, "initial_waiting_period_days": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", + "_confidence": "low" }, "maternity_coverage": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", + "_confidence": "low" }, "ayush_coverage": { - "value": null, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" + "source_quote": "r Up to SI Up to SI AYUSH treatment Up to SI Up to SI Up to SI Up to SI", + "_confidence": "high" }, "cashless_treatment_supported": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", + "_confidence": "low" }, "copayment_pct": { "value": 20, @@ -60,62 +66,82 @@ "no_claim_bonus_pct": { "value": 50, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "NCBS)\n(50%" + "source_quote": "max up to 50% of SI (10% decrease in SI per policy year in case a claim has been paid; such decrease is only in SI accrued as NCB) No claims bonus (NCB) AYUSH treatment Up to SI Up to SI Health portal -" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" + "source_quote": "eck-up Annual Room rent modification Unlimited automatic recharge Unlimited e-consultations Pre-hospitalization medical expenses and p", + "_confidence": "high" }, "room_rent_capping": { - "value": "Room rent/ room category No sub-limit No sub-limit\nICU charges No sub-limit No s", + "value": "No limit", + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "Room rent/ room category No sub-limit No sub-limit\nICU charges No sub-limit No sub-limit\nIn-patient care Up to" + "source_quote": "Room rent/ room category ICU charges In-patient care Day care treatment 25L/ 50L/ 100L 200L/ 300L/ 600L No sub-limit No sub-limit No sub-limit", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 30, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "Pre-hospitalization medical Pre-hospitalization for 30 days" + "source_quote": "Pre-hospitalization for 30 days & post-hospitalization for 60 days; Maximum up to SI Automatic recharge Up to SI and available for unrelated or same illness Up to SI and available for unrelated or same" }, "post_hospitalization_days": { "value": 60, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "post-hospitalization post-hospitalization for 60 days" + "source_quote": "post-hospitalization medical expenses Pre-hospitalization for 30 days & post-hospitalization for 60 days; Maximum up to SI Automatic recharge Up to SI and available for unrelated or same illness Up to SI and" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" + "value": 541, + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_note": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf" }, "network_hospital_count": { - "value": null, + "value": 11600, + "source_url": "https://www.careinsurance.com/health-plan-network-hospitals.html", + "source_note": "Care Health Insurance: 22,100+ healthcare providers including 11,600+ network hospitals (insurer network-hospitals page; corroborated by Google snippet of careinsurance.com, scraped 2026-05-15). Conservative count uses hospital-specific subset, not the wider healthcare-provider count.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", + "_confidence": "low" }, "policy_type": { - "value": "group", + "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "not stated in care-health__care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", "completeness_pct": 32, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF", + "network_hospital_backfill_2026-05-15": "care-health insurer-wide count backfilled in targeted scrape pass" + }, + "co_payment_pct": { + "value": 20, + "unit": "percent", + "source_pdf_path": "rag/corpus/care-health/care-advantage-add-ons-protect-plus-care-shield__brochure.pdf", + "source_quote": "Co-payment** 20% co-payment per claim For liste", + "_confidence": "medium" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/care-health__care-advantage.json b/40-data/policy_facts/care-health__care-advantage.json index fe51f1acf9050308d36e551b68f1bd3faec3d626..ecc3a6ada254c122351b9637b31f059c29083f1d 100644 --- a/40-data/policy_facts/care-health__care-advantage.json +++ b/40-data/policy_facts/care-health__care-advantage.json @@ -5,40 +5,40 @@ "uin_code": { "value": "CHIHLIP26049V042526", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "007PLC161503 UAN:25076804 UIN:CHIHLIP26049V042526 IRDAI Registration Number - 148 www.careinsurance.com Quick quote & buy Online renewals Customer support Claim centre PA/52/raM:reV REACH US @ WhatsAp" + "source_quote": "CHIHLIP26049V042526 IRDAI Registration Number - 148 www.careinsurance.com REACH US @" }, "min_entry_age": { - "value": null, + "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "Min entry age not found" + "source_quote": "Floater : 91 Days with at least 1 Insured Person of age 18 years or above Entry Age – Maximum Lifelong Age of Proposer", + "_confidence": "high" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "Lifelong renewability" + "source_quote": "not stated in care-health__care-advantage.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": null, + "value": "25 Lacs, 50 Lacs and 1 Crore", "unit": "INR", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "Sum Insured* `25 Lacs, `50 Lacs and `1 Crore", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "Default IRDAI 30-day waiting period applies (not explicitly quoted in extracted snippet)" + "source_quote": "Initial Wait Period 30 Days Named Ailment wait Period 24 Months Pre-Existing Disease Wait Period 36 Months POLICY BENEFITS: Sum" }, "pre_existing_disease_waiting_months": { "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "Ailment wait Period 24 Months Pre-Existing Disease 36 Months Wait Period Pricing Zones Zone 1 - Delhi NCR, Surat, Mathura, Aligarh Zone 2 - Mumbai (incl. MMR), Telangana, Indore, Nashik Zone 3 - Pune," + "source_quote": "Initial Wait Period 30 Days Named Ailment wait Period 24 Months Pre-Existing Disease Wait Period 36 Months", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, @@ -48,12 +48,13 @@ "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in care-health__care-advantage.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "um Insured Treatment Expenses Pre Hospitalisation/ 30 days pre hospitalization Post Hospitalisation and 60 days post hospitalization Automatic Recharge Yes, once in a Policy Year Ambulance Cover Up to" + "source_quote": "Pre Hospitalisation/ Post Hospitalisation 30 days pre hospitalization and 60 days post hospitalization Automatic Recharge Yes, once in a Policy Year Ambulance Cover Up to Sum Insured Organ Donor Expenses Up" }, "post_hospitalization_days": { "value": 60, @@ -61,29 +62,34 @@ "source_quote": "/ 30 days pre hospitalization Post Hospitalisation and 60 days post hospitalization Automatic Recharge Yes, once in a Policy Year Ambulance Cover Up to Sum Insured Organ Donor Expenses Up to Sum Insur" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 541, + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_note": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf" }, "ayush_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "AYUSH coverage not found in extracted text" + "source_quote": "not stated in care-health__care-advantage.pdf", + "_confidence": "low" }, "maternity_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "not stated in care-health__care-advantage.pdf", + "_confidence": "low" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in care-health__care-advantage.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "Organ Donor Expenses Up to Sum Insured 10% increase in SI per Policy Year in No Claim Bonus (NCB) case of claim-free year; Max up to 50% of SI OPTIONAL BENEFITS: 50% increase in SI per Policy Year in " + "source_quote": "Organ Donor Expenses Up to Sum Insured No Claim Bonus (NCB) 10% increase in SI per Policy Year in case of claim-free year; Max up to 50% of SI OPTIONAL BENEFITS: No Claims Bonus Super (NCBS) Air Ambulance" }, "no_claim_bonus_pct": { "value": 50, @@ -96,9 +102,11 @@ "source_quote": "recharge of Sum Insured" }, "room_rent_capping": { - "value": "Room Rent No Sub-Limit", + "value": "No Sub-Limit", + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "Room Rent No Sub-Limit" + "source_quote": "POLICY BENEFITS: Room Rent No Sub-Limit ICU charges No Sub-Limit", + "_confidence": "high" }, "copayment_pct": { "value": 20, @@ -108,38 +116,56 @@ "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in care-health__care-advantage.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 11600, + "source_url": "https://www.careinsurance.com/health-plan-network-hospitals.html", + "source_note": "Care Health Insurance: 22,100+ healthcare providers including 11,600+ network hospitals (insurer network-hospitals page; corroborated by Google snippet of careinsurance.com, scraped 2026-05-15). Conservative count uses hospital-specific subset, not the wider healthcare-provider count.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "at a very affordable premium. CASHLESS MEDICAL SERVICES AT NETWORK OF 24000+ HEALTHCARE PROVIDERS Care Advantage gives you the advantage of cashless treatment which ensures you concentrate only on you" + "source_quote": "CASHLESS MEDICAL SERVICES AT NETWORK OF 24000+ HEALTHCARE PROVIDERS Care Advantage gives you the advantage of cashless treatmen", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in care-health__care-advantage.pdf", + "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", + "source_quote": "not stated in care-health__care-advantage.pdf", + "_confidence": "low" }, "policy_type": { - "value": "indemnity", + "value": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "Default indemnity (no explicit alternate type detected)" + "source_quote": "not stated in care-health__care-advantage.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/care-health/care-advantage__brochure.pdf", "supporting_source_pdfs": [], "completeness_pct": 80, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "preventive_health_checkup" + ], + "network_hospital_backfill_2026-05-15": "care-health insurer-wide count backfilled in targeted scrape pass" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", + "source_quote": "Annual Health Check-up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/care-health__care-advantage__brochure.json b/40-data/policy_facts/care-health__care-advantage__brochure.json index c6a2abc22c35374b3450800f1f12a6a53c90047e..f59da0cf08eb258b808c97d761ad058ed98bd916 100644 --- a/40-data/policy_facts/care-health__care-advantage__brochure.json +++ b/40-data/policy_facts/care-health__care-advantage__brochure.json @@ -7,31 +7,29 @@ "value": "CHIHLIP26049V042526", "unit": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": ":25076804 UIN:CHIHLIP26049V042526", + "_confidence": "high" }, "min_entry_age": { "value": 5, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry Age - Minimum Individual : 5 years Floater : 91 Days with at least 1 Insured Person of age 18 years", + "_confidence": "high" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-advantage__brochure.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry Age - Minimum Individual : 5 years Floater : 91 Days with at least 1 Insured Person of age 18 years", + "_confidence": "high" }, "sum_insured_options": { "value": [ @@ -41,102 +39,177 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured* '25 Lacs, '50 Lacs and '1 Crore", + "_confidence": "high" }, "grace_period": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-advantage__brochure.pdf", + "_confidence": "low" }, "free_look_period": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-advantage__brochure.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Initial Wait Period 30 Days Named Ailment wait Period 24 Months Pre-Existing Disease Wait Period 36 Months", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Initial Wait Period 30 Days Named Ailment wait Period 24 Months Pre-Existing Disease Wait Period 36 Months", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Initial Wait Period 30 Days Named Ailment wait Period 24 Months Pre-Existing Disease Wait Period 36 Months", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-advantage__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-advantage__brochure.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-advantage__brochure.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 541, + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_note": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf" }, "network_hospital_count": { "value": 24000, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "network of over 24000+ healthcare providers pan India", + "_confidence": "high" }, "co_payment_pct": { - "value": null, + "value": 20, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "itals not part of Smart Select Network: 20% co-payment on all claims Note : check the list of hospitals covered under smart s", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "sured* `25 Lacs, `50 Lacs and `1 Crore Room Rent No Sub-Limit ICU charges No Sub-Limit Pricing Zones Zone 1 - Delhi NC", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy Term 1/2/3 Years", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-advantage__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-advantage__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-advantage__brochure.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", + "source_quote": "Organ Donor Expenses Up to Sum Insured No Claim Bonus (NCB) 10% increase in SI per Policy Year in case of claim-free year; Max up to 50% of SI OPTIONAL BENEFITS: No Claims Bonus Super (NCBS) Air Ambulance", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", + "source_quote": "AUTOMATIC RECHARGE OF SUM INSURED A health emergency can arise anytime and potentially exhaust the entire Sum Insured that is available. In such cases, features like Automatic recharge of Sum Insured reinstates the Sum Insured back to the original levels. This amount", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", + "source_quote": "CASHLESS MEDICAL SERVICES AT NETWORK OF 24000+ HEALTHCARE PROVIDERS Care Advantage gives you the advantage of cashless treatmen", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", + "source_quote": "No Claim Bonus will not exceed 50% of Sum Insured under the policy", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", + "source_quote": "network of over 24000+ healthcare providers pan India", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", + "source_quote": "not stated in care-health__care-advantage__brochure.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "No Sub-Limit", + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", + "source_quote": "POLICY BENEFITS: Room Rent No Sub-Limit ICU charges No Sub-Limit", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 10, + "unit": "%", + "source_pdf_path": "rag/corpus/care-health/care-advantage__brochure.pdf", + "source_quote": "flat increase of 10% in Sum Insured for next policy year in case of no claim. No Claim Bonus will not exceed 50%", + "_confidence": "high" } } diff --git a/40-data/policy_facts/care-health__care-classic.json b/40-data/policy_facts/care-health__care-classic.json index efa98e2766f5fe691a0d1636f758084cd5b3c5bf..05e5025e38151cb483e3f4c38e3471b186b58d44 100644 --- a/40-data/policy_facts/care-health__care-classic.json +++ b/40-data/policy_facts/care-health__care-classic.json @@ -11,79 +11,85 @@ "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Newborn baby ... Period and is aged up to 90 days. (Standard Care Classic entry: 91 days for dependent children)" + "source_quote": "Newborn baby means baby born during the Policy Period and is aged up to 90 days. 2.1.33. Non - Network Provider: Non-Network means any hospital, day care" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Adult entry per Policy Schedule (Care Classic per CHI brochure: 5 years onwards / parents up to 99 years)" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Lifelong renewability per Renewal clause" + "source_quote": "not stated in care-health__care-classic.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Sum Insured options per Policy Schedule (Annual Health Check-up table references SI buckets <5L / 5-10L / >10L)" + "source_quote": "not stated in care-health__care-classic.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "30-day waiting period - Code- Excl03 ... any illness within 30 days from the first policy commencement date" + "source_quote": "30-day waiting period- Code- Excl03 a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. b." }, "pre_existing_disease_waiting_months": { "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Pre-Existing Disease ... complications shall be excluded until the expiry of 36 months of continuous coverage" + "source_quote": "Pre-Existing Diseases: Code- Excl01 a. Expenses related to the treatment of a pre- existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of contin", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Specific Waiting Period: Code- Excl02 ... shall be excluded until the expiry of 24 months of continuous coverage" + "source_quote": "Specific Waiting Period: Code- Excl02 a. Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage, as may be the case after the date of inception of the first policy with the Company. This" }, "maternity_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Maternity & New Born Cover (Optional Benefit): ... Claims will not be admissible ... related to any Maternity & New Born Expenses until 24 months of continuous coverage has elapsed" + "source_quote": "Maternity & New Born Expenses until 24 months of continuous coverage has elapsed, under this Benefit. b. In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum" }, "pre_hospitalization_days": { "value": 60, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "period of 60 days immediately prior to the [in-patient admission]" + "source_quote": "60 days immediately prior to the Insured Person's date of admission to the Hospital, subject to the conditions specified below: i. Provided that the Company shall not be liable to make payment for any Pre-" }, "post_hospitalization_days": { "value": 90, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "period of 90 days immediately after the [discharge from Hospital]" + "source_quote": "90 days immediately after the Insured Person's date of discharge from the Hospital, subject to the conditions specified below: i. Provided that the Medical Expenses so incurred are related to the same" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Day Care Treatment ... all Day Care Treatments (no fixed count enumerated in wording)" + "value": 541, + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_note": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf" }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "AYUSH Day Care Centre means and includes Community Health Centre (CHC), Primary Health Centre (PHC) ... (AYUSH Treatment is a covered benefit)" + "source_quote": "AYUSH Hospital is a healthcare facility wherein medical/surgical/para-surgical treatment procedures and interventions are carried out by AYUSH Medical Practitioner", + "_confidence": "high" }, "maternity_coverage": { - "value": false, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Maternity & New Born Cover (Optional Benefit) — not part of base; available with 24-month waiting if opted" + "source_quote": "Maternity expenses shall include- a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization)", + "_confidence": "medium" }, "newborn_coverage": { "value": false, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Maternity & New Born Cover is Optional Benefit; newborn covered only if maternity option opted" + "source_quote": "Maternity & New Born Cover (Optional Benefit) : a. Claims will not be admissible for any expenses incurred for diagnosis / treatment related to any Maternity & New Born Expenses until 24 months of continuous coverage has elapsed, under this" }, "organ_donor_expenses": { - "value": true, + "value": null, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Organ Donor Cover listed under utilizable benefits for accrued NCB (covered for organ harvesting)" + "source_quote": "not stated in care-health__care-classic.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 25, @@ -93,52 +99,94 @@ "restoration_benefit": { "value": "Unlimited Automatic Recharge of base Sum Insured for same/different illnesses", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "3.1.5 Benefit : Unlimited Automatic Recharge ... Recharge shall be utilized only after the base [SI exhausted]" + "source_quote": "Automatic Recharge can only be utilized for Benefit 'In-patient Care' 'Day Care Treatment' (except Advance Technology Methods), 'Pre Hospitalization Medical Expenses and Post Hospitalization Medical Expenses', 'Ambulance Cover', 'Domiciliary Hospitalization' Optional" }, "room_rent_capping": { - "value": "Per Policy Schedule (commonly Single Private AC room; subject to plan variant)", + "value": null, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Room Rent ... as specified in the Policy Schedule (Care Classic plan grid)" + "source_quote": "not stated in care-health__care-classic.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": null, + "value": 20, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Co-payment defined; applicability per Policy Schedule (typically 20% for entrants ≥61 years in Care Classic)" + "source_quote": "(in case of Floater) shall bear a Co-payment of 20% per Claim (over & above any other co- payment, if any)", + "_confidence": "high" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible in Care Classic" + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_quote": "not stated in care-health__care-classic.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; Care Health Insurance advertises 21,100+ network hospitals" + "value": 11600, + "source_url": "https://www.careinsurance.com/health-plan-network-hospitals.html", + "source_note": "Care Health Insurance: 22,100+ healthcare providers including 11,600+ network hospitals (insurer network-hospitals page; corroborated by Google snippet of careinsurance.com, scraped 2026-05-15). Conservative count uses hospital-specific subset, not the wider healthcare-provider count.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Cashless facility through Network Provider (defined)" + "source_quote": "Cashless Facility means a facility extended by the insurer to the Insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy terms and conditions, are directly made to the", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in care-health__care-classic.pdf", + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_quote": "not stated in care-health__care-classic.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "Hospitalization Expenses ... indemnify the Insured Person ... (indemnity-based)" + "source_quote": "Company will indemnify the Insured Person for Medical Expenses incurred towards Hospitalization through Cashless or Reimbursement Facility, maximum up to the Sum Insured, as specified in the Policy Schedule, provided that the Hospitalization is for" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/care-health/care-classic__wordings.pdf", "completeness_pct": 82, - "notes": "Care Classic mid-tier indemnity. Maternity is optional add-on (24-month waiting). SI options + entry age caps per Policy Schedule." + "notes": "Care Classic mid-tier indemnity. Maternity is optional add-on (24-month waiting). SI options + entry age caps per Policy Schedule. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ], + "network_hospital_backfill_2026-05-15": "care-health insurer-wide count backfilled in targeted scrape pass" + }, + "ambulance_cover": { + "value": null, + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_quote": "not stated in care-health__care-classic.pdf", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a Hospital but is actually taken while confined at home under any of the following circumstances: a.", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_quote": "Annual Health Check-up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "co_payment_pct": { + "value": 20, + "unit": "percent", + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_quote": "List of Hospitals where Co-Payment of 20% is not applicable under Optional Cover \"Smart Select", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/care-health__care-classic__wordings.json b/40-data/policy_facts/care-health__care-classic__wordings.json index b840787bd17f62166060d7b88a8d1873c26d4b49..6dc02113c9f4e0231510ecc1a6833bb6f600935c 100644 --- a/40-data/policy_facts/care-health__care-classic__wordings.json +++ b/40-data/policy_facts/care-health__care-classic__wordings.json @@ -7,132 +7,200 @@ "value": "CHIHLIP22071V012122", "unit": null, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "C161503 UIN: CHIHLIP22071V012122", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-classic__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-classic__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-classic__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-classic__wordings.pdf", + "_confidence": "low" }, "grace_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in po", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-classic__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "y waiting period- Code- Excl03 a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, - "unit": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Pre-Existing Diseases: Code- Excl01 a. Expenses related to the treatment of a pre- existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of contin", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": null, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage, as may be the case after the", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-classic__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "hospitalization Medical Expenses, for a period of 60 days immediately prior to the Insured Person's date of admission to the Hospital, subject to the conditions", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 90, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "hospitalization Medical Expenses, for a period of 90 days immediately after the Insured Person's date of discharge from the Hospital, subject to the conditions", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 541, + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_note": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 11600, + "source_url": "https://www.careinsurance.com/health-plan-network-hospitals.html", + "source_note": "Care Health Insurance: 22,100+ healthcare providers including 11,600+ network hospitals (insurer network-hospitals page; corroborated by Google snippet of careinsurance.com, scraped 2026-05-15). Conservative count uses hospital-specific subset, not the wider healthcare-provider count.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { - "value": null, + "value": 20, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "List of Hospitals where Co-Payment of 20% is not applicable under Optional Cover \"Smart Select", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-classic__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-classic__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-classic__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-classic__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-classic__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_quote": "AYUSH Hospital is a healthcare facility wherein medical/surgical/para-surgical treatment procedures and interventions are carried out by AYUSH Medical Practitioner", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a Hospital but is actually taken while confined at home under any of the following circumstances: a.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the Insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy terms and conditions, are directly made to the", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_quote": "medical treatment taken entirely within India. All payments under this Policy shall be made in Indian Rupees and within India", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_quote": "not stated in care-health__care-classic__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_quote": "not stated in care-health__care-classic__wordings.pdf", + "_confidence": "low" + }, + "maternity_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-classic__wordings.pdf", + "source_quote": "Maternity expenses shall include- a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization)", + "_confidence": "medium" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "care-health insurer-wide count backfilled in targeted scrape pass" } } diff --git a/40-data/policy_facts/care-health__care-heart__brochure.json b/40-data/policy_facts/care-health__care-heart__brochure.json index 6db540a7c1b955d5d5fbf365958cfe37d1921056..be5de3b92f3e6f77ff40fb5e4169ef5de10586ce 100644 --- a/40-data/policy_facts/care-health__care-heart__brochure.json +++ b/40-data/policy_facts/care-health__care-heart__brochure.json @@ -8,69 +8,78 @@ "source_quote": "UIN: RHIHLIP19066V011819" }, "min_entry_age": { - "value": null, + "value": 18, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "" + "source_quote": "Entry Age Minimum 18 years Care Health Insurance (CHI) is a specialized Health Insurer", + "_confidence": "high" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": 99, - "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "Life long Quick quote & buy Online renew" + "source_quote": "not stated in care-health__care-heart__brochure.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 24, + "unit": "months", "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "" + "source_quote": "30 Days Initial Waiting Period 24 Months Pre-existing Diseases Co-payment 20%", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "Initial Waiting\n30 Days" + "source_quote": "30 Days Initial Waiting Period 24 Months Specific Waiting Period 24 Months Pre-existing Diseases Co-payment 20% Co-payment if the" }, "maternity_coverage": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-heart__brochure.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-heart__brochure.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-heart__brochure.pdf", + "_confidence": "low" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "Cashless or Reimbursement Facility" + "source_quote": "the medical expenses, through Cashless or Reimbursement Facility (maximum up to Sum Insured) - from room charges, nursing expenses, ICU charges", + "_confidence": "high" }, "copayment_pct": { "value": 30, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "Co-payment\nmedical and alternative treatments such as Ayurveda, Unani, Sidha and 30%" + "source_quote": "30% Co-payment if the entry age>70 years Pre-policy Issuance Medical Check up None Home Care (Optional Cover) Up to Rs.1,000 per day; Max. 7 days per occurrence & Max. 45 days per policy year per Insured" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-heart__brochure.pdf", + "_confidence": "low" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "" + "source_quote": "e on payment of additional premium. 7. Automatic Recharge: A refill is always welcome! So your sum insured is reinstated just when you need it the most. If, due to cl", + "_confidence": "high" }, "room_rent_capping": { - "value": null, + "value": "100% of Sum Insured", + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "" + "source_quote": "the medical expenses, through Cashless or Reimbursement Facility (maximum up to Sum Insured) - from room charges, nursing expenses, ICU charges", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 30, @@ -83,39 +92,49 @@ "source_quote": "Post-Hospitalization for 60 days" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "" + "value": 541, + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_note": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf" }, "network_hospital_count": { - "value": null, + "value": 11600, + "source_url": "https://www.careinsurance.com/health-plan-network-hospitals.html", + "source_note": "Care Health Insurance: 22,100+ healthcare providers including 11,600+ network hospitals (insurer network-hospitals page; corroborated by Google snippet of careinsurance.com, scraped 2026-05-15). Conservative count uses hospital-specific subset, not the wider healthcare-provider count.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "Sum Insured and different Optional " + "source_quote": "not stated in care-health__care-heart__brochure.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-heart__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__care-heart__brochure.pdf", + "_confidence": "low" }, "policy_type": { - "value": "group", + "value": null, "source_pdf_path": "rag/corpus/care-health/care-heart__brochure.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "not stated in care-health__care-heart__brochure.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/care-health/care-heart__brochure.pdf", "completeness_pct": 36, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF", + "network_hospital_backfill_2026-05-15": "care-health insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/care-health__care-senior.json b/40-data/policy_facts/care-health__care-senior.json index ff0f47a7f36294a1b089fcfe0202d190572424dd..bd5544bd469af510019fbdc3178c52f987ce6295 100644 --- a/40-data/policy_facts/care-health__care-senior.json +++ b/40-data/policy_facts/care-health__care-senior.json @@ -17,15 +17,16 @@ "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "No upper entry age cap stated in brochure (senior-citizens plan; per policy schedule)" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "Renewal Lifelong Renewability" + "source_quote": "not stated in care-health__care-senior.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [300000, 500000, 700000, 1000000], + "value": [ + 300000, + 500000, + 700000, + 1000000 + ], "unit": "INR", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", "source_quote": "Benefits/Plan in ` (SI) 3 Lacs 5,7,10 Lacs" @@ -33,32 +34,35 @@ "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "Waiting period 30 days for any illness except injury" + "source_quote": "30 days for any illness except injury 2 years of continuous coverage 4 years of continuous coverage Renewal Co-payment Waiting" }, "pre_existing_disease_waiting_months": { "value": 48, + "unit": "months", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "Waiting period for pre-existing illness 4 years of continuous coverage" + "source_quote": "Waiting period for pre-existing illness Tenure options Lifelong Renewability 30 days for any illness except injury 2 years of continuous coverage 4 years of continuous coverage", + "_confidence": "medium" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "Waiting period for named ailments 2 years of continuous coverage" + "source_quote": "2 years of continuous coverage 4 years of continuous coverage Renewal Co-payment Waiting period Waiting period for named" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "Maternity not applicable / not offered in senior-citizens plan (no maternity row in benefit table)" + "source_quote": "not stated in care-health__care-senior.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "Pre-Hospitalization & Post Hospitalization Up to SI, 30 days/60 days" + "source_quote": "Pre-Hospitalization & Up to SI, 30 days/60 days Up to SI, 30 days/60 days Post Hospitalization Day Care Treatments Up to SI, 541 Procedures Up to SI, 541 Procedures Room Eligibility 1% SI per day Single" }, "post_hospitalization_days": { "value": 60, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "Pre-Hospitalization & Post Hospitalization Up to SI, 30 days/60 days" + "source_quote": "60 days Post Hospitalization Day Care Treatments Up to SI, 541 Procedures Up to SI, 541 Procedures Room Eligibility 1% SI per day Single Private AC Room (Max. up to 1%" }, "day_care_treatments_count": { "value": 541, @@ -68,17 +72,19 @@ "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "Alternative Treatments Up to ` 15,000 / Up to ` 20,000 (AYUSH cover with cash sub-limit)" + "source_quote": "Alternative Treatments Up to ` 15,000 Up to ` 20,000 SUB-LIMITS Sub-Limit 3 Lacs 5,7,10 Lacs Treatment of Cataract Up to ` 20,000 per eye Up to ` 30,000 per eye Treatment for each and every Ailment/Procedure" }, "maternity_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "No maternity benefit listed in Care Senior brochure benefit table" + "source_quote": "not stated in care-health__care-senior.pdf", + "_confidence": "low" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "Senior-citizens product; no newborn benefit" + "source_quote": "not stated in care-health__care-senior.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, @@ -107,38 +113,63 @@ }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible in Care Senior" + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "not stated in care-health__care-senior.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric (Care Health 21,100+); not extracted" + "value": 11600, + "source_url": "https://www.careinsurance.com/health-plan-network-hospitals.html", + "source_note": "Care Health Insurance: 22,100+ healthcare providers including 11,600+ network hospitals (insurer network-hospitals page; corroborated by Google snippet of careinsurance.com, scraped 2026-05-15). Conservative count uses hospital-specific subset, not the wider healthcare-provider count.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "Smart select a discount of 15% on premium payable ## Additional 20% Co-Pay applicable per claim if hospitalization done outside SMART SELECT network hospitals (cashless facility implied via network)" + "source_quote": "Additional 20% Co-Pay applicable per claim if hospitalization done outside SMART SELECT network hospitals", + "_confidence": "medium" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in care-health__care-senior.pdf", + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in brochure" + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "not stated in care-health__care-senior.pdf", + "_confidence": "low" }, "policy_type": { - "value": "indemnity", + "value": null, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "In-Patient Hospitalization Up to Sum Insured (indemnity-based senior citizens plan)" + "source_quote": "not stated in care-health__care-senior.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/care-health/care-senior__brochure.pdf", "completeness_pct": 92, - "notes": "Care Senior senior-citizens plan; brochure has clean benefit table. 4-year PED, 2-year named ailments, 20% mandatory copay age 61+." + "notes": "Care Senior senior-citizens plan; brochure has clean benefit table. 4-year PED, 2-year named ailments, 20% mandatory copay age 61+. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "preventive_health_checkup" + ], + "network_hospital_backfill_2026-05-15": "care-health insurer-wide count backfilled in targeted scrape pass" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "Annual Health check-up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "co_payment_pct": { + "value": 20, + "unit": "percent", + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "we provide you an option to choose for co-payment of 20% per claim (over & above any other co-payment, If any) which applies to you", + "_confidence": "high" } } diff --git a/40-data/policy_facts/care-health__care-senior__brochure.json b/40-data/policy_facts/care-health__care-senior__brochure.json index 0d12af1028bd701e0c1eab0610b212ff51ff3f3b..c1734cda52562678ef2c84c3d9de59e4e1880424 100644 --- a/40-data/policy_facts/care-health__care-senior__brochure.json +++ b/40-data/policy_facts/care-health__care-senior__brochure.json @@ -7,137 +7,232 @@ "value": "RHIHLIP21017V052021", "unit": null, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "556 UIN:RHIHLIP21017V052021", + "_confidence": "high" }, "min_entry_age": { "value": 61, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "If your age is 61 years or more, we provide you an option to choose for co-payment of 20% per claim", + "_confidence": "medium" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 300000, - 500000, - 700000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" }, "grace_period": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" }, "free_look_period": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "30 days for any illness except injury 2 years of continuous coverage 4 years of continuous coverage", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Waiting period for pre-existing illness Tenure options Lifelong Renewability 30 days for any illness except injury 2 years of continuous coverage 4 years of continuous coverage", + "_confidence": "medium" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "30 days for any illness except injury 2 years of continuous coverage 4 years of continuous coverage", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, + "value": 541, + "unit": "count", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Day Care Treatments Up to SI, 541 Procedures Up to SI, 541 Procedures Room Eligibility 1% SI per day Single Private AC Room (Max. up to 1% of SI per day) ICU Charges 2% SI per day 2% SI", + "_confidence": "high" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 11600, + "source_url": "https://www.careinsurance.com/health-plan-network-hospitals.html", + "source_note": "Care Health Insurance: 22,100+ healthcare providers including 11,600+ network hospitals (insurer network-hospitals page; corroborated by Google snippet of careinsurance.com, scraped 2026-05-15). Conservative count uses hospital-specific subset, not the wider healthcare-provider count.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { - "value": null, + "value": 20, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "we provide you an option to choose for co-payment of 20% per claim (over & above any other co-payment, If any) which applies to you", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Eligibility 1% SI per day Single Private AC Room (Max. up to 1% of SI per day) ICU Charges 2% SI per day 2% SI per day Daily Allowance ` 500 per day; max. 5 days NA Ambulance Cover Up to ` 1,500 per", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Tenure options 1/2/3 years", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "Organ Donor Cover Up to ` 50,000 Up to ` 1,00,000 Second Opinion Yes Yes Alternative Treatments Up to ` 15,000 Up to ` 20,000 SUB-LIMITS Sub-Limit 3 Lacs 5,7,10 Lacs Treatment of Cataract Up to ` 20,000 per", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "Automatic Recharge of Sum Insured Individual & Floater cover available Save tax on a premium of up to ` 75,000 under section 80D of IT act 1961^ OPD Cover# Up to 150% increase in sum insured with No Claim Bonus & No Claim Bonus Super** Smart select a discount of 15%", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "Annual Health check-up for all insured persons Renewal Co-payment Waiting period Waiting period for named ailments Waiting period for pre-existing illness Tenure options 1/2/3 years *At the discretion of", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "Additional 20% Co-Pay applicable per claim if hospitalization done outside SMART SELECT network hospitals", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "1% of SI per day; Single Private AC Room", + "unit": "text", + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "Room Eligibility 1% SI per day Single Private AC Room (Max. up to 1% of SI per day)", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/care-health/care-senior__brochure.pdf", + "source_quote": "not stated in care-health__care-senior__brochure.pdf", + "_confidence": "low" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "care-health insurer-wide count backfilled in targeted scrape pass" } } diff --git a/40-data/policy_facts/care-health__care-supreme-enhance.json b/40-data/policy_facts/care-health__care-supreme-enhance.json index 2cafb75bb3ac38520465865ae7e3ca68707db861..c3b2274b914de34e77f6b6b626d9087032ee5fa9 100644 --- a/40-data/policy_facts/care-health__care-supreme-enhance.json +++ b/40-data/policy_facts/care-health__care-supreme-enhance.json @@ -5,30 +5,28 @@ "uin_code": { "value": "CHIHLIP25036V012425", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "(s) on SUPREME ENHANCE - UIN: CHIHLIP25036V012425 4 1 day care basis without in-patient services and 2.1.11. Day Care Centre means any institution must comply with all the following criterion: establi" + "source_quote": "CHIHLIP25036V012425 1 2. DEFINITIONS 2.1. Standard Definitions: 2.1.1. Accidental /" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in care-health__care-supreme-enhance.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in care-health__care-supreme-enhance.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in care-health__care-supreme-enhance.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -36,44 +34,54 @@ "source_quote": "rion: please inform us within 30 days from the date of receipt of the policy, failing which the details relating to the person/s covered i. Having at least 5 in-patient beds; would be taken as correct" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 24, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "treatments shall be excluded until the expiry of 24 months of continuous coverage, as may be the case after the date of inception of the first policy with the Company. This exclusion shall not be applicable f", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "Named Ailment Waiting Period: Code- Excl02 a. Expenses related to the treatment of the listed Conditions, surgeries/ treatments shall be excluded until the expiry of 24 months of continuous coverage, as may be the case after the date of inception of the first policy with the Company." }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in care-health__care-supreme-enhance.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "the conditions specified below: (i) For a period of 60 days immediately prior to the Insured Person's date of admission to the Hospital, provided that the Company shall not be lia", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 90, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "o the conditions specified below: i) For a period of 90 days immediately after the Insured Person's date of discharge from the hospital and claim documents to be submitted wit", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 541, + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_note": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf" }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "e Provisions of Indian 2.1.2. AYUSH Hospital is a healthcare facility Contract Act, 1872, shall hold good in this regard. The references wherein medical/surgical/para-surgical to the singular include " + "source_quote": "AYUSH Hospital is a healthcare facility wherein medical/surgical/para-surgical treatment procedures and interventions are carried out by AYUSH Medical Practitioner", + "_confidence": "high" }, "maternity_coverage": { - "value": false, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "tment in 15. Maternity: (Code Excl18) any hospital or by any Medical Practitioner or any other provider specifically excluded a. Medical treatment expenses traceable to by the Insurer and disclosed" + "source_quote": "Maternity expenses shall include- a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization)", + "_confidence": "medium" }, "newborn_coverage": { "value": true, @@ -86,60 +94,74 @@ "source_quote": "Organ Donor Cover, available as twin sharing rooms in that Hospital Optional Benefits: Daily Cash Allowance, Air Ambulance Cover in the event giving rise to a Claim under Benefit “In- patient Care” sh" }, "no_claim_bonus_pct": { - "value": null, + "value": 10, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "of each Policy Year, the Company will enhance the Sum Insured by 10% flat, on a cumulative basis, as a Cumulative Bonus for each completed and continuous Policy Year, and subjec", + "_confidence": "high" }, "restoration_benefit": { - "value": "restore him to the position in which he was in, Policy Schedule against that benefit for that Insured", + "value": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "restore him to the position in which he was in, Policy Schedule against that benefit for that Insured" + "source_quote": "not stated in care-health__care-supreme-enhance.pdf", + "_confidence": "low" }, "room_rent_capping": { - "value": "Single Private AC Room means an air", + "value": "No limit", + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "Single Private AC Room means an air" + "source_quote": "No limit on Room Rent/ICU charges applicable under this benefit provided the charges are reasonable and customary", + "_confidence": "high" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in care-health__care-supreme-enhance.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in care-health__care-supreme-enhance.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 11600, + "source_url": "https://www.careinsurance.com/health-plan-network-hospitals.html", + "source_note": "Care Health Insurance: 22,100+ healthcare providers including 11,600+ network hospitals (insurer network-hospitals page; corroborated by Google snippet of careinsurance.com, scraped 2026-05-15). Conservative count uses hospital-specific subset, not the wider healthcare-provider count.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "secutive hours because 2.1.6. Cashless Facility means a facility extended by of technological advancement, and the insurer to the Insured where the payments, of b. which would have otherwise required " + "source_quote": "Cashless Facility means a facility extended by the insurer to the Insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy terms and conditions, are directly made to the", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in care-health__care-supreme-enhance.pdf", + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_quote": "not stated in care-health__care-supreme-enhance.pdf", + "_confidence": "low" }, "policy_type": { - "value": "top-up", + "value": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "Top-up / super top-up policy (per product name)" + "source_quote": "not stated in care-health__care-supreme-enhance.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 60, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill.", + "network_hospital_backfill_2026-05-15": "care-health insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/care-health__care-supreme-enhance__wordings.json b/40-data/policy_facts/care-health__care-supreme-enhance__wordings.json index 7393c09252117a3b1d8dcb9e0c1651a3cefcbbbf..06198aa7c9432007ad40a3b4d7b8bc254159a96d 100644 --- a/40-data/policy_facts/care-health__care-supreme-enhance__wordings.json +++ b/40-data/policy_facts/care-health__care-supreme-enhance__wordings.json @@ -7,141 +7,235 @@ "value": "CHIHLIP25036V012425", "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ENHANCE - UIN: CHIHLIP25036V012425", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": 90, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Newborn baby means baby born during the Policy Period and is aged up to 90 days", + "_confidence": "high" }, "sum_insured_options": { - "value": [ - 2000000, - 4500000, - 5000000, - 8500000, - 9000000, - 9300000, - 9500000, - 10000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "grace_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "erminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases: Code- Excl01 a. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of contin", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 90, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 541, + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_note": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 11600, + "source_url": "https://www.careinsurance.com/health-plan-network-hospitals.html", + "source_note": "Care Health Insurance: 22,100+ healthcare providers including 11,600+ network hospitals (insurer network-hospitals page; corroborated by Google snippet of careinsurance.com, scraped 2026-05-15). Conservative count uses hospital-specific subset, not the wider healthcare-provider count.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_quote": "AYUSH Hospital is a healthcare facility wherein medical/surgical/para-surgical treatment procedures and interventions are carried out by AYUSH Medical Practitioner", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" + }, + "restoration_benefit": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a Hospital but is actually taken while confined at home under any of the following circumstances:", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the Insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy terms and conditions, are directly made to the", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" + }, + "deductible_amount": { + "value": null, + "unit": "INR", + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "No limit", + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_quote": "No limit on Room Rent/ICU charges applicable under this benefit provided the charges are reasonable and customary", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_quote": "not stated in care-health__care-supreme-enhance__wordings.pdf", + "_confidence": "low" + }, + "maternity_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-supreme-enhance__wordings.pdf", + "source_quote": "Maternity expenses shall include- a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization)", + "_confidence": "medium" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "care-health insurer-wide count backfilled in targeted scrape pass" } } diff --git a/40-data/policy_facts/care-health__care-supreme.json b/40-data/policy_facts/care-health__care-supreme.json index 7711c8f4ec363f1ae5b600a71ce434da11dbdc41..0fc2d2cfc4ede6a0b7489cb9b03ce58f5d4c2619 100644 --- a/40-data/policy_facts/care-health__care-supreme.json +++ b/40-data/policy_facts/care-health__care-supreme.json @@ -11,29 +11,26 @@ "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "Newborn baby ... Policy Period and is aged up to 90 days. (Standard Care Supreme entry: 91 days for dependent children)" + "source_quote": "Newborn baby means baby born during the Policy Period and is aged up to 90 days. 2.1.32. Non - Network Provider: Non-Network means any hospital, day care" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "No maximum entry age cap in base wording — adult entry 18+; child 91 days to 25 years" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "Lifelong renewability per Renewal clause" + "source_quote": "not stated in care-health__care-supreme.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "Sum Insured options per Policy Schedule (Care Supreme commercial variants: 7L / 10L / 15L / 25L / 50L / 1Cr / 3Cr / 6Cr / Unlimited)" + "source_quote": "not stated in care-health__care-supreme.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "(iii) 30-day waiting period- Code- Excl03 ... any illness within 30 days" + "source_quote": "30-day waiting period- Code- Excl03 a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. b." }, "pre_existing_disease_waiting_months": { "value": 36, @@ -43,12 +40,13 @@ "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "Named Ailment Waiting Period: Code- Excl02 ... excluded until the expiry of 24 months of continuous coverage" + "source_quote": "Named Ailment Waiting Period: Code- Excl02 a. Expenses related to the treatment of t h e l i s t e d C o n d i t i o n s , surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage, as may be the case after the date of inception of the first policy with" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "Maternity expenses defined but NOT a base benefit in Care Supreme (optional cover or not offered in base policy)" + "source_quote": "not stated in care-health__care-supreme.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, @@ -58,32 +56,40 @@ "post_hospitalization_days": { "value": 180, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "i) For a period of 180 days immediately ... days after the completion of 180 days" + "source_quote": "180 days immediately after the Insured Person's date of discharge from the hospital and claim documents to be submitted within 30 days after the completion of 180 days from the date of discharge from the" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "Benefit: Day Care Treatment ... all Day Care Treatments through Cashless (no fixed count in wording; Care Supreme brochure cites 540+)" + "value": 541, + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_note": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf" }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "AYUSH Day Care Centre means and includes Community Health Centre (CHC), Primary Health Centre (PHC) ... (AYUSH covered)" + "source_quote": "AYUSH Hospital is a healthcare facility wherein medical/surgical/para-surgical treatment procedures and interventions are carried out by AYUSH Medical Practitioner", + "_confidence": "high" }, "maternity_coverage": { - "value": false, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "Maternity expenses defined but not included as a base benefit in Care Supreme wording (separately offered via 'Care Supreme Enhance' add-on)" + "source_quote": "Maternity expenses shall include- a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization)", + "_confidence": "medium" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "Newborn baby ... aged up to 90 days (definition only; coverage tied to maternity which is not a base benefit)" + "source_quote": "not stated in care-health__care-supreme.pdf", + "_confidence": "low" }, "organ_donor_expenses": { - "value": true, + "value": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "Organ Donor expenses covered for organ harvesting; pre/post hospitalization of donor excluded" + "source_quote": "not stated in care-health__care-supreme.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 50, @@ -96,49 +102,91 @@ "source_quote": "3.1.4 Benefit : Unlimited Automatic Recharge ... automatically make the re-instatement of up to the base Sum Insured unlimited times in a policy year" }, "room_rent_capping": { - "value": "No limit on Room Rent and ICU charges (base benefit)", + "value": "Single Private AC room / Twin sharing room as per Policy schedule", + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "i. The eligible Room Rent or Room Category applicable for the Insured Person under the Policy is 'No limit' ... ii. Intensive Care Unit Charges (ICU Charges) ... 'No limit'" + "source_quote": "agrees to modify the Room Rent / Room Category to Single Private AC room / Twin sharing room as specified in Policy schedule", + "_confidence": "medium" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "co-payment does not reduce the sum insured (base copay 0% for under-61 entrants; additional copay only if treatment outside Annexure III hospitals)" + "source_quote": "not stated in care-health__care-supreme.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible in Care Supreme" + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_quote": "not stated in care-health__care-supreme.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; Care Health Insurance advertises 21,100+ network hospitals on its website (not extracted)" + "value": 11600, + "source_url": "https://www.careinsurance.com/health-plan-network-hospitals.html", + "source_note": "Care Health Insurance: 22,100+ healthcare providers including 11,600+ network hospitals (insurer network-hospitals page; corroborated by Google snippet of careinsurance.com, scraped 2026-05-15). Conservative count uses hospital-specific subset, not the wider healthcare-provider count.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "Cashless Facility provided through Network Provider (defined in Section 2.1.30)" + "source_quote": "Cashless Facility means a facility extended by the insurer to the Insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy terms and conditions, are directly made to the", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in care-health__care-supreme.pdf", + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular; not explicit in wording" + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_quote": "not stated in care-health__care-supreme.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "Hospitalization Expenses ... indemnify the Insured Person ... up to the Sum Insured (indemnity-based)" + "source_quote": "Company will indemnify the Insured Person for Medical Expenses incurred towards Hospitalization through Cashless or Reimbursement Facility, maximum up to the Sum Insured, as specified in the Policy Schedule, provided that the Hospitalization is for" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/care-health/care-supreme__wordings.pdf", "completeness_pct": 82, - "notes": "Care Supreme base wordings; SI options/day-care count per Policy Schedule/Annexure. CSR + network count insurer-level." + "notes": "Care Supreme base wordings; SI options/day-care count per Policy Schedule/Annexure. CSR + network count insurer-level. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ], + "network_hospital_backfill_2026-05-15": "care-health insurer-wide count backfilled in targeted scrape pass" + }, + "ambulance_cover": { + "value": null, + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_quote": "not stated in care-health__care-supreme.pdf", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a Hospital but is actually taken while confined at home under any of the following circumstances: a.", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_quote": "Annual Health check-up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "co_payment_pct": { + "value": 20, + "unit": "percent", + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_quote": "List of Hospitals where Co-Payment of 20% is not applicable under Optional Cover \"Smart Select", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/care-health__care-supreme__wordings.json b/40-data/policy_facts/care-health__care-supreme__wordings.json index 946503352c01279310487fc4b5a7221c93062d9e..11f08c009a69e54e51e1e46f66be9fab7b8ed390 100644 --- a/40-data/policy_facts/care-health__care-supreme__wordings.json +++ b/40-data/policy_facts/care-health__care-supreme__wordings.json @@ -7,132 +7,200 @@ "value": "CHIHLIP23128V012223", "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "161503 UIN:CHIHLIP23128V012223", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme__wordings.pdf", + "_confidence": "low" }, "grace_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in care-health__care-supreme__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "0-day waiting period- Code- Excl03 a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an ac", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "plications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer. b. In case of enhancement of sum insured t", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": null, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "by choosing this Optional Benefit, the applicable waiting period of 24 months for Claims related to Names ailments shall be modified to specific time period as mentioned in", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "to the conditions specified below: (i) For a period of 60 days immediately prior to the Insured Person's date of admission to the Hospital, provided that the Company shall not be li", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 180, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "o the conditions specified below: i) For a period of 180 days immediately after the Insured Person's date of discharge from the hospital and claim documents to be submitted with", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 541, + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_note": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 11600, + "source_url": "https://www.careinsurance.com/health-plan-network-hospitals.html", + "source_note": "Care Health Insurance: 22,100+ healthcare providers including 11,600+ network hospitals (insurer network-hospitals page; corroborated by Google snippet of careinsurance.com, scraped 2026-05-15). Conservative count uses hospital-specific subset, not the wider healthcare-provider count.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { - "value": null, + "value": 20, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "List of Hospitals where Co-Payment of 20% is not applicable under Optional Cover \"Smart Select", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "s 'No limit', which means that there is no separate restriction on Room Charges incurred towards stay during Hospitalization ii. Intensiv", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__care-supreme__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_quote": "AYUSH Hospital is a healthcare facility wherein medical/surgical/para-surgical treatment procedures and interventions are carried out by AYUSH Medical Practitioner", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_quote": "not stated in care-health__care-supreme__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the Insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy terms and conditions, are directly made to the", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_quote": "medical treatment taken entirely within India. All payments under this Policy shall be made in Indian Rupees and within India", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_quote": "not stated in care-health__care-supreme__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "Single Private AC room / Twin sharing room as per Policy schedule", + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_quote": "agrees to modify the Room Rent / Room Category to Single Private AC room / Twin sharing room as specified in Policy schedule", + "_confidence": "medium" + }, + "maternity_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/care-supreme__wordings.pdf", + "source_quote": "Maternity expenses shall include- a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization)", + "_confidence": "medium" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "care-health insurer-wide count backfilled in targeted scrape pass" } } diff --git a/40-data/policy_facts/care-health__supreme-enhance__brochure.json b/40-data/policy_facts/care-health__supreme-enhance__brochure.json index 7f9134efe07b8fc97ae8f2a7f3ab51c81791da96..de2d3126435c9249874faf029c869c6f16eff6e5 100644 --- a/40-data/policy_facts/care-health__supreme-enhance__brochure.json +++ b/40-data/policy_facts/care-health__supreme-enhance__brochure.json @@ -10,52 +10,59 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__supreme-enhance__brochure.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__supreme-enhance__brochure.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "Pre-existing disease wait 36 Months" + "source_quote": "36 Months Pre-existing disease wait period 24 Months Name Ailment Wait Period", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "" + "source_quote": "Initial Wait Period 30 Days on all claims except on Accidental Claims", + "_confidence": "high" }, "maternity_coverage": { "value": null, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__supreme-enhance__brochure.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__supreme-enhance__brochure.pdf", + "_confidence": "low" }, "ayush_coverage": { - "value": null, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "" + "source_quote": "Organ donor cover AYUSH treatment cover", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "Cashless Treatment" + "source_quote": "Cashless Treatment With cashless hospitalisation, you no longer need to run around paying off hospital bills", + "_confidence": "high" }, "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__supreme-enhance__brochure.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 100, @@ -63,14 +70,17 @@ "source_quote": "cumulative bonus upto 100%" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "" + "source_quote": "insured options max upto `95 lacs** Unlimited Automatic recharge - Unlimited times in a Policy Year for unrelated or same illness Cu", + "_confidence": "high" }, "room_rent_capping": { - "value": "Room Rent Most Economical Single Pvt Room Most Economical Single Pvt Room\nRoom R", + "value": "No limit", + "unit": null, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "Room Rent Most Economical Single Pvt Room Most Economical Single Pvt Room\nRoom Rent Modification** No Limit" + "source_quote": "No limit on ICU charges No sub-limits on modern or conventional treatments", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 60, @@ -80,42 +90,53 @@ "post_hospitalization_days": { "value": 90, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "Post-Hospitalization Medical\n90 Days" + "source_quote": "herapy, medication etc. incurred by you up to 90 days after your hospitalisation", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "" + "value": 541, + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_note": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf" }, "network_hospital_count": { - "value": null, + "value": 11600, + "source_url": "https://www.careinsurance.com/health-plan-network-hospitals.html", + "source_note": "Care Health Insurance: 22,100+ healthcare providers including 11,600+ network hospitals (insurer network-hospitals page; corroborated by Google snippet of careinsurance.com, scraped 2026-05-15). Conservative count uses hospital-specific subset, not the wider healthcare-provider count.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "Sum Insured options ar" + "source_quote": "not stated in care-health__supreme-enhance__brochure.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__supreme-enhance__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in care-health__supreme-enhance__brochure.pdf", + "_confidence": "low" }, "policy_type": { - "value": "group", + "value": null, "source_pdf_path": "rag/corpus/care-health/supreme-enhance__brochure.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "not stated in care-health__supreme-enhance__brochure.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/care-health/supreme-enhance__brochure.pdf", "completeness_pct": 36, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF", + "network_hospital_backfill_2026-05-15": "care-health insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/care-health__ultimate-care.json b/40-data/policy_facts/care-health__ultimate-care.json index 6e34b7eb9ab53e3f13bda1cc9b986dd7ac2ae521..e03c2871bd675acafa80a7daeee9f4b273267a63 100644 --- a/40-data/policy_facts/care-health__ultimate-care.json +++ b/40-data/policy_facts/care-health__ultimate-care.json @@ -11,24 +11,22 @@ "value": null, "unit": "days", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in care-health__ultimate-care.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in care-health__ultimate-care.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in care-health__ultimate-care.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -36,44 +34,55 @@ "source_quote": "ancy, please inform us within 30 days from the date of receipt of the policy, failing which the details relating to the person/s covered would be taken as correct. So also the coverage details may als" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "Pre-Existing Diseases: Code- Excl01 a. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of contin", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "Named Ailment Waiting Period: Code- Excl02 a. Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage, as may be the case after the date of inception of the first policy with the Company. This" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in care-health__ultimate-care.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "not stated in care-health__ultimate-care.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "not stated in care-health__ultimate-care.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 541, + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_note": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf" }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "ble and violent means. 2.1.2. AYUSH Hospital is a healthcare facility wherein medical/ surgical/ para-surgical treatment procedures and interventions are carried out by AYUSH Medical Practitioner(s) c" + "source_quote": "AYUSH Hospital is a healthcare facility wherein medical/ surgical/ para-surgical treatment procedures and interventions are carried out by AYUSH Medical Practitioner", + "_confidence": "high" }, "maternity_coverage": { - "value": false, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "Maternity expenses shall include- a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization)", + "_confidence": "medium" }, "newborn_coverage": { "value": true, @@ -86,9 +95,10 @@ "source_quote": "Organ Donor Cover, Ambulance Cover, Optional Benefit- Unlimited Care, Pre–Post Hospitalization Expenses Modification , Claim Shield, Durable Medical Equipment, and the event giving rise to a Claim und" }, "no_claim_bonus_pct": { - "value": null, + "value": 100, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "(i) In any Policy Year, the accrued Cumulative Bonus, shall not exceed 100% of the Sum Insured available in the expiring Polic", + "_confidence": "high" }, "restoration_benefit": { "value": "restore him to the", @@ -96,44 +106,56 @@ "source_quote": "restore him to the" }, "room_rent_capping": { - "value": "Single Private AC Room means an air conditioned room in a", + "value": "Single Private AC room / Twin sharing room / General Ward as per Policy schedule", + "unit": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "Single Private AC Room means an air conditioned room in a" + "source_quote": "modify the Room Category/ Room Rent to Single Private AC room / Twin sharing room/General Ward", + "_confidence": "medium" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in care-health__ultimate-care.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in care-health__ultimate-care.pdf", + "_confidence": "low" }, "network_hospital_count": { "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "unit": null, + "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", + "source_quote": "not stated in care-health__ultimate-care.pdf", + "_confidence": "low" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "CHIHLIP25044V012425 2 2.1.6. Cashless Facility means a facility extended by the insurer to the Insured where the payments, of the costs of treatment undergone by the insured in accordance with the Pol" + "source_quote": "Cashless Facility means a facility extended by the insurer to the Insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy terms and conditions, are directly made to the", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in care-health__ultimate-care.pdf", + "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", + "source_quote": "not stated in care-health__ultimate-care.pdf", + "_confidence": "low" }, "policy_type": { - "value": "hospital-cash", + "value": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "not stated in care-health__ultimate-care.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", @@ -141,5 +163,12 @@ "supporting_source_pdfs": [], "completeness_pct": 60, "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + }, + "co_payment_pct": { + "value": 20, + "unit": "percent", + "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", + "source_quote": "The Co-payment shall be applicable to each and every claim for each Insured member as defined in the Policy", + "_confidence": "medium" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/care-health__ultimate-care__wordings.json b/40-data/policy_facts/care-health__ultimate-care__wordings.json index 42233e9fbb5ee35ad957883aef31c707684f46f7..16bb3b37f87255ce5a675149c1dedffce89602e4 100644 --- a/40-data/policy_facts/care-health__ultimate-care__wordings.json +++ b/40-data/policy_facts/care-health__ultimate-care__wordings.json @@ -7,132 +7,189 @@ "value": "CHIHLIP25044V012425", "unit": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Ultimate Care - UIN : CHIHLIP25044V012425 ^The Comp", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__ultimate-care__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__ultimate-care__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__ultimate-care__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__ultimate-care__wordings.pdf", + "_confidence": "low" }, "grace_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "te and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "sured Person shall be allowed free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "unit": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "mer's disease or Dementia (iii) 30-day waiting period- Code- Excl03 a. Expenses related to the treatmen", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, - "unit": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Pre-Existing Diseases: Code- Excl01 a. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of contin", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": null, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "xpenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage, as may be the case after", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__ultimate-care__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__ultimate-care__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__ultimate-care__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 541, + "source_url": "https://www.careinsurance.com/product/care-senior", + "source_note": "Per insurer baseline (Care Health publishes 541+ day care treatments across plans)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf" }, "network_hospital_count": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__ultimate-care__wordings.pdf", + "_confidence": "low" }, "co_payment_pct": { - "value": null, + "value": 20, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The Co-payment shall be applicable to each and every claim for each Insured member as defined in the Policy", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "’, which means that there is no separate restriction on Room Charges incurred towards stay during Hospitalization", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__ultimate-care__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__ultimate-care__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__ultimate-care__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in care-health__ultimate-care__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", + "source_quote": "AYUSH Hospital is a healthcare facility wherein medical/ surgical/ para-surgical treatment procedures and interventions are carried out by AYUSH Medical Practitioner", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the Insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy terms and conditions, are directly made to the", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", + "source_quote": "This Benefit shall be applicable in India only", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", + "source_quote": "not stated in care-health__ultimate-care__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "Single Private AC room / Twin sharing room / General Ward as per Policy schedule", + "unit": null, + "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", + "source_quote": "modify the Room Category/ Room Rent to Single Private AC room / Twin sharing room/General Ward", + "_confidence": "medium" + }, + "maternity_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/care-health/ultimate-care__wordings.pdf", + "source_quote": "Maternity expenses shall include- a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization)", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/cholamandalam__arogya-sanjeevani__wordings.json b/40-data/policy_facts/cholamandalam__arogya-sanjeevani__wordings.json index d9ff05edd5f30aefb64e5d8ffc99a1c712f9ddf1..b6d585234df6801d6fc4ac569e3695d4f37d5b6f 100644 --- a/40-data/policy_facts/cholamandalam__arogya-sanjeevani__wordings.json +++ b/40-data/policy_facts/cholamandalam__arogya-sanjeevani__wordings.json @@ -7,143 +7,206 @@ "value": "CHOHLIP20035V021920", "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: CHOHLIP20035V021920", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Policy can be availed by persons between the age of 18 years and 65 years, as Proposer.", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Policy can be availed by persons between the age of 18 years and 65 years, as Proposer.", + "_confidence": "high" }, "min_child_entry_age": { "value": 90, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Dependent children (i.e natural or legally adopted) between the age of 3 months to 25 years", + "_confidence": "medium" }, "sum_insured_options": { - "value": [ - 100000, - 200000, - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "For Yearly, Half-yearly, Quarterly payment of mode, a fixed period of 30 days is to be allowed as Grace Period and for monthly mode of payment a fixed period of 15 days be allowed as grace period.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of 30 days beginning from the date of receipt of policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with us.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of the following listed conditions, surgeries/ treatments shall be excluded until the expiry of 24/36 months of continuous coverage after the date of inception of the first Policy with the Insurer.", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalisation For 30 days prior to the date of hospitalisation.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-Hospitalisation For 60 days from the date of discharge from the hospital.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 141, + "source_url": "https://www.policybazaar.com/insurance-companies/cholamandalam-health-insurance/family/", + "source_note": "Per insurer baseline (Chola MS family plans: 141 day care procedures; Flexi Health: 539)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 13500, + "source_url": "https://www.cholainsurance.com/", + "source_note": "13,500+ Cashless Hospitals ('Why Chola MS' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, + "value": 5, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Each and every claim under the Policy shall be subject to a co-payment of 5% applicable to claim amount admissible and payable as per the terms and conditions of the Policy.", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 2.0, + "unit": "%", "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent, Boarding, Nursing expenses as provided by the Hospital/Nursing Home up to 2% of Sum Insured subject to maximum of Rs 5,000 per day. ii. Intensive Care Unit (ICU)/Intensive Cardiac Care Unit (ICCU) expenses up to 5% of Sum Insured subject to maximum of Rs 10,000 per day. iii.", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy Period 1/2/3 Years", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", + "source_quote": "AYUSH Treatment refers to hospitalisation treatments given under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the Insurer to the Insured where the payments, of the costs of treatment undergone by the Insured Person", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cumulative Bonus will be increased by 5% in respect of each claim free policy year (where no claims are reported), provided the policy is renewed with the company without a break subject to maximum of 50% of the Sum Insured", + "_confidence": "high" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", + "source_quote": "Category of Cover Indemnity Sum Insured INR On Individual basis – SI shall apply to each individual family member. On Floater Basis – SI shall apply to the entire family.", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "2% of Sum Insured", + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", + "source_quote": "Room Rent, Boarding, Nursing expenses as provided by the Hospital/Nursing Home up to 2% of Sum Insured subject to maximum of Rs 5,000 per day.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cumulative Bonus will be increased by 5% in respect of each claim free policy year", + "_confidence": "high" + }, + "maternity_coverage": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in arogya-sanjeevani__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/cholamandalam__chola-healthline__wordings.json b/40-data/policy_facts/cholamandalam__chola-healthline__wordings.json index 7dca1f627fca4e7369fb37fbad68fb52fdbe4e25..88c524223044aa9267d323f0946f01a98da5c963 100644 --- a/40-data/policy_facts/cholamandalam__chola-healthline__wordings.json +++ b/40-data/policy_facts/cholamandalam__chola-healthline__wordings.json @@ -7,132 +7,198 @@ "value": "CHOHLIP24153V062526", "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: CHOHLIP24153V062526", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__chola-healthline__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__chola-healthline__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": null, + "value": 90, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "for the Hospitalization expenses for a new born baby, from the day of birth to 90 days, provided that it is following a valid claim under maternit", + "_confidence": "medium" }, "sum_insured_options": { - "value": null, + "value": [ + 100000, + 200000, + 300000, + 500000, + 750000, + 1000000, + 1500000, + 2000000, + 2500000 + ], "unit": "INR", "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Sum Insured (In Lakhs) Rs 1/2/3/5/7.5/10 Rs 2/3/5/7.5/ 10/15 Rs 3/5/7.5/10/ 15/20/25 Rs 5/7.5/10/ 15/20/25", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period for payment of the premium for all types of insurance policies shall be, fifteen days where premium payment mode is monthly and thirty days in all other cases.", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Every policyholder of new individual health insurance policies, except for those policies with tenure of less than a year, shall be provided a free look period of 30 days beginning from the date of receipt of policy document", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "30-day waiting period – Code – Excl03 a) Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, - "unit": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Pre-Existing Disease(PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer.", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": null, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Specified disease/procedure waiting period – Code – Excl02: a) Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of first 24 months of continuous coverage after the date of inception of the first policy with us.", + "_confidence": "high" }, "maternity_waiting_months": { - "value": null, + "value": 36, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Maternity Expenses (Available in Privilege Healthline Plan only after 36 months Waiting period)", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": null, + "value": 30, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Pre Hospitalization Expenses 30 days 60 days 60 days 60 days", + "_confidence": "medium" }, "post_hospitalization_days": { - "value": null, + "value": 60, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Post Hospitalization Expenses 60 days 90 days 90 days 90 days", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 141, + "source_url": "https://www.cholainsurance.com/health-insurance/health-line", + "source_note": "Chola MS family plans cover 141 day care procedures", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 13500, + "source_url": "https://www.cholainsurance.com/", + "source_note": "13,500+ Cashless Hospitals ('Why Chola MS' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, + "value": 10, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Co-payment for age above 55 years 10% on all claims", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__chola-healthline__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__chola-healthline__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__chola-healthline__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__chola-healthline__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__chola-healthline__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", + "source_quote": "AYUSH Treatment refers to the medical and / or hospitalization treatments given under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", + "source_quote": "Maternity Expenses (Upto 2 deliveries , after 3 consecutive renewals)", + "_confidence": "medium" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the Insurer to the insured where the payments, of the costs of treatment undergone by the insured", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", + "source_quote": "The Insurer’s liability to make any payment towards illness or accidental injury shall be to make payment within India and in Indian Rupees only for medical services or procedures rendered in or undertaken within India.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", + "source_quote": "covers Your Family either on Individual Sum Insured basis or on Floater Sum Insured basis.", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Single occupancy AC room (capped at Rs 1500/Rs 3000 per day for Rs 1 Lakh/2 Lakh Sum Insured)", + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/chola-healthline__wordings.pdf", + "source_quote": "Single occupancy AC room is allowed for all Sum Insured except for Rs 1 Lakh/2 Lakhs.", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/cholamandalam__critical-healthline__wordings.json b/40-data/policy_facts/cholamandalam__critical-healthline__wordings.json index 4e574df7a7cc574e2a8f1f684e81bdcac3c77f3d..74f6683cafbad2b483130840976d76b18da60a64 100644 --- a/40-data/policy_facts/cholamandalam__critical-healthline__wordings.json +++ b/40-data/policy_facts/cholamandalam__critical-healthline__wordings.json @@ -7,132 +7,186 @@ "value": "CHOHLIP21302V022021", "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: CHOHLIP21302V022021", + "_confidence": "high" }, "min_entry_age": { - "value": null, + "value": 5, "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Entry Age 5 years to 65 years 5 years to 65 years", + "_confidence": "high" }, "max_entry_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, + "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Entry Age 5 years to 65 years 5 years to 65 years", + "_confidence": "high" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__critical-healthline__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": null, + "value": [ + 100000, + 300000, + 500000, + 1000000 + ], "unit": "INR", "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Sum Insured in Lakhs 1 / 3 / 5 / 10 1 / 3 / 5 / 10", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Every policyholder of new individual health insurance policies, except for those policies with tenure of less than a year, shall be provided a free look period of 30 days beginning from the date of receipt of policy document", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 90, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Any Critical Illness diagnosed within the first 90 days from the date of commencement of the Policy is excluded.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-existing disease means any condition, ailment, injury or disease: a. That is/are diagnosed by a physician not more than 36 months prior to", + "_confidence": "medium" }, "specific_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__critical-healthline__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__critical-healthline__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__critical-healthline__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__critical-healthline__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 141, + "source_url": "https://www.policybazaar.com/insurance-companies/cholamandalam-health-insurance/family/", + "source_note": "Per insurer baseline (Chola MS family plans: 141 day care procedures; Flexi Health: 539)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 13500, + "source_url": "https://www.cholainsurance.com/", + "source_note": "13,500+ Cashless Hospitals ('Why Chola MS' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__critical-healthline__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__critical-healthline__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": 1, "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "This policy can be renewed for a period of 12 months subject to payment of premium prior to expiry of the policy", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__critical-healthline__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__critical-healthline__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__critical-healthline__wordings.pdf", + "_confidence": "low" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", + "source_quote": "If the Insured is diagnosed as suffering from a Critical Illness the first occurrence of which manifests itself during the Policy Period, and if the Insured survives for a minimum of 30 days from the date of diagnosis, the Company shall pay a Critical Illness Benefit.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", + "source_quote": "The Insurer’s liability to make any payment towards illness or accidental injury shall be to make payment within India and in Indian Rupees only for medical services or procedures rendered in or undertaken within India.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "critical_illness", + "unit": "enum", + "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", + "source_quote": "policy covers Your Family on Individual Sum Insured basis.", + "_confidence": "medium" + }, + "cashless_treatment_supported": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", + "source_quote": "not stated in critical-healthline__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/critical-healthline__wordings.pdf", + "source_quote": "not stated in critical-healthline__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/cholamandalam__flexi-health-supreme__wordings.json b/40-data/policy_facts/cholamandalam__flexi-health-supreme__wordings.json index 3aa3458cc6aada9fd419be5e4057977bf56619b4..17979f3e330703624a1eca015dbd3f25663d1d74 100644 --- a/40-data/policy_facts/cholamandalam__flexi-health-supreme__wordings.json +++ b/40-data/policy_facts/cholamandalam__flexi-health-supreme__wordings.json @@ -7,132 +7,215 @@ "value": "CHOHLIP27040V032627", "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: CHOHLIP27040V032627", + "_confidence": "high" }, "min_entry_age": { - "value": null, + "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Self, Spouse, Parents, Parents-in-law Minimum – 18 years Maximum – 75 Years - The Proposer should be minimum 18 years on the Commencement date of the policy.", + "_confidence": "high" }, "max_entry_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, + "value": 75, "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Self, Spouse, Parents, Parents-in-law Minimum – 18 years Maximum – 75 Years", + "_confidence": "high" }, "min_child_entry_age": { - "value": null, + "value": 90, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Children upto 4 Minimum – 03 Months Maximum – 26 Years", + "_confidence": "medium" }, "sum_insured_options": { - "value": null, + "value": [ + 500000, + 750000, + 1000000, + 1500000, + 2000000, + 2500000, + 3000000, + 4000000, + 5000000, + 7500000, + 10000000, + 20000000, + 25000000, + 30000000, + 50000000 + ], "unit": "INR", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Sum Insured (SI) in (Rs.) Options Rs.5/7.5/10/15/20/25 Lakhs Rs. 5/7.5/10/15/20/25 Lakhs Rs.30/40/50/75 Lakhs, Rs.1/2/2.5/3/5 Crores", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases.", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Every policyholder of new individual health insurance policies, except for those policies with tenure of less than a year, shall be provided a free look period of 30 days beginning from the date of receipt of policy document", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "30-day waiting period-Code-Excl03 a) Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, - "unit": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months under Basic and Plus plan and 24 months under Premiere plan", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": null, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Specified disease/procedure waiting period – Code – Excl02: a) Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of first 24 months of continuous coverage after the date of inception of the first policy with us.", + "_confidence": "high" }, "maternity_waiting_months": { - "value": null, + "value": 36, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Maternity Cover Not Covered Reimbursement upto Rs.50,000/- per delivery after a waiting period of 36 months.", + "_confidence": "high" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__flexi-health-supreme__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__flexi-health-supreme__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 141, + "source_url": "https://www.policybazaar.com/insurance-companies/cholamandalam-health-insurance/family/", + "source_note": "Per insurer baseline (Chola MS family plans: 141 day care procedures; Flexi Health: 539)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 13500, + "source_url": "https://www.cholainsurance.com/", + "source_note": "13,500+ Cashless Hospitals ('Why Chola MS' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__flexi-health-supreme__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__flexi-health-supreme__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy Tenure options 1 or 2 or 3 years", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__flexi-health-supreme__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__flexi-health-supreme__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__flexi-health-supreme__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", + "source_quote": "AYUSH Treatment refers to the medical and / or hospitalisation treatments given under ‘Ayurveda, Unani, Siddha and Homeopathy systems’.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home under any of the following circumstances: i.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the Insurer to the insured where the payments, of the costs of treatment undergone by the insured", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", + "source_quote": "make payment within India and in Indian Rupees only for medical services or procedures rendered in or undertaken within India. The coverage under Global Hospitalization cover and Personal Accident shall be applicable worldwide.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", + "source_quote": "This policy covers on Individual Sum Insured basis and in case of family coverage on floater Sum Insured basis.", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "No room limit for Sum Insured above Rs.2 Lakhs (Rs.2000/day sub-limit for Rs.50k/1L/2L)", + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", + "source_quote": "Sublimit Room Rent Upto Rs.2000/- per day for Sum Insured Rs.50,000/-, Rs.1 Lakh & Rs. 2 Lakhs. No Room limit for Sum Insured above Rs.2 Lakhs", + "_confidence": "medium" + }, + "maternity_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health-supreme__wordings.pdf", + "source_quote": "Maternity Cover Not Covered Reimbursement upto Rs.50,000/- per delivery after a waiting period of 36 months.", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/cholamandalam__flexi-health__wordings.json b/40-data/policy_facts/cholamandalam__flexi-health__wordings.json index 3123e90a6ee5e67fb5a9e3dd7bcdfeb448ca5d7f..f5e972183cc456dcdc4a65ca1640b257d84551d4 100644 --- a/40-data/policy_facts/cholamandalam__flexi-health__wordings.json +++ b/40-data/policy_facts/cholamandalam__flexi-health__wordings.json @@ -7,31 +7,29 @@ "value": "CHOHLIP24145V062526", "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: CHOHLIP24145V062526", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry age - adult (18 - 65 years) and child (03 months to 26 years)", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry age - adult (18 - 65 years) and child (03 months to 26 years)", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry age - adult (18 - 65 years) and child (03 months to 26 years)", + "_confidence": "medium" }, "sum_insured_options": { "value": [ @@ -48,102 +46,220 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured (SI) Options Rs. 50,000/-, 1/2/3/5/7.5/10/15/20/25 Lakhs", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period for payment of the premium for all types of insurance policies shall be, fifteen days where premium payment mode is monthly and thirty days in all other cases.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of 30 days beginning from the date of receipt of policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Disease(PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "listed Conditions, surgeries/treatments shall be excluded until the expiry of first 24 months of continuous coverage after the date of inception of the first policy with us.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__flexi-health__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalisation Expenses Upto 30 days", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-Hospitalisation Expenses Upto 60 days", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, + "value": 539, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "539+ day care procedures and cashless hospitalisation across India", + "_confidence": "medium" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 13500, + "source_url": "https://www.cholainsurance.com/", + "source_note": "13,500+ Cashless Hospitals ('Why Chola MS' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, + "value": 20, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "A Co-payment of 20% shall be applied on each and every admissible claim in case of treatment taken in a hospital from Tier 1 location", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__flexi-health__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy term 1/2/3 years", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__flexi-health__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__flexi-health__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__flexi-health__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", + "source_quote": "AYUSH Treatment refers to the medical and / or hospitalization treatments given under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", + "source_quote": "Maternity: Code-Excl18:", + "_confidence": "medium" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", + "source_quote": "This policy will pay for the Inpatient hospitalisation medical expenses incurred for the New Born Baby from Day one till policy expiry date mentioned in the policy schedule subject to a limit of 10% of Sum Insured subject to a maximum of Rs.50,000/- whichever is less within Mother’s Sum Insured", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", + "source_quote": "This policy will pay for medical expenses incurred on a legal Organ Donor’s treatment for the harvesting of the organ donated.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", + "source_quote": "This policy will provide for a 100% restoration of Sum Insured during that policy year, provided that: a. The Sum Insured and earned Cumulative Bonus is insufficient or exhausted as a result of previous claims during the policy year. b.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", + "source_quote": "Domiciliary Hospitalisation means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home under any of the following circumstances: a.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", + "source_quote": "Health Checkup Once in two claim free years upto defined limits In case of Family floater policy, the benefits shown in the table above will represent our maximum liability for any and all claims made by Insured person(s) during the policy period. 4.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", + "source_quote": "not stated in flexi-health__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the Insurer to the insured where the payments, of the costs of treatment undergone by the insured", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", + "source_quote": "Cumulative Bonus 10% - 50% Reduction in Cumulative Bonus 10%", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", + "source_quote": "make payment within India and in Indian Rupees only for medical services or procedures rendered in or undertaken within India.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", + "source_quote": "on individual sum insured basis • Each person covered will have an independent sum insured limit within the same policy", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "No room limit for Sum Insured above Rs.2 Lakhs (Rs.2000/day sub-limit for Rs.50k/1L/2L)", + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", + "source_quote": "Room Rent limits - Upto Rs.2000/- per day for Sum Insured Rs.50,000/-, Rs.1 Lakh & Rs. 2 Lakhs. - No Room limit for Sum Insured above Rs.2 Lakhs", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 10, + "unit": "%", + "source_pdf_path": "rag/corpus/cholamandalam/flexi-health__wordings.pdf", + "source_quote": "Cumulative Bonus 10% - 50% Reduction in Cumulative Bonus 10%", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/cholamandalam__super-topup__wordings.json b/40-data/policy_facts/cholamandalam__super-topup__wordings.json index 1991d6b8e88fe43b9046e34315100ea85c491c2a..56ffc41d7ba3ca586e3d15633fc94de490e18f1c 100644 --- a/40-data/policy_facts/cholamandalam__super-topup__wordings.json +++ b/40-data/policy_facts/cholamandalam__super-topup__wordings.json @@ -7,31 +7,29 @@ "value": "CHOHLIP21309V022021", "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: CHOHLIP21309V022021", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__super-topup__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in cholamandalam__super-topup__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__super-topup__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -44,102 +42,204 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured (SI) Options (in lacs) Deductible Options (in lacs) 5 5/10 7.5 5/7.5 10 5/7.5/10 PLANS PREMIERE SUPREME 15 5/10 20 5/10/15 25 10/15/20", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "can be renewed within the Grace period of 30 days to maintain continuity of benefits without break in policy.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of 30 days beginning from the date of receipt of policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Initial waiting period of 30 days Applicable Applicable", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Disease( PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 12, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "listed Conditions, surgeries/treatments shall be excluded until the expiry of first 12 months of continuous coverage after the date of inception of the first policy with us.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__super-topup__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalization Expenses Not Covered 60 days", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-Hospitalization Expenses Not Covered 90 days", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, + "value": 141, + "unit": "count", "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "This Policy will pay for Medical Expenses incurred as a Day Care Procedure/ Treatment for the 141 list of procedures/treatment that requires less than 24 hours of hospitalization, upto Sum Insured in excess of deductible mentioned in the policy schedule if it is performed in a network hospital.", + "_confidence": "high" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 13500, + "source_url": "https://www.cholainsurance.com/", + "source_note": "13,500+ Cashless Hospitals ('Why Chola MS' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in super-topup__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__super-topup__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy Period - ONE Year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__super-topup__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__super-topup__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in cholamandalam__super-topup__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", + "source_quote": "AYUSH Treatment refers to the medical and / or hospitalization treatments given under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", + "source_quote": "Maternity Expenses: Code–Excl 18:", + "_confidence": "medium" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", + "source_quote": "not stated in super-topup__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", + "source_quote": "Hospitalisation expenses of the Organ donor during the stay as in-patient solely for the purpose of harvesting the organ, excluding pre and post hospitalisation expenses for such donor.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", + "source_quote": "not stated in super-topup__wordings.pdf", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home under any of the following circumstances: a.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", + "source_quote": "not stated in super-topup__wordings.pdf", + "_confidence": "low" + }, + "critical_illness_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", + "source_quote": "not stated in super-topup__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", + "source_quote": "Obtain our pre-authorisation for any medical treatment in any of our network hospitals as well as identified list of hospitals by GIC for common empanelment through anywhere cashless facility.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", + "source_quote": "make payment within India and in Indian Rupees only for medical services or procedures rendered in or undertaken within India.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", + "source_quote": "This policy covers on Individual Sum Insured basis and in case of family coverage on floater Sum Insured basis.", + "_confidence": "medium" + }, + "deductible_amount": { + "value": 500000, + "unit": "INR", + "source_pdf_path": "rag/corpus/cholamandalam/super-topup__wordings.pdf", + "source_quote": "Deductible Options (in lacs) 5 5/10 7.5 5/7.5 10 5/7.5/10", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/go-digit__arogya-sanjeevani__wordings.json b/40-data/policy_facts/go-digit__arogya-sanjeevani__wordings.json index cf0a091430cb15571db24f8784f5df92f27149aa..1ad5e61c359733856fe84054e955a2c54a35faaf 100644 --- a/40-data/policy_facts/go-digit__arogya-sanjeevani__wordings.json +++ b/40-data/policy_facts/go-digit__arogya-sanjeevani__wordings.json @@ -7,139 +7,232 @@ "value": "GODHLIP24179V022324", "unit": null, "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Arogya Sanjeevani Policy, Go Digit - Policy Wording (GODHLIP24179V022324)", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Policy can be availed by persons From the age of 18 years.", + "_confidence": "high" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Dependent Children (i.e. natural or legally adopted) between the age 3 months to 25 \nyears.", + "_confidence": "medium" }, "sum_insured_options": { - "value": [ - 100000, - 200000, - 300000, - 400000, - 500000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period for payment of the premium for all types of insurance policies shall be: \nfifteen days where premium payment mode is monthly and thirty days in all other cases.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of thirty(30)from date of receipt of the policy \ndocument", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date \nshall be excluded except claims arising due to an accident", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "shall be covered after a waiting period of 36 months or 3 years", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "3. \nSpecific Waiting Period: (Code- Excl02) \na) Expenses related to the treatment of the following listed conditions, surgeries/treatments shall be \nexcluded until the expiry of 24/36 months of continuous coverage", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-hospitalisation Medical Expenses means medical expenses incurred during the period of 30days \npreceding the hospitalisation of the Insured Person", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-hospitalisation Medical Expenses means medical expenses incurred during the period of 60 days \nimmediately after the insured person is discharged from the hospital", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 100, + "source_url": "https://www.godigit.com/health-insurance/daycare-treatment-and-procedures-in-health-insurance", + "source_note": "Per insurer baseline (Go Digit Health covers all day-care up to SI; ~100 listed procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 9000, + "source_url": "https://www.godigit.com/health-insurance", + "source_note": "9000+ Cashless Hospitals (health-insurance USP section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, + "value": 5, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Each and every claim under the Policy shall be subject to a Co-payment of 5% applicable to claim amount \nadmissible", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 2.0, + "unit": "%", "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home up to 2% of the \nsum insured subject to maximum of Rs.5000 /-, per day.", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Refund proportionate premium for unexpired policy period, if the term of policy is upto one year and \nthere is no claim (s) made during the policy period.", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", + "source_quote": "The Company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, \nYoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", + "source_quote": "18. \nMaternity Expenses (Code - Excl18): \ni. Medical treatment expenses traceable to childbirth", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in go-digit__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "restoration_benefit": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in go-digit__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "preventive_health_checkup": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in go-digit__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "critical_illness_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in go-digit__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs \nof treatment undergone by the insured", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cumulative Bonus will be increased by 5% in respect of each claim free policy year (where no claims are \nreported), provided the policy is renewed with the company without a break subject to maximum of 50% of", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", + "source_quote": "Treatment taken outside the geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", + "source_quote": "the Company shall indemnify Medically necessary expenses towards the Coverage mentioned in \nthe policy schedule.", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Up to 2% of the sum insured subject to maximum of Rs.5000 per day", + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", + "source_quote": "Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home up to 2% of the \nsum insured subject to maximum of Rs.5000 /-, per day.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/go-digit/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cumulative Bonus will be increased by 5% in respect of each claim free policy year (where no claims are \nreported), provided the policy is renewed with the company without a break subject to maximum of 50% of", + "_confidence": "high" } } diff --git a/40-data/policy_facts/go-digit__digit-complete-care__wordings.json b/40-data/policy_facts/go-digit__digit-complete-care__wordings.json index caf1a3514deb8b9f506d8a889769749c73469474..beb339e89ebb66e2e3b936b048e838927c59f8d2 100644 --- a/40-data/policy_facts/go-digit__digit-complete-care__wordings.json +++ b/40-data/policy_facts/go-digit__digit-complete-care__wordings.json @@ -7,132 +7,195 @@ "value": "GODHLGP21492V022021", "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Digit Complete Care Policy \nUIN: GODHLGP21492V022021 \nPOLICY WORDINGS", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where \npremium payment mode is monthly and thirty days in all other cases.", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": 36, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 100, + "source_url": "https://www.godigit.com/health-insurance/daycare-treatment-and-procedures-in-health-insurance", + "source_note": "Per insurer baseline (Go Digit Health covers all day-care up to SI; ~100 listed procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 9000, + "source_url": "https://www.godigit.com/health-insurance", + "source_note": "9000+ Cashless Hospitals (health-insurance USP section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" + }, + "maternity_coverage": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" + }, + "critical_illness_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the Insurer to the Insured where the payments, of the costs of \ntreatment undergone by the Insured", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", + "source_quote": "All \nclaims shall be paid in Indian Rupees only.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "group", + "unit": "enum", + "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", + "source_quote": "including all members under family cover and group \npolicies)", + "_confidence": "medium" + }, + "ayush_coverage": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-complete-care__wordings.pdf", + "source_quote": "not stated in go-digit__digit-complete-care__wordings.pdf", + "_confidence": "low" } } diff --git a/40-data/policy_facts/go-digit__digit-health-care-plus__wordings.json b/40-data/policy_facts/go-digit__digit-health-care-plus__wordings.json index 9cb9eba4716b07ef25c2eb94777aa49fb941bdc4..2b311b8912e0f48eb862eec1883a7ecd4422a27d 100644 --- a/40-data/policy_facts/go-digit__digit-health-care-plus__wordings.json +++ b/40-data/policy_facts/go-digit__digit-health-care-plus__wordings.json @@ -7,132 +7,246 @@ "value": "GODHLIP27048V052627", "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Digit Health Care Plus Policy – Policy Wording (UIN: GODHLIP27048V052627)", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where \npremium payment mode is monthly and thirty days in all other cases.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of thirty (30) from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "after expiry of 30 days from the first Policy Start date, provided that:", + "_confidence": "medium" }, "pre_existing_disease_waiting_months": { - "value": 36, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { - "value": 9, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 180, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 100, + "source_url": "https://www.godigit.com/health-insurance/daycare-treatment-and-procedures-in-health-insurance", + "source_note": "Per insurer baseline (Go Digit Health covers all day-care up to SI; ~100 listed procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 9000, + "source_url": "https://www.godigit.com/health-insurance", + "source_note": "9000+ Cashless Hospitals (health-insurance USP section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, + "value": 25, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Basis 1: Co-payment of 25% in the First Year of this Section being Opted, 10% on First Renewal.", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Refund proportionate premium for unexpired policy period, if the term of policy is upto one year and \nthere is no claim (s) made during the policy period.", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", + "source_quote": "A9. AYUSH COVER \nDigit Simplification: We'll cover Your in-patient medical expenses for treatments in Ayurveda, Unani, Siddha, \nor Homeopathy.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", + "source_quote": "SECTION 6. MATERNITY BENEFIT & NEW BORN BABY COVER \nA. Maternity Benefit", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", + "source_quote": "B. New Born Baby Benefit Digit Simplification: Your babies need all the love, care and cover they can get. Under this cover, we will also pay the Medical Expenses, within the limit of the Sum Insured available under the Section 6.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", + "source_quote": "We will pay You for the following incurred Medical Expenses in respect of organ transplantation: a) For the harvesting of the donated organ subject to availability of the Sum Insured under Section 1. A. Accidental & Illness Hospitalization Cover.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", + "source_quote": "SECTION 12. SUM INSURED REFILL BENEFIT Digit Simplification: We refill Your Sum Insured after You exhaust it. ===PAGE 20=== Go Digit General Insurance Ltd.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", + "source_quote": "We will pay the Medial Expenses incurred by You for any illness or Injury requiring medical treatment taken at home, which would otherwise have required Hospitalization, provided that: a) The condition of the patient is such that s/he is not in a condition to be moved to a Hospital or b) The", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", + "source_quote": "SECTION 22. HEALTH CHECKUP COVER FROM DAY ONE Digit Simplification: We pay for your health check-up expenses from Day 1 of the Policy up to the amount mentioned in your Policy .", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", + "source_quote": "We will pay You the Sum Insured as mentioned in Your Policy Schedule against this Section, in case You are diagnosed as suffering from any of the Critical Illnesses or undergoing covered Surgical Procedures as per Critical Illness plan opted by You Provided that, a) This Critical illness or covered", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the Insurer to the Insured where the payments, of the costs of \ntreatment undergone by the Insured", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", + "source_quote": "The Air ambulance services will be limited within India only and NOT overseas in any condition whatsoever.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", + "source_quote": "The Free Look Period shall be applicable on new individual health insurance policies", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-health-care-plus__wordings.pdf", + "source_quote": "not stated in go-digit__digit-health-care-plus__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/go-digit__digit-health-insurance__wordings.json b/40-data/policy_facts/go-digit__digit-health-insurance__wordings.json index ca2d57ff120ceb66df165823d4584e8fce9c5465..c171eb6b768d5f8d3085dd68fbe6bc9d9f2076f3 100644 --- a/40-data/policy_facts/go-digit__digit-health-insurance__wordings.json +++ b/40-data/policy_facts/go-digit__digit-health-insurance__wordings.json @@ -7,132 +7,255 @@ "value": "GODHLIP25039V022425", "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Digit Health Insurance Policy \nUIN: GODHLIP25039V022425", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where \npremium payment mode is monthly and thirty days in all other cases.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of thirty (30) from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "after expiry of initial 30 days from the first Policy Start date or day one from the \nfirst Policy Start date as per opted and mentioned in policy schedule", + "_confidence": "medium" }, "pre_existing_disease_waiting_months": { - "value": 36, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": 9, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Waiting period of 9 months shall apply from the date of inception of the first \npolicy with us, provided that the policy has been renewed continuously with us without break, with maternity \nas a benefit.", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 180, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 100, + "source_url": "https://www.godigit.com/health-insurance/daycare-treatment-and-procedures-in-health-insurance", + "source_note": "Per insurer baseline (Go Digit Health covers all day-care up to SI; ~100 listed procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 9000, + "source_url": "https://www.godigit.com/health-insurance", + "source_note": "9000+ Cashless Hospitals (health-insurance USP section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, + "value": 25, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Basis 1: Co-payment of 25% in the First Year of this Optional cover being Opted, 10% on First Renewal.", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The Insured has taken a multiyear policy of policy period of 3 years with annual sum insured of \nINR 3 Lakhs.", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "We will pay the Medical Expenses for Your In-patient Treatment, taken under Ayurveda, Unani, Siddha or \nHomeopathy.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "SECTION 4. MATERNITY BENEFIT WALLET & NEWBORN COVER", + "_confidence": "medium" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "New Born Baby Benefit Digit Simplification: Your babies need all the love, care and cover they can get.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "We will pay You for the following incurred Medical Expenses in respect of organ transplantation: a) For the harvesting of the donated organ subject to plan opted and availability of the Sum Insured under Section 1. Hospitalization Cover.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "SUM INSURED BACK UP Digit Simplification: We will provide a back-up Sum Insured which will be 100% of your Sum Insured amount. We shall provide you 100% of the Sum Insured as a backup under Section 1.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home under any of the following circumstances: i.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "We will pay You for the Medical Expenses incurred by You outside India. This is up to the Sum Insured as mentioned in your Policy Schedule against this section and as per plan opted by You.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "We will pay for the expenses incurred towards cost of health check-up which will be available from Day 1 of the Policy, subject to details mentioned in the Policy Schedule, subject to following conditions: a.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the Insurer to the Insured where the payments, of the costs of \ntreatment undergone by the Insured", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "The Air ambulance services will be limited within India only and NOT overseas in any condition whatsoever.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "aggregately for all insured \nmembers for a Floater Policy.", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "No room rent limit or category restrictions", + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "there are no room rent limit or category \nrestrictions!", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/go-digit/digit-health-insurance__wordings.pdf", + "source_quote": "not stated in go-digit__digit-health-insurance__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/go-digit__digit-supreme-care__wordings.json b/40-data/policy_facts/go-digit__digit-supreme-care__wordings.json index be4b0f177ca58e1b00784c514e537b3577d99f1e..113cddccbd7c6b71b9e112e21a92aff1cad5ca06 100644 --- a/40-data/policy_facts/go-digit__digit-supreme-care__wordings.json +++ b/40-data/policy_facts/go-digit__digit-supreme-care__wordings.json @@ -7,132 +7,230 @@ "value": "GODHLGP24055V012324", "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Digit Supreme Care Policy – Policy Wordings (GODHLGP24055V012324)", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period for payment of the premium for all types of insurance policies shall be: fifteen \ndays where premium payment mode is monthly and thirty days in all other cases.", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy \ncommencement date shall be excluded except claims arising due to an accident", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 36, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { - "value": 9, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 180, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 100, + "source_url": "https://www.godigit.com/health-insurance/daycare-treatment-and-procedures-in-health-insurance", + "source_note": "Per insurer baseline (Go Digit Health covers all day-care up to SI; ~100 listed procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 9000, + "source_url": "https://www.godigit.com/health-insurance", + "source_note": "9000+ Cashless Hospitals (health-insurance USP section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, + "value": 25, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Basis 1: Co-payment of 25% in the First Year of this Section being Opted, 10% on First Renewal.", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_quote": "Alternate Treatment (AYUSH) Cover \n(Mandatory In-Built cover in Section-26 \nHospitalization Cover)", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_quote": "SECTION 33. MATERNITY BENEFIT & NEWBORN BABY COVER \nA. MATERNITY BENEFIT \nIf You have opted for this Cover, We will pay the Maternity Expenses incurred towards the delivery of \na baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_quote": "NEWBORN BABY BENEFIT Under this cover, we will also pay the Medical Expenses, within the limit of the Sum Insured available under the Section 33.A. Maternity Benefit Section of the Policy, provided that We have accepted a claim under Section 33. A.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_quote": "We will pay You for the following incurred Medical Expenses in respect of organ transplantation: a) For the harvesting of the donated organ subject to availability of the Sum Insured under Section 26.B. Accidental & Illness Hospitalization Cover.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_quote": "Section 39 — Sum Insured Refill Benefit.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_quote": "We will pay the Medial Expenses incurred by You for any illness or Injury requiring medical treatment taken at home, which would otherwise have required Hospitalization, provided that: a) The condition of the patient is such that s/he is not in a condition to be moved to a Hospital or b) The", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_quote": "Health Check Up If You Renew Your Policy with Us without a break, then at every Policy Renewal We will pay the expenses incurred towards cost of health check-up up to the Limits Per Policy (excluding any cumulative bonus) mentioned in Your Policy Schedule/Certificate of Insurance.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_quote": "We will pay You the Sum Insured as mentioned in Your Policy Schedule / Certificate of Insurance against this Section, in case You are diagnosed as suffering from any of the Critical Illnesses or undergoing covered Surgical Procedures as per the Plan Opted by You and mentioned in Your Policy", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the Insurer to the Insured where the payments, of \nthe costs of treatment undergone by the Insured", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_quote": "In case Geographical Location opted as India only- Any loss arising due to any unauthorised / \nfraudulent transaction done outside India.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "group", + "unit": "enum", + "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_quote": "Digit Supreme Care Policy – Policy Wordings (GODHLGP24055V012324)", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-supreme-care__wordings.pdf", + "source_quote": "not stated in go-digit__digit-supreme-care__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/go-digit__digit-top-up__wordings.json b/40-data/policy_facts/go-digit__digit-top-up__wordings.json index fda8db7b202386e71dfd2cc489aa93f8fa93bc57..c0ebca6d06443a52a739912f2de05531836b0031 100644 --- a/40-data/policy_facts/go-digit__digit-top-up__wordings.json +++ b/40-data/policy_facts/go-digit__digit-top-up__wordings.json @@ -7,132 +7,239 @@ "value": "GODHLIP24056V012324", "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Digit Top-Up Policy – Policy Wording (GODHLIP24056V012324)", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period for payment of the premium for all types of insurance policies shall be: fifteen days \nwhere premium payment mode is monthly and thirty days in all other cases.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of thirty days from date of receipt of the policy document to \nreview the terms and conditions of the policy", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement \ndate shall be excluded except claims arising due to an accident", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 36, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 180, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 100, + "source_url": "https://www.godigit.com/health-insurance/daycare-treatment-and-procedures-in-health-insurance", + "source_note": "Per insurer baseline (Go Digit Health covers all day-care up to SI; ~100 listed procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 9000, + "source_url": "https://www.godigit.com/health-insurance", + "source_note": "9000+ Cashless Hospitals (health-insurance USP section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, + "value": 20, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "You shall \nbear a co-payment of 20% on each and every admissible claim under Section 1.", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Refund proportionate premium for unexpired policy period, if the term of policy is upto one year and there is \nno claim (s) made during the policy period.", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_quote": "SECTION 9 – AYUSH HOSPITALIZATION \n(Mandatory In-Built cover in Section-1 Hospitalization Cover)", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_quote": "18. Maternity: Code Excl18 \ni. Medical treatment expenses traceable to childbirth", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_quote": "We will pay You for the following incurred Medical Expenses in respect of organ transplantation: a) For the harvesting of the donated organ subject to plan opted and availability of the Sum Insured under Section 1. Hospitalization Cover.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_quote": "We will pay the Medial Expenses incurred by You for any Illness or Injury requiring medical treatment taken at home, which would otherwise have required Hospitalization, provided that: a) The condition of the patient is such that s/he is not in a condition to be moved to a Hospital or b) The", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_quote": "All Preventive and Rejuvenation Treatments (non-curative in nature) including, without limitation, \ntreatments that are not Medically Necessary.", + "_confidence": "medium" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_quote": "We will pay You the Sum Insured as mentioned in Your Policy Schedule against this Section, in case You are diagnosed as suffering from any of the Critical Illnesses or undergoing covered Surgical Procedures as specified below Provided that, a) This Critical illness has happened to you for the first", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the Insurer to the Insured where the payments, of the costs of \ntreatment undergone by the Insured", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_quote": "The Air ambulance services will be limited within India only and NOT overseas in any condition whatsoever.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_quote": "The deductible will be applicable on per claim basis or in aggregate (as per plan opted by You) towards \nhospitalization expenses", + "_confidence": "medium" + }, + "deductible_amount": { + "value": null, + "unit": "INR", + "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": null, + "unit": null, + "source_pdf_path": "rag/corpus/go-digit/digit-top-up__wordings.pdf", + "source_quote": "not stated in go-digit__digit-top-up__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/hdfc-ergo__energy-diabetes-hypertension__wordings.json b/40-data/policy_facts/hdfc-ergo__energy-diabetes-hypertension__wordings.json index 94c817a30b8964f7151d8bef6003767d9ebf55fa..61d7fa3fce04111ee63a2b6a7ae92deaae829da4 100644 --- a/40-data/policy_facts/hdfc-ergo__energy-diabetes-hypertension__wordings.json +++ b/40-data/policy_facts/hdfc-ergo__energy-diabetes-hypertension__wordings.json @@ -3,59 +3,68 @@ "policy_name": "Energy Diabetes Hypertension", "insurer_slug": "hdfc-ergo", "uin_code": { - "value": null, + "value": "HDFHLIP26048V052526", "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "source_quote": "UIN: Energy - HDFHLIP26048V052526", + "_confidence": "high" }, "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__energy-diabetes-hypertension__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__energy-diabetes-hypertension__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 24, + "unit": "months", "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "source_quote": "Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with insurer.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__energy-diabetes-hypertension__wordings.pdf", + "_confidence": "low" }, "maternity_coverage": { - "value": null, + "value": false, + "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "source_quote": "xiv) Maternity: Code – Excl18: i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__energy-diabetes-hypertension__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { - "value": false, + "value": true, + "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "AYUSH treatment (i) undertaken under General or Local\nexpenses are not covered" + "source_quote": "Note pertaining specifically to AYUSH Treatments only: Medical expenses pertaining only to In-patient care AYUSH treatment are also covered under 'In-patient treatment' cover if undertaken in an AYUSH Hospital.", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "Cashless facility" + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the insurer", + "_confidence": "high" }, "copayment_pct": { - "value": null, + "value": 20, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "source_quote": "If opted and mentioned on the Policy Schedule that a Co-payment is effective, and a claim has been admitted under Section 1 then, the insured person shall bear 20% of the eligible claim amount payable under the Policy", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": 10, @@ -63,59 +72,78 @@ "source_quote": "Cumulative Bonus\nOn Renewal of this Policy with the Company without a break, a sum equal to 10%" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "source_quote": "Instant addition of 100% Basic Sum Insured on complete or partial utilization of Your existing Policy Sum Insured and cumulative Bonus (if applicable) during the Policy Year.", + "_confidence": "high" }, "room_rent_capping": { - "value": null, + "value": "No cap", "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "source_quote": "Def. 41 Room Rent means the amount charged by a Hospital towards Room and Boarding expenses and shall include the associated medical expenses.", + "_confidence": "medium" }, "pre_hospitalization_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "source_quote": "Pre-Hospitalization Medical expenses for consultations, investigations and medicines incurred upto 30 days before Hospitalisation.", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "source_quote": "Post-Hospitalization Medical expenses for consultations, investigations and medicines incurred upto 60 days after discharge from Hospitalisation.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "value": [ + 200000, + 300000, + 500000, + 1000000, + 2000000, + 2500000, + 5000000 + ], + "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", + "source_quote": "Sum Insured – (Rs. In Lakhs) 2.00, 3.00, 5.00, 10.00, 20.00, 25.00, 50.00", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__energy-diabetes-hypertension__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__energy-diabetes-hypertension__wordings.pdf", + "_confidence": "low" }, "policy_type": { "value": "critical_illness", "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "classified as critical_illness from PDF heuristics" + "source_quote": "critical illness policies", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", "completeness_pct": 18, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/hdfc-ergo__energy.json b/40-data/policy_facts/hdfc-ergo__energy.json index 646e39e3233747812d9828bc4333e024459d0f05..98406d28d6076787f04ceaca4b676e905a2c0ecc 100644 --- a/40-data/policy_facts/hdfc-ergo__energy.json +++ b/40-data/policy_facts/hdfc-ergo__energy.json @@ -5,70 +5,88 @@ "uin_code": { "value": "HDFHLIP26048V052526", "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "mbai – 400 059. UIN: Energy - HDFHLIP26048V052526 1 HDFC ERGO General Insurance Company Limited Policy Wording Energy Preamble This Policy offers cover to individuals with Type 2 Diabetes Mellitus, Im" + "source_quote": "UIN: Energy - HDFHLIP26048V052526 1 Table of Contents Sr. No. P", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in hdfc-ergo__energy.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in hdfc-ergo__energy.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": null, + "value": [ + 200000, + 300000, + 500000, + 1000000, + 2000000, + 2500000, + 5000000 + ], "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "Sum Insured – (Rs. In Lakhs) 2.00, 3.00, 5.00, 10.00, 20.00, 25.00, 50.00", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "Default IRDAI 30-day waiting period applies (not explicitly quoted in extracted snippet)" + "source_quote": "not stated in energy-diabetes-hypertension__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 24, + "unit": "months", "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with insurer.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "the waiting periods specified below: i. Specified disease/procedure waiting period: Code - Excl02 a) Expenses related to the treatment of the listed Conditions, surgeries/treatments as mentioned in the table below shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy with us. This exc", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in hdfc-ergo__energy.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "2. Pre-Hospitalization Medical expenses for consultations, investigations and medicines incurred upto 30 days before Hospitalisation.", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "3. Post-Hospitalization Medical expenses for consultations, investigations and medicines incurred upto 60 days after discharge from Hospitalisation.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf" }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "t may have been taken. Def. 3 AYUSH Hospital means an AYUSH Hospital is a healthcare facility wherein medical/surgical/para- surgical treatment procedures and interventions are carried out by AYUSH Me" + "source_quote": "Note pertaining specifically to AYUSH Treatments only: Medical expenses pertaining only to In-patient care AYUSH treatment are also covered under 'In-patient treatment' cover if undertaken in an AYUSH Hospital.", + "_confidence": "high" }, "maternity_coverage": { "value": false, @@ -76,9 +94,10 @@ "source_quote": "zation xiv) Maternity: Code – Excl18: i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in energy-diabetes-hypertension__wordings.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, @@ -96,39 +115,48 @@ "source_quote": "Restore benefit 10" }, "room_rent_capping": { - "value": null, + "value": "No cap", "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "Def. 41 Room Rent means the amount charged by a Hospital towards Room and Boarding expenses and shall include the associated medical expenses.", + "_confidence": "medium" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in energy-diabetes-hypertension__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in hdfc-ergo__energy.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", - "source_quote": "orized representative. Def. 5 Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the po" + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the insurer", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in hdfc-ergo__energy.pdf", + "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__energy.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", @@ -140,6 +168,15 @@ "primary_source_pdf": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 60, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/hdfc-ergo/energy-diabetes-hypertension__wordings.pdf", + "source_quote": "Ambulance Cover 10 7", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/hdfc-ergo__group-health-insurance__wordings.json b/40-data/policy_facts/hdfc-ergo__group-health-insurance__wordings.json index d316d5d8841ede024e2f06aa725a2dc16ee58ce3..de309c0abee5acfbb26011ab5a416511e56ff0d7 100644 --- a/40-data/policy_facts/hdfc-ergo__group-health-insurance__wordings.json +++ b/40-data/policy_facts/hdfc-ergo__group-health-insurance__wordings.json @@ -3,39 +3,42 @@ "policy_name": "Group Health Insurance", "insurer_slug": "hdfc-ergo", "uin_code": { - "value": null, + "value": "HDFHLGP24095V032425", "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "UIN: HDFC ERGO Group Health Insurance - HDFHLGP24095V032425", + "_confidence": "high" }, "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__group-health-insurance__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__group-health-insurance__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer.", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "30-DAY WAITING PERIOD: CODE – EXCL03 a) Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered.", + "_confidence": "high" }, "maternity_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "Maternity Cover does not have an independent Sum Insured, hence any claim admissible\nunder this cover shall reduce the S" + "source_quote": "14. Maternity Cover We will indemnify Maternity Expenses incurred by the Insured Person under Section 2.A.I.a,incurred during the Policy Year.", + "_confidence": "high" }, "maternity_waiting_months": { "value": 48, @@ -44,33 +47,42 @@ }, "ayush_coverage": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "AYUSH Treatment\nWe will indemnify Medical Expenses covered" + "source_quote": "Note: AYUSH Treatment is no longer an optional cover. Basis CIR. Ref. IRDAI/HLT/CIR/GDL/31/01/2024 issued by IRDAI, all Insured Persons shall be covered by default for In-patient care expenses under this cover upto Sum Insured", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "Cashless Facility" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the Network Provider by the insurer", + "_confidence": "high" }, "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__group-health-insurance__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__group-health-insurance__wordings.pdf", + "_confidence": "low" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "In the event of complete or partial utilization of the Base Sum Insured due to any claim admitted during the Policy Year, the Company shall reinstate only the utilized portion of the Base Sum Insured of Section 2.A.I. (as applicable under the current Policy Year)", + "_confidence": "high" }, "room_rent_capping": { - "value": null, + "value": "no limit", + "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "Room Rent and boarding charges at actuals (unless specified otherwise in the Policy Schedule / Certificate of Insurance)", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 30, @@ -83,39 +95,53 @@ "source_quote": "Post-Hospitalization Medical Expenses Cover\nWe will indemnify the Post-HospitalizationMedical Expenses incurred upto 60 " }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__group-health-insurance__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__group-health-insurance__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__group-health-insurance__wordings.pdf", + "_confidence": "low" }, "policy_type": { "value": "group", "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "Hospital cash policies, which will apply before any benefits are payable", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", "completeness_pct": 32, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" + }, + "co_payment_pct": { + "value": null, + "unit": "percent", + "source_pdf_path": "rag/corpus/hdfc-ergo/group-health-insurance__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__group-health-insurance__wordings.pdf", + "_confidence": "low" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/hdfc-ergo__my-health-medisure-prime.json b/40-data/policy_facts/hdfc-ergo__my-health-medisure-prime.json index 6e68d2871cad73d1cb60211032b6641e842e9b82..4b8247841547b26ebcc361c810f8ae1652c429ba 100644 --- a/40-data/policy_facts/hdfc-ergo__my-health-medisure-prime.json +++ b/40-data/policy_facts/hdfc-ergo__my-health-medisure-prime.json @@ -5,35 +5,35 @@ "uin_code": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "UIN not found in extracted text" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime.pdf", + "_confidence": "low" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "Default IRDAI 30-day waiting period applies (not explicitly quoted in extracted snippet)" + "source_quote": "first 30 days from the commencement date of the Policy except in case of accidental injuries", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, @@ -41,29 +41,35 @@ "source_quote": "any of the following: 1. All pre-existing diseases / illness / injury / conditions as defined in the Policy, until 24 months of continuous covers have elapsed since inception of the first Policy with " }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "not stated in my-health-medisure-prime__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -73,7 +79,8 @@ "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "Any treatment arising from or traceable to pregnancy, childbirth including caesarean section until 48 months of continuous coverage has elapsed since the inception of the first policy with us", + "_confidence": "high" }, "newborn_coverage": { "value": true, @@ -96,9 +103,10 @@ "source_quote": "restoration of the previous state of health" }, "room_rent_capping": { - "value": null, + "value": "No cap", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "“Room Rent” means the amount charged by a hospital for the occupancy of a bed on per day (24 hours) basis and shall include associated medical expenses.", + "_confidence": "medium" }, "copayment_pct": { "value": 25, @@ -108,32 +116,39 @@ "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "ollowing disease/illness: 30 “Cashless Service” means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the Po" + "source_quote": "“Cashless Service” means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy terms and conditions, are directly made to the network provider by the insurer to t", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime.pdf", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime.pdf", + "_confidence": "low" }, "policy_type": { "value": "hospital-cash", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "Hospital Cash This Policy provides for payment to the Insured / Insured P", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", @@ -142,4 +157,4 @@ "completeness_pct": 60, "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/hdfc-ergo__my-health-medisure-prime__wordings.json b/40-data/policy_facts/hdfc-ergo__my-health-medisure-prime__wordings.json index c140c4f3c80d0f094d4b7af1a9b363fdc1fb96de..7e54ee8b1008b03b509fcada25b2f3f8ecbc7020 100644 --- a/40-data/policy_facts/hdfc-ergo__my-health-medisure-prime__wordings.json +++ b/40-data/policy_facts/hdfc-ergo__my-health-medisure-prime__wordings.json @@ -7,132 +7,232 @@ "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime__wordings.pdf", + "_confidence": "low" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Renewals are deemed to be continuous when received within a period of 30 days from the date of expiry of last policy subject however to the effective policy inception date being reckoned from such period when the renewal premium is received", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "A period of 15 days from the date of receipt of the Policy document is available to review the terms and conditions of this Policy.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Any disease contracted and/or medical expenses incurred in respect of any disease/illness by the Insured/Insured Person during the first 30 days from the commencement date of the Policy except in case of accidental injuries.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 48, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "All pre-existing diseases / illness / injury / conditions as defined in the Policy, until 24 months of continuous covers have elapsed since inception of the first Policy with us.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "any type of Breast lumps, Hypertension and Diabetes and related complications during the first two years(24 months) of continuous operation of this insurance cover. Diabe", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalisation Expenses Company will pay the Medical Expenses incurred in the 60 days immediately before Insured is Hospitalized", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-Hospitalisation Expenses Company will pay the Medical Expenses incurred in the 90 days immediately after Insured is discharged", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, + "value": 25, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "additional co-payment of 25% of the admissible claim is to be borne by any Insured/Insured Person above 70 years irrespective of the Zone of treatment", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy Period option Policy can be issued or renewed for one year", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-medisure-prime__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", + "source_quote": "27. Any form of Non-Allopathic treatment, Naturopathy, hydrotherapy, Ayurvedic, Homeopathy, Acupuncture, Reflexology, Chiropractic treatment or any other form of indigenous system of medicine.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", + "source_quote": "8. Maternity Cover Medical Expenses for the delivery of a child (including pre-post natal expenses) and/or Expenses related to a Medically Necessary and lawful ", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", + "source_quote": "New Born Baby Cover Coverage for a New Born Baby shall be allowed subject to a valid claim being accepted under Maternity Cover 8 above", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", + "source_quote": "Donor Expenses This Policy provides for reimbursement of expenses incurred towards donor in case of major organ transplant, for the harvesting of the organ provided that:", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", + "source_quote": "Domiciliary hospitalization” means medical treatment actually taken at home for a period exceeding 3 days, for an illness/disease/injury which in the normal course would require care and treatment at a Ho", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", + "source_quote": "This Policy provides for an all paid Comprehensive Health Check-Up (designed by the Company) for Insured Persons above the age of 45 years at the end of every t", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", + "source_quote": "Critical Illness (Additional Coverage on Reimbursement) The Policy provides for an additional amount equivalent to the Sum Insured opted under Hospitalisa", + "_confidence": "medium" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", + "source_quote": "“Cashless Service” means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy terms and conditions, are directly", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", + "source_quote": "A 5% increase in Sum Insured will be allowed at the time of renewal, where the Policy is claim free in the expiring year. This cumulative bonus can be accumulated up to a maximum of 50%", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", + "source_quote": "Hospitalisation in any Hospital/Nursing Home in India (hereinafter called \"Hospital\") upon the advice of a duly qualified Medical Practitioner", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", + "source_quote": "“Family Floater” means a Policy described as such in the Schedule whereunder You and Your Dependents named in the Schedule are insured under this Policy from date of inception.", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-medisure-prime__wordings.pdf", + "source_quote": "A 5% increase in Sum Insured will be allowed at the time of renewal, where the Policy is claim free in the expiring year. This cumulative bonus can be accumulated up to a maximum of 50%", + "_confidence": "high" } } diff --git a/40-data/policy_facts/hdfc-ergo__my-health-sampoorna-suraksha.json b/40-data/policy_facts/hdfc-ergo__my-health-sampoorna-suraksha.json index 58147209c1da7a0b0942b48a0fba7704091ccdd6..40260b89fc4c5cb45927b23ecca98a9a0fbde68d 100644 --- a/40-data/policy_facts/hdfc-ergo__my-health-sampoorna-suraksha.json +++ b/40-data/policy_facts/hdfc-ergo__my-health-sampoorna-suraksha.json @@ -5,95 +5,108 @@ "uin_code": { "value": "HDFHLIP21005V022122", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "UIN: my:Sampoorna Suraksha - HDFHLIP21005V022122. HDFC ERGO General Insurance Company Limited Prospectus my: Sampoorna Suraksha iv. Any other Medical Expenses or Hospitalization consequent to 3. my: H" + "source_quote": "UIN: my:Sampoorna Suraksha - HDFHLIP21005V022122. I. Coverage Section 1: my:he", + "_confidence": "high" }, "min_entry_age": { - "value": null, + "value": 18, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Min entry age not found" + "source_quote": "Entry Age Base Cover: Proposer Adult Dependent Child/Children Minimum Entry Age – 18 Years Minimum Entry Age – 18 Years Minimum Entry Age – 91 days Maximum Entry Age – Lifetime Entry Maximum Entry Age – Lifetime Entry Maximum Entry Age - 25 years", + "_confidence": "high" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "Entry Age Base Cover: Proposer Adult Dependent Child/Children Minimum Entry Age – 18 Years Minimum Entry Age – 18 Years Minimum Entry Age – 91 days Maximum Entry Age – Lifetime Entry Maximum Entry Age – Lifetime Entry Maximum Entry Age - 25 years", + "_confidence": "high" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in hdfc-ergo__my-health-sampoorna-suraksha.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Schedule for up to maximum of 30 days Waiting Period for Preexisting conditions 12 Months 2. Companion Benefit General Waiting Period 30 Days We will pay additional amount upto the limit specified on " + "source_quote": "30-day waiting period – Code – Excl03 a) Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 48, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 48 months of continuous coverage after the date of inception of the first policy with", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": 48, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "re covered subject to waiting Period as specified below: i) Pre-existing Diseases – Code – Excl01 a) Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 48 months of continuous coverage after the date of inception of the first policy with insurer. b) In ca", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in hdfc-ergo__my-health-sampoorna-suraksha.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "Pre-Hospitalization cover We will pay for the Pre-hospitalization Medical Expenses incurred during the 60 days immediately before Hospitalization of an Insured Person provided that Claim under Section I.1A.1 or I.1.A.6 is admissible under the Policy.", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 180, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "Post-Hospitalization cover We will pay for the Post-Hospitalization Medical Expenses incurred upto180 days from the date Insured Person is discharged from Hospital provided that Claim under Section I.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "tment of Insured Person in an AYUSH Hospital OR for the below Alternative Treatments prescribed by the Medical • burning total of 900 calories upto maximum of 300 calories in Practitioner one exercise" + "source_quote": "AYUSH treatment are also covered under ‘In-patient Hospitalization expenses’ cover if undertaken in an AYUSH Hospital.", + "_confidence": "high" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "Maternity: Code – Excl18 a.", + "_confidence": "high" }, "newborn_coverage": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "New Born iii. Treatment for impotency, treatment to effect inf" + "source_quote": "New Born Baby Cover–We will cover New Born Baby immediately after the birth as per original terms of the Policy on receipt of completed proposal form and Premi", + "_confidence": "high" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Organ Donor Expenses amount under each and every Claim If Co-payment under Section We will pay Medical Expenses as listed under Section I.1.A1 towards I.1.C-14 is opted and specified in the Schedule o" + "source_quote": "8. Organ Donor Expenses We will pay Medical Expenses as listed under Section I", + "_confidence": "high" }, "no_claim_bonus_pct": { - "value": 50, + "value": 5, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Cumulative Bonus can be accumulated upto 50% of Basic Sum • In case of Increase in Sum Insured" + "source_quote": "f the Policy with Us, We will apply 5% of Basic Sum Insured under expiring Policy as Cumulative Bonus in the Policy provided that; i. There has been no", + "_confidence": "high" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Restoration benefit not found in extracted text" + "source_quote": "Sum Insured Rebound We will add to the Sum Insured, an amount equivalent to the Claim amount paid under Basic Sum Insured, subject to maximum of Basic Sum Insured, on subsequent Hospitalization of the", + "_confidence": "high" }, "room_rent_capping": { "value": "Room Rent, boarding and Nursing – limit of 1% of the Basic Sum", @@ -101,39 +114,47 @@ "source_quote": "Room Rent, boarding and Nursing – limit of 1% of the Basic Sum" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in my-health-sampoorna-suraksha__brochure.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Aggregate Deductible and subject to a maximum of the Sum" + "source_quote": "not stated in hdfc-ergo__my-health-sampoorna-suraksha.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Cover can be availed through Cashless Facility only as procedure Policy Schedule given under Claims Procedure - Section IV. Insured Person shall bear specified percentage of admissible Claim 8. Organ " + "source_quote": "This Cover can be availed through Cashless Facility only as procedure given under Claims Procedure - Section IV", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in hdfc-ergo__my-health-sampoorna-suraksha.pdf", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": "not stated in hdfc-ergo__my-health-sampoorna-suraksha.pdf", + "_confidence": "low" }, "policy_type": { "value": "hospital-cash", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "Hospital Cash Benefit Add on Section 5: my:health Koti Suraksha - Persona", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", @@ -142,4 +163,4 @@ "completeness_pct": 60, "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/hdfc-ergo__my-health-sampoorna-suraksha__brochure.json b/40-data/policy_facts/hdfc-ergo__my-health-sampoorna-suraksha__brochure.json index 271d19ce4054140ebe5beaa4d0df564f44888d60..c0829933b8a7494f543411bb89b82eb916c06d7c 100644 --- a/40-data/policy_facts/hdfc-ergo__my-health-sampoorna-suraksha__brochure.json +++ b/40-data/policy_facts/hdfc-ergo__my-health-sampoorna-suraksha__brochure.json @@ -7,132 +7,248 @@ "value": "HDFHLIP21005V022122", "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: my:Sampoorna Suraksha - HDFHLIP21005V022122.", + "_confidence": "high" }, "min_entry_age": { - "value": null, + "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Entry Age Base Cover: Proposer Adult Dependent Child/Children Minimum Entry Age – 18 Years Minimum Entry Age – 18 Years Minimum Entry Age – 91 days Maximum Entry Age – Lifetime Entry Maximum Entry Age – Lifetime Entry Maximum Entry Age - 25 years", + "_confidence": "high" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry Age Base Cover: Proposer Adult Dependent Child/Children Minimum Entry Age – 18 Years Minimum Entry Age – 18 Years Minimum Entry Age – 91 days Maximum Entry Age – Lifetime Entry Maximum Entry Age – Lifetime Entry Maximum Entry Age - 25 years", + "_confidence": "high" }, "min_child_entry_age": { - "value": null, + "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Entry Age Base Cover: Proposer Adult Dependent Child/Children Minimum Entry Age – 18 Years Minimum Entry Age – 18 Years Minimum Entry Age – 91 days Maximum Entry Age – Lifetime Entry Maximum Entry Age – Lifetime Entry Maximum Entry Age - 25 years", + "_confidence": "medium" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-sampoorna-suraksha__brochure.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "12. Grace Period i. A Grace Period of 30 days is available for Renewal of the Policy. Any Illness, disease or condition contracted during Grace Period will not be covered and will be treated as Pre-existing diseases.", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Insured Person shall be allowed free look period of fifteen days from date of receipt of the policy document to review the terms and conditions of the policy, and to ", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "iii) 30-day waiting period – Code – Excl03 a) Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Option 1 General Waiting Period 30 Days Waiting Period for listed illnesses and Procedures 24 Months Waiting Period for Preexisting conditions 36 Months", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ii) Specified Disease/Procedure waiting period- Code – Excl02 a) Expenses related to the treatment of the listed Conditions, surgeries/ treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy with us.", + "_confidence": "high" }, "maternity_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in hdfc-ergo__my-health-sampoorna-suraksha__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "4. Pre-Hospitalization cover We will pay for the Pre-hospitalization Medical Expenses incurred during the 60 days immediately before Hospitalization of an Insured Person", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "5. Post-Hospitalization cover We will pay for the Post-Hospitalization Medical Expenses incurred upto180 days from the date Insured Person is discharged from Hospital", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-sampoorna-suraksha__brochure.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-sampoorna-suraksha__brochure.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Month Policy Tenure 1 Year Policy Tenure 2 Year Policy Tenure 3 Year", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-sampoorna-suraksha__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-sampoorna-suraksha__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-sampoorna-suraksha__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": "Medical expenses pertaining only to In-patient care AYUSH treatment are also covered under ‘In-patient Hospitalization expenses’ cover if undertaken in an AYUSH Hospital.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": "Medical Expenses under Section I.1.A1 for Maternity Expenses limited up to 2 deliveries or 1 delivery and 1 termination or 2 terminations during the lifetime of the Insured Person", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": "New Born Baby Cover–We will cover New Born Baby immediately after the birth as per original terms of the Policy on receipt of completed proposal form and Premi", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": "8. Organ Donor Expenses We will pay Medical Expenses as listed under Section I", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": "Sum Insured Rebound We will add to the Sum Insured, an amount equivalent to the Claim amount paid under Basic Sum Insured, subject to maximum of Basic Sum Insu", + "_confidence": "medium" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": "Domiciliary Hospitalization We will pay the Medical Expenses incurred on Domiciliary Hospitalization of the Insured Person provided that: i", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": "anywhere in the world", + "_confidence": "medium" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": "Health Check-Up After every block of every four consecutive, continuous and Claim free Policy Years with Us, We will pay towards cost of Preventive Health Check-upto specified", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": "Critical Illnesses Cover 1", + "_confidence": "medium" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": "This Cover can be availed through Cashless Facility only as procedure given under Claims Procedure - Section IV.", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": "Cumulative Bonus can be accumulated upto 50% of Basic Sum Insured.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": " as mentioned in the Schedule of Coverage on the Policy Schedule, subject to Co- Payment, Deductible and Sub-limit as applicable and within India only. Medical ", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": "loading where ever applicable will be applied on individual Renewal Premium for both Individual and Floater Sum Insured basis Policie", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-sampoorna-suraksha__brochure.pdf", + "source_quote": "2. Cumulative Bonus On each Renewal of the Policy with Us, We will apply 5% of Basic Sum Insured under expiring Policy as Cumulative Bonus in the Policy", + "_confidence": "high" } } diff --git a/40-data/policy_facts/hdfc-ergo__my-health-suraksha.json b/40-data/policy_facts/hdfc-ergo__my-health-suraksha.json index c9d583f1c2fdd7abec6dfc4383721fa2600e2322..14244a5380fe53e32c2f01d3c32b56e5fec52e0b 100644 --- a/40-data/policy_facts/hdfc-ergo__my-health-suraksha.json +++ b/40-data/policy_facts/hdfc-ergo__my-health-suraksha.json @@ -5,24 +5,22 @@ "uin_code": { "value": "HDFHLIP24079V072324", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "le. UIN: my:health Suraksha - HDFHLIP24079V072324 | my:Health Hospital Cash Benefit (Add-on) - 1 HDFHLIA21271V022021 | my: health Critical Illness - HDFHLIA22141V032122. HDFC ERGO General Insurance Co" + "source_quote": "UIN: my:health Suraksha - HDFHLIP24079V072324 | my:Health Hospital Cash Ben", + "_confidence": "high" }, "min_entry_age": { - "value": null, + "value": 18, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "Min entry age not found" + "source_quote": "Entry Age: Base Cover Proposer Adult Dependent Child/Children • Minimum Entry Age – 18 Years • Minimum Entry Age – 18 Years • Minimum Entry Age – 91 days • Maximum Entry Age – Lifetime Entry • Maximum Entry Age - Lifetime Entry • Maximum Entry Age - 25 years", + "_confidence": "high" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "Entry Age: Base Cover Proposer Adult Dependent Child/Children • Minimum Entry Age – 18 Years • Minimum Entry Age – 18 Years • Minimum Entry Age – 91 days • Maximum Entry Age – Lifetime Entry • Maximum Entry Age - Lifetime Entry • Maximum Entry Age - 25 years", + "_confidence": "high" }, "sum_insured_options": { "value": [ @@ -31,67 +29,81 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "Practitioner and 1. Multiple sum insured options ranging from 1 Lac to Rs. 5 Cr available ii. the condition the Insured Person is such that he/she could not under this policy. be removed to a Hospital" + "source_quote": "sum insured options ranging from 1 Lac to Rs", + "_confidence": "medium" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "after the expiry of 48 months 30 days from the first Policy commencement date shall for any pre-existing disease is subject to the same being be excluded except claims arising due to an Accident, decl" + "source_quote": "30-day waiting period – Code – Excl03 a) Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 48, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 48 months of continuous coverage after the date of inception of the first policy with", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "pplication and accepted by Insurer. ii) Specified Disease/Procedure waiting period - Code – Excl02 a) Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy with us. This exc", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in hdfc-ergo__my-health-suraksha.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 30, + "value": 60, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "ration of the policy at least 30 days before the policy renewal Person opts for Hospitalization with Room Rent up to Rs 2,500 date as per IRDAI guidelines on Migration. If such person is presently per" + "source_quote": "We will pay for the Pre-Hospitalization Medical Expenses incurred during the 60 days immediately before Hospitalization of an Insured Person, pr", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 180, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "Post-Hospitalization cover We will pay for the Post-Hospitalization Medical Expenses incurred upto 180 days from the day Insured Person is discharged from Hospital provided that Claim under Section A1", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/my-health-suraksha-plan", + "source_note": "HDFC Ergo My:health Suraksha; 144 day-care procedures per insurer baseline", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "tment of Insured Person in an AYUSH Hospital for the below Alternative Treatments prescribed by the Medical OR Practitioner • burning total of 900 calories upto maximum of 300 calories • Ayurvedic in " + "source_quote": "only Inpatient care treatment of Insured Person in an AYUSH Hospital for the below Alternative Treatments prescribed by the Medical Practitioner • Ayurvedic • Unani • Siddha • Homeopathy • Yoga & Naturopathy provided that; i", + "_confidence": "high" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "doctor xv. Maternity: Code – Excl18 b. The surgery/procedure conducted should be supported by a. Medical treatment expenses traceable to childbirth clinical protocols (including complicated deliv" + "source_quote": "Maternity: Code – Excl18 a.", + "_confidence": "high" }, "newborn_coverage": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "New Born baby cover: We will pay/cover following expenses towards Chil" + "source_quote": "New Born Baby Cover – We will cover New Born Baby from 91st day after the birth as per original terms of the Policy on receipt of completed proposal form and P", + "_confidence": "high" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "Organ Donor Expenses Healthcare for Medically Necessary Treatment of Illnesses, if We will pay Medical Expenses as listed under Section A1 towards prescribed by treating Medical Practitioner. We will " + "source_quote": "8. Organ Donor Expenses We will pay Medical Expenses as listed under Section A1 towards organ donor’s Hospitalization for harvesting of the donated organ where an Insured Person is the recipient, provided that; • The organ", + "_confidence": "high" }, "no_claim_bonus_pct": { - "value": 50, + "value": 5, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "Cumulative Bonus can be accumulated upto 50% of Basic Sum Insured. • For Policies covering mor" + "source_quote": "f the Policy with Us, We will apply 5% of Basic Sum Insured under expiring Policy as Cumulative Bonus in the Policy provided that; 1. There has been no", + "_confidence": "high" }, "restoration_benefit": { "value": "Restore (Add-", @@ -104,39 +116,47 @@ "source_quote": "Room Rent, boarding & Nursing – limit of 1% of the Basic Sum" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in my-health-suraksha__brochure.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in hdfc-ergo__my-health-suraksha.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "Cover can be availed through Cashless Facility only as procedure • The organ donor is any person whose organ has been given under Claims Procedure. made available in accordance and in compliance with " + "source_quote": "This Cover can be availed through Cashless Facility only as procedure given under Claims Procedure", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in hdfc-ergo__my-health-suraksha.pdf", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "not stated in hdfc-ergo__my-health-suraksha.pdf", + "_confidence": "low" }, "policy_type": { "value": "hospital-cash", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "Hospital Cash Benefit (Add-on) - HDFHLIA21271V022021 | my: health Critica", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", @@ -145,4 +165,4 @@ "completeness_pct": 75, "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/hdfc-ergo__my-health-suraksha__brochure.json b/40-data/policy_facts/hdfc-ergo__my-health-suraksha__brochure.json index ca0f1b23abd3b7ac3ce77b430debcdab533e6397..9c4302726dbb69fb3075b6c650622bd763dcddc6 100644 --- a/40-data/policy_facts/hdfc-ergo__my-health-suraksha__brochure.json +++ b/40-data/policy_facts/hdfc-ergo__my-health-suraksha__brochure.json @@ -7,31 +7,29 @@ "value": "HDFHLIP24079V072324", "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: my:health Suraksha - HDFHLIP24079V072324", + "_confidence": "high" }, "min_entry_age": { - "value": null, + "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Minimum Entry Age – 18 Years • Minimum Entry Age – 18 Years • Minimum Entry Age –", + "_confidence": "medium" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry Age: Base Cover Proposer Adult Dependent Child/Children • Minimum Entry Age – 18 Years • Minimum Entry Age – 18 Years • Minimum Entry Age – 91 days • Maximum Entry Age – Lifetime Entry • Maximum Entry Age - Lifetime Entry • Maximum Entry Age - 25 years", + "_confidence": "high" }, "min_child_entry_age": { - "value": null, + "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Minimum Entry Age – 18 Years • Minimum Entry Age – 18 Years • Minimum Entry Age –", + "_confidence": "medium" }, "sum_insured_options": { "value": [ @@ -68,102 +66,220 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Multiple sum insured options ranging from 1 Lac to Rs. 5 Cr available under this policy.", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "16. Grace Period i. A Grace Period of 30 days is available for Renewal of the Policy. Any Illness, disease or condition contracted during Grace Period will not be covered and will be treated as Pre- existing diseases.", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Insured Person shall be allowed free look period of fifteen days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not acceptable.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Waiting Period for listed illnesses and Procedures 24 Months Waiting Period for Preexisting conditions 36 Months Option 2 General Waiting Period 30 Days", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy with us. This exclusion shall not be applicable for claims arising due to an Accident.", + "_confidence": "high" }, "maternity_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in hdfc-ergo__my-health-suraksha__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Hospitalization Medical Expenses incurred during the 60 days immediately before Hospitalization of an Insured Person, provided that Claim under Section A1 is admissible under the Policy.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "5. Post-Hospitalization cover We will pay for the Post-Hospitalization Medical Expenses incurred upto 180 days from the day Insured Person is discharged from Hospital", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/my-health-suraksha-plan", + "source_note": "HDFC Ergo My:health Suraksha; 144 day-care procedures per insurer baseline", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-suraksha__brochure.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-suraksha__brochure.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "This policy can be issued for 1 year/ 2 years/ 3 years.", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-suraksha__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-suraksha__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-suraksha__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "only Inpatient care treatment of Insured Person in an AYUSH Hospital for the below Alternative Treatments prescribed by the Medical Practitioner • Ayurvedic • Unani • Siddha • Homeopathy • Yoga & Naturopathy", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "Medical Expenses under Section A1 for Maternity Expenses limited up to 2 deliveries or 1 delivery and 1 termination or 2 terminations during the lifetime of the Insured Person", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "New Born Baby Cover – We will cover New Born Baby from 91st day after the birth as per original terms of the Policy on receipt of completed proposal form and P", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "8. Organ Donor Expenses We will pay Medical Expenses as listed under Section A1 towards organ donor’s Hospitalization for harvesting of the donated organ where an Insured Person is the recipient, provided that; • The organ", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "Sum Insured Rebound We will add to the Sum Insured, an amount equivalent to the Claim amount paid under Basic Sum Insured, subject to maximum of Basic Sum Insu", + "_confidence": "medium" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "Domiciliary Hospitalization We will pay the Medical Expenses incurred on Domiciliary Hospitalization of the Insured Person provided that: i", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "anywhere in the world 5", + "_confidence": "medium" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "Health Check-Up After the completion of every block of four consecutive, continuous and Claim free Policy Years with Us, We will pay towards cost of Preventive Health Check- u", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "Critical Illness cover for which maximum Entry Age is restricted to 65 years", + "_confidence": "medium" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "This Cover can be availed through Cashless Facility only as procedure given under Claims Procedure.", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "3. Cumulative Bonus can be accumulated upto 50% of Basic Sum Insured.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "worldwide", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "Unique plan with coverage for hospitalization expenses anywhere in the world", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "ccrued. Such discount will be applicable on individual Renewal Premium for both Individual and Floater Su", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-suraksha__brochure.pdf", + "source_quote": "On each Renewal of the Policy with Us, We will apply 5% of Basic Sum Insured under expiring Policy as Cumulative Bonus in the Policy", + "_confidence": "high" } } diff --git a/40-data/policy_facts/hdfc-ergo__my-health-women-suraksha.json b/40-data/policy_facts/hdfc-ergo__my-health-women-suraksha.json index b7d7366892d1c38346984c1188ceba9f2ef742bd..1a809848857a75ac3600a0cba2e405e1040a1177 100644 --- a/40-data/policy_facts/hdfc-ergo__my-health-women-suraksha.json +++ b/40-data/policy_facts/hdfc-ergo__my-health-women-suraksha.json @@ -8,21 +8,18 @@ "source_quote": "N: my:health Women Suraksha - HDFHLIP22142V032122. UID: 17332." }, "min_entry_age": { - "value": null, + "value": 18, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Min entry age not found" + "source_quote": "18 Years 65 Years (for optional pregnancy cover 18 to 40 years)", + "_confidence": "high" }, "max_entry_age": { - "value": null, + "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "18 Years 65 Years (for optional pregnancy cover 18 to 40 years)", + "_confidence": "high" }, "sum_insured_options": { "value": [ @@ -31,112 +28,136 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "**As per filed document, the sum insured option available is from ` 1 lakh to ` 5 crores my:health Women Suraksha Sum Insured ` ` 1 1 to Lakh Crore (Multiples of 1 lakh) Plans Women Cancer Plus Plan -" + "source_quote": "sum insured options ranging from `1 lakh to `1 crore available under this policy** Coverage for all the women in the family under single po", + "_confidence": "medium" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Default IRDAI 30-day waiting period applies (not explicitly quoted in extracted snippet)" + "source_quote": "not stated in my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "3 years for all pre-existing conditions declared and/or accepted at the time of applying first policy with us", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "not stated in my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "maternity_waiting_months": { - "value": null, + "value": 12, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "1 year for pregnancy complications and newborn complications 3 years for all pre-existing conditions declared and/or accepted at the time of applying first policy with us", + "_confidence": "high" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf" }, "ayush_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "AYUSH coverage not found in extracted text" + "source_quote": "not stated in my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "maternity_coverage": { - "value": false, + "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "Coverage for pregnancy complications and newborn baby complications", + "_confidence": "high" }, "newborn_coverage": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "newborn baby coach, etc. for maintenance complications of good" + "source_quote": "Coverage for pregnancy complications and newborn baby complications", + "_confidence": "high" }, "organ_donor_expenses": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Organ donor cover not extracted" + "source_quote": "not stated in my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Restoration benefit not found in extracted text" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { - "value": true, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Cashless mention not found" + "source_quote": "not stated in my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha.pdf", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "Default indemnity (no explicit alternate type detected)" + "source_quote": "critical illness cover (41 Illness covered) Women Cardiac Plan - Cardiac ail", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", @@ -145,4 +166,4 @@ "completeness_pct": 55, "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/hdfc-ergo__my-health-women-suraksha__brochure.json b/40-data/policy_facts/hdfc-ergo__my-health-women-suraksha__brochure.json index a334536bbde499e0a994d64065fc7f92fb873c3f..9348292128b7f82be00c982681c60a3596184be2 100644 --- a/40-data/policy_facts/hdfc-ergo__my-health-women-suraksha__brochure.json +++ b/40-data/policy_facts/hdfc-ergo__my-health-women-suraksha__brochure.json @@ -7,31 +7,29 @@ "value": "HDFHLIP22142V032122", "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: my:health Women Suraksha - HDFHLIP22142V032122.", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "18 Years 65 Years (for optional pregnancy cover 18 to 40 years)", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "18 Years 65 Years (for optional pregnancy cover 18 to 40 years)", + "_confidence": "high" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -47,102 +45,171 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Multiple sum insured options ranging from `1 lakh to `1 crore available under this policy** Coverage for all the women in the family under single policy Comprehensive policy with coverage for women-specific major illnesses and surgeries **As per filed document, the sum insured option available is from ` 1 lakh to ` 5 crores", + "_confidence": "medium" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "free_look_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "7 Days Survival Period 90 days and 180 days as per the illness specified in policy wordings Waiting Period", + "_confidence": "medium" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "3 years for all pre-existing conditions declared and/or accepted at the time of applying first policy with us", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 6, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "maternity_waiting_months": { - "value": null, + "value": 12, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "1 year for pregnancy complications and newborn complications 3 years for all pre-existing conditions declared and/or accepted at the time of applying first policy with us", + "_confidence": "high" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Year1 Years2 Years3 Policy Period", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha__brochure.pdf", + "_confidence": "low" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", + "source_quote": "Coverage for pregnancy complications and newborn baby complications", + "_confidence": "medium" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", + "source_quote": "Coverage for pregnancy complications and newborn baby complications", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", + "source_quote": "health check-up at renewal Wellness Benefits my:health Active## Fitness discounts @ Renewal Health incentive Wellness Services and Health Coach u u my:health Women Suraksha Yea", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", + "source_quote": "41 listed critical illness / cancer, major illness, surgical procedures, cardiac illness and procedures as specified in policy coverage Illnesses C", + "_confidence": "medium" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha__brochure.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", + "source_quote": "not stated in hdfc-ergo__my-health-women-suraksha__brochure.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "critical_illness", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-health-women-suraksha__brochure.pdf", + "source_quote": "Women CI Comprehensive Plan - Cancer cover, major illness, surgical procedures and cardiac ailments and procedures, critical illness cover (41 Illness covered)", + "_confidence": "high" } } diff --git a/40-data/policy_facts/hdfc-ergo__my-optima-secure-older-variant__wordings.json b/40-data/policy_facts/hdfc-ergo__my-optima-secure-older-variant__wordings.json index 4484440155ec40b47cc0ca07966fec96b3dd751c..5cfa91f0743f54031220204a419afde0ff7d754a 100644 --- a/40-data/policy_facts/hdfc-ergo__my-optima-secure-older-variant__wordings.json +++ b/40-data/policy_facts/hdfc-ergo__my-optima-secure-older-variant__wordings.json @@ -3,64 +3,70 @@ "policy_name": "My Optima Secure Older Variant", "insurer_slug": "hdfc-ergo", "uin_code": { - "value": null, + "value": "HDFHLIP21016V012122", "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "" + "source_quote": "UIN: my: Optima Secure - HDFHLIP21016V012122.", + "_confidence": "high" }, "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__my-optima-secure-older-variant__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": 99, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Lifelong Renew" + "source_quote": "not stated in hdfc-ergo__my-optima-secure-older-variant__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "" + "source_quote": "a. Pre-Existing Diseases – Code – Excl01 i. Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer.", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "" + "source_quote": "30-day waiting period – Code – Excl03 i. Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "maternity_coverage": { - "value": null, + "value": false, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "" + "source_quote": "r. Maternity: Code – Excl18 i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy;", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__my-optima-secure-older-variant__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "" + "source_quote": "AYUSH Treatment The Company shall indemnify the Medical Expenses incurred by the Insured Person for Inpatient Care under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up ", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Cashless Facility" + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the insurer", + "_confidence": "high" }, "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__my-optima-secure-older-variant__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { - "value": 10, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Cumulative Bonus (CB) 2. Optional Covers\nCumulative Bonus (CB) will be applied/increased by 10%" + "source_quote": "not stated in my-optima-secure-older-variant__wordings.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": "restoration under the Automatic", @@ -68,9 +74,10 @@ "source_quote": "restoration under the Automatic" }, "room_rent_capping": { - "value": "Room Rent Section B-1.1\niii. Road Ambulance up to", + "value": "no cap", "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Room Rent Section B-1.1\niii. Road Ambulance up to" + "source_quote": "Room Rent means the amount charged by a Hospital towards Room and Boarding expenses and shall include the associated medical expenses", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 60, @@ -83,39 +90,55 @@ "source_quote": "Post Hospitalization Medical expenses incurred in 180 days" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "" + "value": [ + 500000, + 1000000, + 1500000, + 2000000, + 2500000, + 5000000, + 10000000, + 20000000 + ], + "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", + "source_quote": "Sum Insured under the Policy 5 Lacs 10 Lacs 15 Lacs 20,25 & 50 Lacs 100 & 200 Lacs", + "_confidence": "medium" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__my-optima-secure-older-variant__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__my-optima-secure-older-variant__wordings.pdf", + "_confidence": "low" }, "policy_type": { "value": "group", "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "hospital cash policies which will apply before any benefits are payable b", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", "completeness_pct": 36, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/hdfc-ergo__my-optima-secure__wordings.json b/40-data/policy_facts/hdfc-ergo__my-optima-secure__wordings.json index 0b53f695899ee964985a08263997a6882f2f7a3f..4d0c7b1778e64d88fd36be8af178fbd64ce4ba9f 100644 --- a/40-data/policy_facts/hdfc-ergo__my-optima-secure__wordings.json +++ b/40-data/policy_facts/hdfc-ergo__my-optima-secure__wordings.json @@ -3,59 +3,64 @@ "policy_name": "My Optima Secure", "insurer_slug": "hdfc-ergo", "uin_code": { - "value": null, + "value": "HDFHLIP25041V062425", "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" + "source_quote": "UIN: my: Optima Secure - HDFHLIP25041V062425", + "_confidence": "high" }, "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__my-optima-secure__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__my-optima-secure__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" + "source_quote": "Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 36 months (Unless specified otherwise in the Policy Schedule) of continuous coverage after the date of inception of the first policy with insurer.", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" + "source_quote": "30-day waiting period: Code – Excl03 i. Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "maternity_coverage": { - "value": null, + "value": false, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" + "source_quote": "o. Maternity: Code – Excl18: i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy;", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__my-optima-secure__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" + "source_quote": "1.4. AYUSH Treatment The Company shall indemnify the Medical Expenses incurred by the Insured Person only for Inpatient Care under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "Cashless facility" + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the insurer", + "_confidence": "high" }, "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__my-optima-secure__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 10, @@ -63,9 +68,10 @@ "source_quote": "Cumulative bonus from 10%" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" + "source_quote": "The company shall instantly add 100% of the Base Sum Insured under this benefit in the event of an admissible claim during the Policy Year due to which Sum Insured was partially or completely exhausted.", + "_confidence": "high" }, "room_rent_capping": { "value": "Room rent expenses shall be covered\nupto 1%", @@ -83,39 +89,55 @@ "source_quote": "Post-Hospitalization expenses days from 180 days" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "Sum Insured for this optional c" + "value": [ + 500000, + 1000000, + 1500000, + 2000000, + 2500000, + 5000000, + 10000000, + 20000000 + ], + "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", + "source_quote": "Sum Insured options range from Rs", + "_confidence": "medium" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__my-optima-secure__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in hdfc-ergo__my-optima-secure__wordings.pdf", + "_confidence": "low" }, "policy_type": { "value": "hospital_cash", "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "classified as hospital_cash from PDF heuristics" + "source_quote": "hospital cash policies which will apply before any benefits are payable b", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", "completeness_pct": 27, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/hdfc-ergo__optima-enhance.json b/40-data/policy_facts/hdfc-ergo__optima-enhance.json index 9609318a2b7b0b33d2d8c8bbb65a9a0a888f45a0..8ade50d0eb1a2205ebbd4a05011b45eede05913c 100644 --- a/40-data/policy_facts/hdfc-ergo__optima-enhance.json +++ b/40-data/policy_facts/hdfc-ergo__optima-enhance.json @@ -5,7 +5,8 @@ "uin_code": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "UIN not found in extracted text" + "source_quote": "not stated in hdfc-ergo__optima-enhance.pdf", + "_confidence": "low" }, "min_entry_age": { "value": 91, @@ -17,18 +18,15 @@ "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in hdfc-ergo__optima-enhance.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in hdfc-ergo__optima-enhance.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -38,42 +36,51 @@ "pre_existing_disease_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "not stated in hdfc-ergo__optima-enhance.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "not stated in optima-enhance__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in hdfc-ergo__optima-enhance.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "Pre-Hospitalisation Medical Expenses incurred upto 60 days before the date of admission to the Hospital", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 90, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "Post-Hospitalisation Medical Expenses incurred upto 90 days after discharge from the Hospital.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf" }, "ayush_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "AYUSH coverage not found in extracted text" + "source_quote": "not stated in optima-enhance__wordings.pdf", + "_confidence": "low" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "pregnancy (including voluntary termination), miscarriage (except as a result of an Accident or Illness), maternity or child birth (including caesarean section), except in the case of ectopic pregnancy in relation to", + "_confidence": "high" }, "newborn_coverage": { "value": true, @@ -81,14 +88,16 @@ "source_quote": "New born baby means baby born during the Policy Period and is aged upto 90 days. Def. 38. Non Network means any Hospital, day car" }, "organ_donor_expenses": { - "value": true, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "Organ Donor: i) Claims which have NOT been admitted otherwise required Medical and surgical Expenses of the under 1a) for the insured person. hospitalization of more organ donor for harvesting the org" + "source_quote": "not stated in optima-enhance__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in hdfc-ergo__optima-enhance.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": "restoration of surface continuity of the skin and subcutaneous tissues", @@ -96,44 +105,53 @@ "source_quote": "restoration of surface continuity of the skin and subcutaneous tissues" }, "room_rent_capping": { - "value": null, + "value": "No cap", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "Room Rent means the amount charged by a Hospital towards Room and Boarding expenses and shall include the associated medical expenses.", + "_confidence": "medium" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in optima-enhance__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in hdfc-ergo__optima-enhance.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "ion 1)a): hospitalisation. e. Cashless Service: Toll Free 1800-102-0333 www.apollomunichinsurance.com Email: customerservice@apollomunichinsurance.com Page 7 of 24 Policy Wordings – Optima Enhance We/" + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy terms and conditions, are directly made to the network provider by the insurer to t", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in hdfc-ergo__optima-enhance.pdf", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__optima-enhance.pdf", + "_confidence": "low" }, "policy_type": { "value": "top-up", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "Top-up / super top-up policy (per product name)" + "source_quote": "hospital cash policies which will apply before any benefits are payable b", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", @@ -142,4 +160,4 @@ "completeness_pct": 55, "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/hdfc-ergo__optima-enhance__wordings.json b/40-data/policy_facts/hdfc-ergo__optima-enhance__wordings.json index d29adc5ee58059d96e15e1893659be1dbb2ed40d..853141d03b61c3ca27f9ecac205af77cec1e9c61 100644 --- a/40-data/policy_facts/hdfc-ergo__optima-enhance__wordings.json +++ b/40-data/policy_facts/hdfc-ergo__optima-enhance__wordings.json @@ -7,132 +7,225 @@ "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": null, + "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Your children Aged between 91 days and 25 years if they are unmarried", + "_confidence": "high" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "A Grace Period of 30 days for renewing the Policy is available under this Policy. Any disease/ condition contracted during the Grace Period will not be covered and will be treated as a Pre- existing Condition.", + "_confidence": "high" }, "free_look_period": { - "value": 15, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "investigation, treatment or admission started within 30 days from Policy Commencement Date, except for the claims arising due to an Accident. However if the condition is ", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "iii) 48 months waiting period from Policy Commencement Date for all Pre-existing Conditions declared and/or accepted at the time of application", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ii) A waiting period of 24 months from the first Policy Commencement Date will be applicable to the medical and surgical treatment of illnesses / diagnoses or surgical procedures mentioned in the following table.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "b. Pre-Hospitalisation Medical Expenses incurred upto 60 days before the date of admission to the Hospital", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "c. Post-Hospitalisation Medical Expenses incurred upto 90 days after discharge from the Hospital. This is applicable both for In patient and Day Care treatment.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Def. 48. Policy Year means a year following the Commencement Date and its subsequent annual anniversary.", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", + "source_quote": "xii) Types of treatment, defined Illnesses/ conditions/ supplies: a. Non allopathic treatment.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", + "source_quote": "pregnancy (including voluntary termination), miscarriage (except as a result of an Accident or Illness), maternity or child birth (including caesarean section), except in the case of ectopic pregnancy in relati", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", + "source_quote": "not stated in optima-enhance__wordings.pdf", + "_confidence": "low" + }, + "restoration_benefit": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" + }, + "preventive_health_checkup": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", + "source_quote": "Preventive care, vaccination including inoculation and immunisations (except in case of post-bite treatment)", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy terms and conditions, are directly made to the network provider by the insurer", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", + "source_quote": "This Policy only covers medical treatment taken within India. All payments under this Policy will only be made in Indian Rupees within India.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", + "source_quote": "eligible Medical Expenses incurred less the Deductible amount. A. Waiting Period All Illne", + "_confidence": "medium" + }, + "deductible_amount": { + "value": null, + "unit": "INR", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-enhance__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__optima-enhance__wordings.pdf", + "_confidence": "low" } } diff --git a/40-data/policy_facts/hdfc-ergo__optima-plus.json b/40-data/policy_facts/hdfc-ergo__optima-plus.json index e2ba2fe6a9858ca77ac43b65b3f155baccc927c9..3b23df90ef2fb299f935fffba2e7df1aae6eb1f1 100644 --- a/40-data/policy_facts/hdfc-ergo__optima-plus.json +++ b/40-data/policy_facts/hdfc-ergo__optima-plus.json @@ -5,7 +5,8 @@ "uin_code": { "value": "HDHHLIP21336V022021", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "400 059. UIN: Optima Plus- 1 HDHHLIP21336V022021 HDFC ERGO General Insurance Company Limited Policy Wording Optima Plus Preamble HDFC ERGO General Insurance Company Limited will provide the insurance " + "source_quote": "UIN: Optima Plus- HDHHLIP21336V022021 1 Table of Contents Sr. No. P", + "_confidence": "high" }, "min_entry_age": { "value": 91, @@ -17,18 +18,15 @@ "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "Lifelong renewability: s an Insured Person. There is no maximum cover ceasing age under this Policy. We may apply a risk loading on the premium payable (based upon the declarations made in the proposal form and the health s" + "source_quote": "not stated in hdfc-ergo__optima-plus.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in hdfc-ergo__optima-plus.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -36,34 +34,41 @@ "source_quote": "the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. II. This exclusion shall " }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "Pre-existing Condition means any condition, ailment, injury, or disease: (a) that is/are diagnosed by a physician not more than 36 months prior to the date of commencement of the policy issued by the insurer", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "table below shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy with us. This exc", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in hdfc-ergo__optima-plus.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "Pre-Hospitalisation Medical Expenses The Medical Expenses incurred in the 60 days immediately before the Insured Person was Hospitalised", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 90, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "Post-hospitalisation Medical Expenses The Medical Expenses incurred in the 90 days immediately after the Insured Person was discharged post Hospitalisation", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -76,9 +81,10 @@ "source_quote": "ization xv. Maternity: Code – Excl18 a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in optima-plus__wordings.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, @@ -88,32 +94,38 @@ "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in hdfc-ergo__optima-plus.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "Restoration benefit not found in extracted text" + "source_quote": "not stated in hdfc-ergo__optima-plus.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "not stated in hdfc-ergo__optima-plus.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in optima-plus__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in hdfc-ergo__optima-plus.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -123,12 +135,15 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in hdfc-ergo__optima-plus.pdf", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__optima-plus.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", @@ -140,6 +155,15 @@ "primary_source_pdf": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 55, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_quote": "Emergency Ambulance We will reimburse the expenses incurred on an ambulance offered by a healthcare or ambulance service provider used to transfer the", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/hdfc-ergo__optima-plus__wordings.json b/40-data/policy_facts/hdfc-ergo__optima-plus__wordings.json index 9b72b0aee76fe07a282ab2e604fa56cd085cac45..0aae1229db8b319525236dd1f7d2c6f0b43ff605 100644 --- a/40-data/policy_facts/hdfc-ergo__optima-plus__wordings.json +++ b/40-data/policy_facts/hdfc-ergo__optima-plus__wordings.json @@ -7,132 +7,234 @@ "value": "HDHHLIP21336V022021", "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: Optima Plus- HDHHLIP21336V022021", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-plus__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The parent was below 65 years at his initial participation in the Optima Plus Policy", + "_confidence": "medium" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ii) Your children Aged between 91 days and 21 years if they are unmarried.", + "_confidence": "high" }, "sum_insured_options": { - "value": null, + "value": [ + 500000 + ], "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Sum Insured per Insured Person per Policy Year Rs 500, 000", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases.", + "_confidence": "high" }, "free_look_period": { - "value": 15, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of thirtydays from date of receipt of the policy document to review the terms and conditions of the policy, and to re", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "30-day Waiting Period: Code – Excl03 I. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Specified disease/procedure waiting period: Code – Excl02 I. Expenses related to the treatment of the listed Conditions, surgeries/treatments as mentioned in the table below shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy with us.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-plus__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "1 b) Pre-hospitalization Covered, maximum upto 60 days", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "1 c) Post-hospitalization Covered, maximum upto 90 days", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-plus__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-plus__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Def. 14. Policy Year means a year following the Commencement Date and its subsequent annual anniversary.", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-plus__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-plus__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-plus__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_quote": "xxi. Any non-allopathic treatment except to the extent of coverage provided for under 'In-patient treatment' cover.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_quote": "urred during hospitalization) except ectopic pregnancy; b. E", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__optima-plus__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_quote": "e) Organ Donor The Medical Expenses for an organ donor’s treatment for the harvesting of the organ donated, provided that:", + "_confidence": "high" + }, + "restoration_benefit": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__optima-plus__wordings.pdf", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_quote": "Domiciliary Treatment Covered", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_quote": "Preventive care, and other nutritional and electrolyte supplements, unless certified to be required by the attending Medical Practitioner as a direct consequence of an ot", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__optima-plus__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_quote": "Cashless service: Treatment, Consultation or Procedure: Trea", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_quote": "This Policy only covers medical treatment taken within India, and payments under this Policy shall only be made in Indian Rupees within India.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_quote": "Deductible (Rs. In Lacs) (As mentioned in Policy Schedule) Rs 100,000; 200,000; 300,000; 400,000; 500,000", + "_confidence": "medium" + }, + "deductible_amount": { + "value": null, + "unit": "INR", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-plus__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__optima-plus__wordings.pdf", + "_confidence": "low" } } diff --git a/40-data/policy_facts/hdfc-ergo__optima-restore.json b/40-data/policy_facts/hdfc-ergo__optima-restore.json index 5b61c2b3e5d2aca860dab8a1aad238c3f2088bba..f414234374b177b3a3d1691cc69dc3fd80be8471 100644 --- a/40-data/policy_facts/hdfc-ergo__optima-restore.json +++ b/40-data/policy_facts/hdfc-ergo__optima-restore.json @@ -19,13 +19,16 @@ "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", "source_quote": "Maximum Age: The maximum entry age is 65 years. There is no maximum cover ceasing age in this Policy." }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "Life-long Renewal: We offer life-long renewal regardless of your health status or previous claims" - }, "sum_insured_options": { - "value": [300000, 500000, 1000000, 1500000, 2000000, 2500000, 5000000], + "value": [ + 300000, + 500000, + 1000000, + 1500000, + 2000000, + 2500000, + 5000000 + ], "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", "source_quote": "Basic Sum Insured per Insured Person per Policy Year (Rs. in Lakh) 3.00 5.00 10.00 15.00 20.00, 25.00, 50.00" @@ -48,7 +51,8 @@ "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "Pregnancy, dental treatment, external aids and appliances. (listed under MAJOR EXCLUSIONS)" + "source_quote": "not stated in hdfc-ergo__optima-restore.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, @@ -61,24 +65,29 @@ "source_quote": "1c) Post-Hospitalization Covered upto 180 Days" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "1d) Day Care Procedures All Day Care Treatments Covered" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/optima-restore-individual", + "source_note": "HDFC Ergo Optima Restore covers all listed day-care procedures (144 per insurer-wide list)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf" }, "ayush_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "Non-allopathic treatment, congenital external diseases, cosmetic surgery (listed under MAJOR EXCLUSIONS)" + "source_quote": "not stated in optima-restore__brochure.pdf", + "_confidence": "low" }, "maternity_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "Pregnancy, dental treatment, external aids and appliances. (MAJOR EXCLUSIONS)" + "source_quote": "not stated in optima-restore__brochure.pdf", + "_confidence": "low" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "Not covered in base (no newborn-specific benefit listed in brochure feature table)" + "source_quote": "not stated in optima-restore__brochure.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, @@ -101,19 +110,22 @@ "source_quote": "No sub-limit on room rent : With this health plan you can get the room you like and the treatment you deserve without a hassle." }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "No geography based sub-limits ... no additional copays or sub-limits." + "source_quote": "not stated in optima-restore__brochure.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible in Optima Restore" + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "not stated in hdfc-ergo__optima-restore.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": 10000, - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "Cashless transactions: Optim Restore enables you to get treated on a cashless basis across 10,000+ cashless network hospitals." + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -123,22 +135,50 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted in this curation pass" + "source_quote": "not stated in hdfc-ergo__optima-restore.pdf", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "Quick turnaround time: You do not have to worry about pre-authorization, we have a quick turnaround time. (No explicit hour count)" + "source_quote": "not stated in hdfc-ergo__optima-restore.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "1a) In-patient Treatment Covered upto sum insured (indemnity health plan)" + "source_quote": "Critical Illness One opinion per policy year 1j) Emergency Air Ambulance Cov", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", "completeness_pct": 88, - "notes": "Parsed via pdfplumber from local brochure. CSR insurer-level (null)." + "notes": "Parsed via pdfplumber from local brochure. CSR insurer-level (null). | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "Ambulance Cover Upto Rs", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "Domiciliary Treatment Covered upto sum insured 1f) Organ Donor Covered upto sum insured 1g) Ambulance Cover Upto Rs", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "preventive health check up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } } diff --git a/40-data/policy_facts/hdfc-ergo__optima-restore__brochure.json b/40-data/policy_facts/hdfc-ergo__optima-restore__brochure.json index 80f14367d3a1ff67526b5429c96b6768c28880b5..fc817a8e69dfa6a5e01cad3e11383bf0537a6035 100644 --- a/40-data/policy_facts/hdfc-ergo__optima-restore__brochure.json +++ b/40-data/policy_facts/hdfc-ergo__optima-restore__brochure.json @@ -7,31 +7,29 @@ "value": "HDHHLIP21322V062021", "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: HDHHLIP21322V062021 UID: 6520", + "_confidence": "high" }, "min_entry_age": { - "value": null, + "value": 91, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The minimum entry age is 91 days. Children between 91 days and 5 years can be insured provided either parent is getting insured under this Policy.", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maximum Age: The maximum entry age is 65 years. There is no maximum cover ceasing age in this Policy.", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Minimum Age: The minimum entry age is 91 days. Children between 91 days and 5 years can be insured provided either parent is getting insured under this Policy.", + "_confidence": "high" }, "sum_insured_options": { "value": [ @@ -45,102 +43,198 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured per Insured Person per Policy Year (Rs. in Lakh) 3.00 5.00 10.00 15.00 20.00, 25.00, 50.00", + "_confidence": "high" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in hdfc-ergo__optima-restore__brochure.pdf", + "_confidence": "low" }, "free_look_period": { - "value": 15, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in hdfc-ergo__optima-restore__brochure.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Any treatment within first 30 days of cover except any accidental injury.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Any Pre-existing diseases/conditions will be covered after \u0003a waiting period of 3 years.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "2 years exclusion for specific diseases like cataract, hernia, hysterectomy, joint replacement etc.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-restore__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "1b) Pre-Hospitalization Covered upto 60 Days", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "1c) Post-Hospitalization Covered upto 180 Days", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/optima-restore-individual", + "source_note": "HDFC Ergo Optima Restore covers all listed day-care procedures (144 per insurer-wide list)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf" }, "network_hospital_count": { - "value": 10000, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-restore__brochure.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-restore__brochure.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2 + ], "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The cover will be valid for 1 or 2 year(s) as opted.", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-restore__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-restore__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__optima-restore__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "not stated in hdfc-ergo__optima-restore__brochure.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "1f) Organ Donor Covered upto sum insured", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "restoration of sum insured if utilized during the year, 100% no claim bonus after 2 claim free years and much more! Optima Restore is a plan that: Optima Restore Health Insurance Plan WALK FOR HEALTH RESTORE BENEFIT* A H", + "_confidence": "medium" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "Domiciliary Treatment Covered upto sum insured 1f) Organ Donor Covered upto sum insured 1g) Ambulance Cover Upto Rs", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "HEALTH CHECK UP Optima Restore helps you keep track of your health status with Its preventive health check up benefit offered at renewal Irrespective of claim status", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "E-Opinion in respect of a Critical Illness One opinion per policy year 1j) Emergency Air Ambulance Cover Not Covered Covered upto Rs", + "_confidence": "medium" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "Cashless transactions: Optim Restore enables you to get treated on a cashless basis across 10,000+ cashless network hospitals.", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "2X MULTIPLIER BENEFIR 50% increase in your basic sum insured for every claim free year, subject to a maximum of 100%.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "No matter where you buy your policy you can get treated In any city or hospital you like in the country with no add", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "nt parents/parents-in-law are eligible for buying this cover on an individual or floater basis", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", + "source_quote": "2X MULTIPLIER BENEFIR 50% increase in your basic sum insured for every claim free year, subject to a maximum of 100%.", + "_confidence": "high" } } diff --git a/40-data/policy_facts/hdfc-ergo__optima-secure-older-variant.json b/40-data/policy_facts/hdfc-ergo__optima-secure-older-variant.json index 43228a9df105c158924bd8549d018ef022447860..443f2f095105c3a5d799e593d67f13ad8ea64b02 100644 --- a/40-data/policy_facts/hdfc-ergo__optima-secure-older-variant.json +++ b/40-data/policy_facts/hdfc-ergo__optima-secure-older-variant.json @@ -5,24 +5,22 @@ "uin_code": { "value": "HDFHLIP21016V012122", "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "license. my: Optima Secure - HDFHLIP21016V012122. 1202GUA 9 - reV/WWP HDFC ERGO General Insurance Company Limited Customer Information Sheet my: Optima Secure Description is illustrative and not exhau" + "source_quote": "UIN: my: Optima Secure - HDFHLIP21016V012122. HDFC ERGO General Insurance", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in hdfc-ergo__optima-secure-older-variant.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Lifelong renewability: olicy document. Section D.1 • Lifelong Renewal under the Policy with 30 days Grace Period. Section D.1 14 Insured’s • Disclosure of material facts sought to be declared on the Proposal Section D.1 Obl" + "source_quote": "not stated in hdfc-ergo__optima-secure-older-variant.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -34,92 +32,111 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "sured Person per Policy Year. Sum Insured 5 Lacs 10 Lacs 15 Lacs 20,25 & 50 Lacs 100 & 200 Lacs under the Policy Limit of Cover Rs. 1,500 Rs. 2,000 Rs. 4,000 Rs. 5,000 Rs. 8,000 For Family Floater Pol" + "source_quote": "Sum Insured in Lakhs (Rs.) Premium (Rs", + "_confidence": "medium" }, "initial_waiting_period_days": { - "value": 15, + "value": 30, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "ured’s Rights • Free Look for 15 days from the date of receipt of the Policy document. Section D.1 • Lifelong Renewal under the Policy with 30 days Grace Period. Section D.1 14 Insured’s • Disclosure " + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "Pre-existing Diseases will be covered after a waiting period of 36 months.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "s/treatmentsshall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy with us. This exc", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in hdfc-ergo__optima-secure-older-variant.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "Pre-Hospitalization Medical expenses for 60 days before hospitalization", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 180, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "Post Hospitalization Medical expenses incurred in 180 days after the hospitalization", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf" }, "ayush_coverage": { - "value": true, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "pitalization Section B-1.3 4. AYUSH Treatment Section B-1.4 5. Pre-Hospitalization Medical expenses for 60 days before Section B-1.5 hospitalization 6. Post Hospitalization Medical expenses incurred i" + "source_quote": "not stated in my-optima-secure-older-variant__wordings.pdf", + "_confidence": "low" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "idered a r. Maternity: Code – Excl18 medical necessity, it must be certified by the attending i. Medical treatment expenses traceable to childbirth Medical Practitioner. (including complicated del" + "source_quote": "Maternity: Code – Excl18 i.", + "_confidence": "high" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in my-optima-secure-older-variant__wordings.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Organ Donor Expenses Section B-1.7 8. Cumulative Bonus Section B-1.8 Section B-2 – Optional Covers The Covers listed below are optional covers and will be covered upto the Sub-limits mentioned in the " + "source_quote": "7. Organ Donor Expenses The Company shall indemnify the Medical Expenses covered under Section B-1", + "_confidence": "high" }, "no_claim_bonus_pct": { - "value": 10, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Cumulative Bonus (CB) will be applied/increased by 10% of The Covers listed below are optional covers. A" + "source_quote": "not stated in my-optima-secure-older-variant__wordings.pdf", + "_confidence": "low" }, "restoration_benefit": { - "value": "Restore Benefit Section B-2", + "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Restore Benefit Section B-2" + "source_quote": "012122. Restore Benefit would be triggered only upon complete or partial utilization of the Base Sum Insured by t", + "_confidence": "medium" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "not stated in hdfc-ergo__optima-secure-older-variant.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in my-optima-secure-older-variant__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Aggregate Deductible Section B-2" + "source_quote": "not stated in hdfc-ergo__optima-secure-older-variant.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -129,17 +146,21 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in hdfc-ergo__optima-secure-older-variant.pdf", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__optima-secure-older-variant.pdf", + "_confidence": "low" }, "policy_type": { "value": "hospital-cash", "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure-older-variant__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "hospital cash policies which will apply before any benefits are payable b", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", @@ -148,4 +169,4 @@ "completeness_pct": 65, "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/hdfc-ergo__optima-secure.json b/40-data/policy_facts/hdfc-ergo__optima-secure.json index 91ddc772a5642dd430832249a7238aa32e9fecae..3d714035982d2762b63e08b73cea1cfedd57fb7a 100644 --- a/40-data/policy_facts/hdfc-ergo__optima-secure.json +++ b/40-data/policy_facts/hdfc-ergo__optima-secure.json @@ -5,7 +5,8 @@ "uin_code": { "value": "HDFHLIP25041V062425", "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "UIN: my: Optima Secure - 1 HDFHLIP25041V062425" + "source_quote": "UIN: my: Optima Secure - HDFHLIP25041V062425 1 Table of Contents Sr. No. P", + "_confidence": "high" }, "min_entry_age": { "value": 91, @@ -19,16 +20,22 @@ "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", "source_quote": "Maximum Age: The maximum entry age is 65 years." }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "There is no maximum cover ceasing age in this Policy. (Life-long Renewal)" - }, "sum_insured_options": { - "value": [500000, 750000, 1000000, 1500000, 2000000, 2500000, 5000000, 10000000, 20000000], + "value": [ + 500000, + 750000, + 1000000, + 1500000, + 2000000, + 2500000, + 5000000, + 10000000, + 20000000 + ], "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "Base Sum Insured 5 & 7.5 Lacs 10 Lacs 15 Lacs 20, 25, 50 & 100 & 200" + "source_quote": "Sum Insured options range from Rs", + "_confidence": "medium" }, "initial_waiting_period_days": { "value": 30, @@ -36,9 +43,10 @@ "source_quote": "Expenses related to the treatment of any illness within 30 days from the first Policy" }, "pre_existing_disease_waiting_months": { - "value": 36, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months" + "source_quote": "not stated in my-optima-secure__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": 24, @@ -48,7 +56,8 @@ "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "Maternity: Code – Excl18 (Maternity not covered in base; available only via optional 'Parenthood' add-on)" + "source_quote": "not stated in hdfc-ergo__optima-secure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, @@ -61,79 +70,96 @@ "source_quote": "180 days unless otherwise specified in the Policy Schedule, immediately post the date of discharge" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "Day Care Treatment covered (all listed day-care procedures included; no fixed count in wording)" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/optima-secure/", + "source_note": "HDFC Ergo Optima Secure covers all listed day-care procedures (144 per insurer-wide list)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf" }, "ayush_coverage": { - "value": true, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "1.4. AYUSH Treatment ... in any AYUSH Hospital." + "source_quote": "not stated in my-optima-secure__wordings.pdf", + "_confidence": "low" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "Maternity: Code – Excl18 (excluded in base; Parenthood add-on optional)" + "source_quote": "Maternity: Code – Excl18: i.", + "_confidence": "high" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "Newborn baby cover available only under Parenthood add-on, not in base" + "source_quote": "not stated in my-optima-secure__wordings.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "1.7. Organ Donor Expenses The Company shall indemnify the Medical Expenses ... towards the organ donor's Hospitalization for harvesting" + "source_quote": "7. Organ Donor Expenses The Company shall indemnify the Medical Expenses covered under Section B-1", + "_confidence": "high" }, "no_claim_bonus_pct": { - "value": 50, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "Modification of Cumulative bonus from 10% of Base Sum Insured upto 100% ... to 25% of Base Sum Insured upto 100% (base CB: 50% on renewal, max 100%)" + "source_quote": "not stated in my-optima-secure__wordings.pdf", + "_confidence": "low" }, "restoration_benefit": { - "value": "Automatic Restore Benefit: 100% of Base Sum Insured, once per policy year", + "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "2.6. Automatic Restore Benefit ... Automatic Restore Equal to 100% of Base sum" + "source_quote": "Automatic Restore Benefit The company shall instantly add 100% of the Base Sum Insured under this benefit in the event of an admissible claim during the Policy Year due to which Sum Insured was partially or completely exha", + "_confidence": "medium" }, "room_rent_capping": { "value": "No room rent capping (any room category)", "source_pdf_path": "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf", - "source_quote": "No room rent capping is a feature of HDFC ERGO Optima series (per product brochure summary)" + "source_quote": "No sub-limit on room rent : With this health plan you can get the room you like and the treatment you des", + "_confidence": "medium" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "No co-payment shall apply if Insured Person from Tier 2 avails a treatment in Tier 1. (No base copay; optional zone-based copay only)" + "source_quote": "not stated in my-optima-secure__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "Aggregate Deductible refers to a cost-sharing agreement ... Insured agrees to bear a self-opted amount (optional, not base)" + "source_quote": "not stated in hdfc-ergo__optima-secure.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric — not extracted from PDF; HDFC ERGO publishes 13,000+ network hospitals on its website but not verified here" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured ..." + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the insurer to t", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted in this curation pass" + "source_quote": "not stated in hdfc-ergo__optima-secure.pdf", + "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT for cashless authorization not specified in policy wording; governed by IRDAI Master Circular (one hour for initial, three hours for discharge)" + "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__optima-secure.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", - "source_quote": "Sum Insured means the aggregate limit of indemnity ... (indemnity-based health insurance)" + "source_quote": "hospital cash policies which will apply before any benefits are payable b", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-13", @@ -142,6 +168,29 @@ "rag/corpus/hdfc-ergo/optima-restore__brochure.pdf" ], "completeness_pct": 85, - "notes": "Parsed via pdfplumber from local policy wording. CSR + network count are insurer-level and intentionally null pending IRDAI/website verification." + "notes": "Parsed via pdfplumber from local policy wording. CSR + network count are insurer-level and intentionally null pending IRDAI/website verification. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", + "source_quote": "Ambulance means a motor vehicle operated by a licenced/authorised service provider and equipped for the transport and paramedical treatment of the per", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness/disease/injury which in the normal course would requi", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/hdfc-ergo/my-optima-secure__wordings.pdf", + "source_quote": "Preventive Health Check-up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } } diff --git a/40-data/policy_facts/hdfc-ergo__total-health-plan.json b/40-data/policy_facts/hdfc-ergo__total-health-plan.json index 584a5d2c7ff45d829dc5fe49b6e1e34cc2012953..6783ec085705cad9dc075444543c67291c791719 100644 --- a/40-data/policy_facts/hdfc-ergo__total-health-plan.json +++ b/40-data/policy_facts/hdfc-ergo__total-health-plan.json @@ -19,16 +19,12 @@ "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", "source_quote": "ho is unmarried , age between 91 days to 21 years, financially dependent on the primary insured or proposer and does not have his / her independent sources of income.Children Aged between 1 to 90 Days" }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" - }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in hdfc-ergo__total-health-plan.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -36,34 +32,41 @@ "source_quote": "the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. II. This exclusion shall " }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 48, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "48 months prior to the effective date of the policy issued by the insurer or its reinstatement", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "table below shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy with us. This exc", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in hdfc-ergo__total-health-plan.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "incurred upto 30 days before Hospitalisation.", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "incurred upto 60 days after discharge from Hospitalisation.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -81,14 +84,16 @@ "source_quote": "New Born Baby means those babies born to you and your spouse during the Policy Period aged bet" }, "organ_donor_expenses": { - "value": true, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "Organ Donor: 1. Claims which have NOT Medical treatment of the been admitted under organ donor for harvesting 1a). the organ. 2. Admission not HDFC ERGO General Insurance Company Limited. IRDAI Reg. N" + "source_quote": "not stated in total-health-plan__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in hdfc-ergo__total-health-plan.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": "reinstatement or", @@ -98,22 +103,26 @@ "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "not stated in hdfc-ergo__total-health-plan.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in total-health-plan__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in hdfc-ergo__total-health-plan.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -123,17 +132,21 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in hdfc-ergo__total-health-plan.pdf", + "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", + "source_quote": "not stated in hdfc-ergo__total-health-plan.pdf", + "_confidence": "low" }, "policy_type": { "value": "hospital-cash", "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "group health insurance policy), to transfer the credit gained for pre-existing con", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", @@ -142,4 +155,4 @@ "completeness_pct": 65, "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/hdfc-ergo__total-health-plan__wordings.json b/40-data/policy_facts/hdfc-ergo__total-health-plan__wordings.json index a2bd2acf0697db0a04c4d0ec65992d7471704524..67cd700b457957a67a2e2c8bd9e2f8f6f59be9cd 100644 --- a/40-data/policy_facts/hdfc-ergo__total-health-plan__wordings.json +++ b/40-data/policy_facts/hdfc-ergo__total-health-plan__wordings.json @@ -7,132 +7,223 @@ "value": "HDHHLIP21317V032021", "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: Total Health Plan - HDHHLIP21317V032021.", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__total-health-plan__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "provided that the parent was below 65 years at his initial participation in the Total Health Plan Policy", + "_confidence": "medium" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "age between 91 days to 21 years, financially dependent on the primary insured or proposer and does not have hi", + "_confidence": "high" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__total-health-plan__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": ", the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.", + "_confidence": "high" }, "free_look_period": { "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "cy. The insured person shall be allowed free look period of fifteen days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same ", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "30-day Waiting Period – Code Excl03 I. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "iii) Pre- Existing Diseases: Code- Excl01 I. Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 48 months of continuous coverage after the date of inception of the first policy with insurer.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "disease/procedure waiting period- Code- Excl02 I. Expenses related to the treatment of the listed Conditions, surgeries/treatments as mentioned in the table below shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy with us.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__total-health-plan__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": 30, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "consultations, investigations and medicines incurred upto 30 days before Hospitalisation.", + "_confidence": "high" }, "post_hospitalization_days": { - "value": 90, + "value": 60, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-hospitalisation Medical expenses for consultations, investigations and medicines incurred upto 60 days after discharge from Hospitalisation.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 144, + "source_url": "https://www.hdfcergo.com/health-insurance/day-care-treatment", + "source_note": "Per insurer baseline (HDFC Ergo day-care treatment page lists 144 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 16000, + "source_url": "https://www.hdfcergo.com/", + "source_note": "16000+ Cashless Healthcare providers (homepage 'Why Choose HDFC ERGO' / 'Cashless Network' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__total-health-plan__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__total-health-plan__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Def. 17. Policy Year means a year following the Commencement Date and its subsequent annual anniversary.", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__total-health-plan__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__total-health-plan__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in hdfc-ergo__total-health-plan__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", + "source_quote": "Non-disclosure of Pre-existing Illness or Material fact as sought to be declared on the Proposal form. xix. Non-allopathic Treatments", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", + "source_quote": "not stated in total-health-plan__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", + "source_quote": "not stated in total-health-plan__wordings.pdf", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", + "source_quote": "Domiciliary Treatment means medical treatment for an Illness/disease/injury which in the normal course would require care and treatment at a Hospital but is actually taken while", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", + "source_quote": "only covers medical treatment taken within India", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", + "source_quote": "Health Check-up", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", + "source_quote": "E-Opinion in respect of a Critical Illness We shall arrange and pay for a second opinion from Our panel of Medical Practitioners, if: - The Insured Person suffers", + "_confidence": "medium" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the insurer", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", + "source_quote": "This Policy only covers medical treatment taken within India. All payments under this Policy will only be made in Indian rupees within India.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/hdfc-ergo/total-health-plan__wordings.pdf", + "source_quote": "Family Floater means a Policy described as such in the Schedule where under You and Your Dependents named in the Schedule are insured under this Policy as at the Commencement Date.", + "_confidence": "medium" + }, + "maternity_coverage": { + "value": false, + "_confidence": "high", + "source_quote": "xv) Maternity:Code – Excl18 k. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy;" } } diff --git a/40-data/policy_facts/icici-lombard__arogya-sanjeevani.json b/40-data/policy_facts/icici-lombard__arogya-sanjeevani.json index 93d5d532cba0b1b1f007e3b043bc013b6310561f..db6394107e9d27a81ad4698ba600affe38237943 100644 --- a/40-data/policy_facts/icici-lombard__arogya-sanjeevani.json +++ b/40-data/policy_facts/icici-lombard__arogya-sanjeevani.json @@ -5,30 +5,28 @@ "uin_code": { "value": "ICIHLIP20178V011920", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "horized representative. UIN : ICIHLIP20178V011920 Arogya Sanjeevani Policy 3.14.Day Care Treatment means medical treatment, and/or surgical a) it needs ongoing or long-term monitoring through procedur" + "source_quote": "ICIHLIP20178V011920 For Buy/ Renew/ Service/ Claim related queries Log on to" }, "min_entry_age": { - "value": null, + "value": 90, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "iii. Dependent Children (i.e. natural or legally adopted) between the age 3 months to 25 years.", + "_confidence": "medium" }, "max_entry_age": { - "value": null, + "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "Eligibility Policy can be availed by persons between the age of 18 years and 65years, as Proposer.", + "_confidence": "high" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in icici-lombard__arogya-sanjeevani.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -36,19 +34,22 @@ "source_quote": "the treatment of any illness within 30 days from the first policy commencement date shall be excluded 4.7. The expenses that are not covered in this policy are placed under List- except claims arising" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 48, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "48 months of continuous coverage after the date of inception of", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "Specific Waiting Period: (Code- Excl02) a) Expenses related to the treatment of the following listed conditions, surgeries/treatments shall be excluded until the expiry of 24/48 months of continuous coverage, as may be the case after the date of inception of the first policy with the insurer.", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in icici-lombard__arogya-sanjeevani.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, @@ -61,9 +62,11 @@ "source_quote": "o the date of hospitalization Post Hospitalisation For 60 days from the date of discharge from the hospital Sublimit for room/doctors fee 1. Room Rent, Boarding, Nursing Expenses all inclusive as prov" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -73,17 +76,19 @@ "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "15. Maternity Expenses (Code- Excl18): 1.2. Procedure for reimbursement of claims: i) Medical treatment expenses traceable to childbirth (including For reimbursement of claims the insured person many" + "source_quote": "Maternity Expenses (Code- Excl18): i) Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ii) expenses towards miscarriage (unless due to an accident) and lawful medical" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in icici-lombard__arogya-sanjeevani.pdf", + "_confidence": "low" }, "organ_donor_expenses": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "Organ donor cover not extracted" + "source_quote": "not stated in icici-lombard__arogya-sanjeevani.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 5, @@ -103,43 +108,49 @@ "copayment_pct": { "value": 5, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "ccess, the insured person may Copayment of 5% applicable to claim amount admissible and payable obtain the treatment as per treating doctor's advice and submit as pe" + "source_quote": "Copayment of 5% applicable to claim amount admissible and payable as per the terms and conditions of the Policy. The amount payable shall be after deduction of the copayment. 7.15. Maternity Expenses (Code- Excl18): i)" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in icici-lombard__arogya-sanjeevani.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 6500, + "source_url": "https://www.bankbazaar.com/health-insurance/icici-health-insurance.html", + "source_note": "ICICI Lombard: 6,500+ network hospitals (BankBazaar aggregator citing ICICI Lombard; insurer page returns 403 to scrapers). Higher figures (~10,600) circulate but not directly verifiable; used conservative count. Scraped 2026-05-15.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "s thereof 3. DEFINITIONS 3.8. Cashless Facility means a facility extended by the insurer to the The terms defined below and at other junctures in the Policy have the insured where the payments, of the" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured person in accordance with the Policy terms and conditions, are directly made to the network provider by the insurer to the extent" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in icici-lombard__arogya-sanjeevani.pdf", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in icici-lombard__arogya-sanjeevani.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "ures are to the Company shall indemnify Medically necessary, expenses towards the be carried out; Coverage mentioned in the policy schedule. iii. Maintaining daily records of the patients and making" + "source_quote": "Company shall indemnify Medically necessary, expenses towards the Coverage mentioned in the policy schedule. Provided further that, any amount payable under the policy shall be subject to the terms of coverage (including any co-pay, sub limits)," }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 75, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill.", + "network_hospital_backfill_2026-05-15": "icici-lombard insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/icici-lombard__arogya-sanjeevani__wordings.json b/40-data/policy_facts/icici-lombard__arogya-sanjeevani__wordings.json index 3707de4c104fce4b5c8cc0ad57fa2d73b53e964b..440314d00878e215a2ca568352c1e4179149a4e7 100644 --- a/40-data/policy_facts/icici-lombard__arogya-sanjeevani__wordings.json +++ b/40-data/policy_facts/icici-lombard__arogya-sanjeevani__wordings.json @@ -7,142 +7,242 @@ "value": "ICIHLIP20178V011920", "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Arogya Sanjeevani Policy UIN : ICIHLIP20178V011920", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Eligibility Policy can be availed by persons between the age of 18 years and 65years, as Proposer.", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Eligibility Policy can be availed by persons between the age of 18 years and 65years, as Proposer.", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "dependent Children (i.e. natural or legally adopted) between the age 3 months to 25 years.", + "_confidence": "medium" }, "sum_insured_options": { - "value": [ - 100000, - 150000, - 200000, - 250000, - 300000, - 350000, - 400000, - 450000, - 500000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in icici-lombard__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "a fixed period of 30 days is to be allowed as Grace Period and for all other modes of payment a fixed period of 15 days be allowed as grace period.", + "_confidence": "high" }, "free_look_period": { "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of fifteen days from date of receipt of the Policy document to review the terms and conditions of the Policy", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First Thirty Days Waiting Period (Code- Excl03) i. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 48 months of continuous coverage after the date of inception of the first policy with us.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of the following listed conditions, surgeries/treatments shall be excluded until the expiry of 24/48 months of continuous coverage", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre Hospitalisation For 30 days prior to the date of hospitalization Post Hospitalisation For 60 days from the date of discharge from the hospital", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre Hospitalisation For 30 days prior to the date of hospitalization Post Hospitalisation For 60 days from the date of discharge from the hospital", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 6500, + "source_url": "https://www.bankbazaar.com/health-insurance/icici-health-insurance.html", + "source_note": "ICICI Lombard: 6,500+ network hospitals (BankBazaar aggregator citing ICICI Lombard; insurer page returns 403 to scrapers). Higher figures (~10,600) circulate but not directly verifiable; used conservative count. Scraped 2026-05-15.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 5, + "unit": "%", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "9.3. Co-payment Each and every claim under the Policy shall be subject to a Copayment of 5% applicable to claim amount admissible and payable as per the terms and conditions of the Policy.", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "3.41.Policy period means period of one policy year as mentioned in the schedule for which the Policy IS issued", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_quote": "4.2. AYUSH Treatment The Company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the limit of sum insured", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_quote": "7.15. Maternity Expenses (Code- Excl18): i) Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy;", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in icici-lombard__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "restoration_benefit": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in icici-lombard__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in icici-lombard__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "worldwide_emergency_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in icici-lombard__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "critical_illness_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in icici-lombard__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_quote": "3.8. Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured person in accordance with the Policy terms and conditions, are directly made to the network provider by the insurer", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cumulative Bonus will be increased by 5% in respect of each claim free policy year (where no claims are reported), provided the policy is renewed with the company without a break subject to maximum of 50% of the sum insured under the current policy year.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_quote": "7.19. Treatment taken outside the geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_quote": "the maximum, total and cumulative liability for any and all claims made under the Policy, in respect of that Insured Person (on Individual basis) or all Insured Persons (on Floater basis) during the Policy Year.", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": null, + "_confidence": "low", + "source_quote": "not stated in icici-lombard__arogya-sanjeevani__wordings.pdf" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/icici-lombard/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cumulative Bonus will be increased by 5% in respect of each claim free policy year (where no claims are reported), provided the policy is renewed with the company without a break", + "_confidence": "high" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "icici-lombard insurer-wide count backfilled in targeted scrape pass" } } diff --git a/40-data/policy_facts/icici-lombard__complete-health-insurance-health-shield__wordings.json b/40-data/policy_facts/icici-lombard__complete-health-insurance-health-shield__wordings.json index 2278e80372529b8cdad9b6bbca38a878f99eee95..d9891afa538e9c3926dac628cea78d0b89a5992c 100644 --- a/40-data/policy_facts/icici-lombard__complete-health-insurance-health-shield__wordings.json +++ b/40-data/policy_facts/icici-lombard__complete-health-insurance-health-shield__wordings.json @@ -3,29 +3,28 @@ "policy_name": "Complete Health Insurance Health Shield", "insurer_slug": "icici-lombard", "uin_code": { - "value": null, + "value": "ICIHLIP22096V062122", "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "" + "source_quote": "UIN - ICIHLIP22096V062122 1", + "_confidence": "high" }, "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__complete-health-insurance-health-shield__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": 99, - "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "life-long renew" + "source_quote": "not stated in icici-lombard__complete-health-insurance-health-shield__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "Pre-existing diseases: Declared and accepted PED will be covered after 24 months" + "source_quote": "Code- Excl01: Pre-Existing Diseases a) Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of th", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, @@ -33,24 +32,28 @@ "source_quote": "Initial waiting period: 30 days" }, "maternity_coverage": { - "value": null, + "value": false, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "" + "source_quote": "xv. Code- Excl18: Maternity: Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__complete-health-insurance-health-shield__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "AYUSH therapy sections as required\nand/or has equipped operation theatre where surgical Treatment normally taken on an o" + "source_quote": "Reimbursement of expenses for AYUSH treatment In Patient AYUSH Hospitalization Medical expenses for day care procedures where such procedures are undertaken by an Insured Person as an In-patient in a Hospital", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "Cashless Facility" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance w", + "_confidence": "high" }, "copayment_pct": { "value": 10, @@ -63,59 +66,80 @@ "source_quote": "no claim bonus of 50%" }, "restoration_benefit": { - "value": null, + "value": "Reset Benefit: up to 100% of Sum Insured once per policy year (plans with SI Rs.3 lacs and above)", "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "" + "source_quote": "For plans with Sum Insured ₹ 3lacs and above, We will reset up to", + "_confidence": "high" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__complete-health-insurance-health-shield__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "" + "source_quote": "Pre & Post Medical Expenses incurred due to Illness up to 30 days period immediately before and 60", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "" + "source_quote": "Pre & Post Medical Expenses incurred due to Illness up to 30 days period immediately before and 60", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf" }, "network_hospital_count": { "value": 6500, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "6500+ network hospitals" + "source_quote": "available at over 6500+ network hospitals. 8 Sub Limit (a) Cataract, where sub-limit of Rs. 20,000/- is applicable per eye per Policy year for Plans with Sum Insured 9 Renewal Condition", + "_confidence": "high" }, "sum_insured_options": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "" + "value": [ + 300000, + 400000, + 500000, + 700000, + 1000000, + 1500000, + 2000000, + 2500000, + 5000000 + ], + "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", + "source_quote": "3 lacs/ 4 lacs/ 5 lacs Sum Insured (Rs.) 7 lacs/ 10 lacs 15lacs / 20lacs / 25Lacs / 50lacs d. Benefits covered Medical Expenses incurred due to Illness up to 30 days period immediately before and 60 days immediately after an", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__complete-health-insurance-health-shield__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, + "value": 4, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "" + "source_quote": "mplete set of documents & information, We will respond within 4 hours of the actual receipt of such pre authorization request wi", + "_confidence": "high" }, "policy_type": { - "value": "group", + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "not stated in icici-lombard__complete-health-insurance-health-shield__wordings.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", "completeness_pct": 41, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/icici-lombard__complete-health-insurance-umbrella__wordings.json b/40-data/policy_facts/icici-lombard__complete-health-insurance-umbrella__wordings.json index d68e4eb34c557e4066dc9c1237028b7c4da3c9bc..032a0cc7582319b3ab60716bfa9ffe2dd819a2cd 100644 --- a/40-data/policy_facts/icici-lombard__complete-health-insurance-umbrella__wordings.json +++ b/40-data/policy_facts/icici-lombard__complete-health-insurance-umbrella__wordings.json @@ -10,47 +10,50 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__complete-health-insurance-umbrella__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__complete-health-insurance-umbrella__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": 3, + "value": 24, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "Pre-Existing Condition/Disease(s) or any Illness or Injury which existed within the first 3 months" + "source_quote": "Code- Excl01: Pre-Existing Diseases a) Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of th", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "" + "source_quote": "a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising", + "_confidence": "high" }, "maternity_coverage": { - "value": false, + "value": true, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "Maternity Cover has been opted for.\nii. Specific Exclusion (Exclusions other than those mentioned under e.i above)\na. An" + "source_quote": "9. Maternity Cover We will cover the Medical Expenses incurred for delivery of a child, including a caesarian section, during Hospitalization or lawful medical ter", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__complete-health-insurance-umbrella__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "AYUSH Treatment at a AYUSH Hospital or AYUSH Day Care Centre.\nii. This Cover will be provided on reimburs" + "source_quote": "Ayush Hospital is a healthcare facility wherein medical/surgical/para-surgical treatment procedures and interventions are carried out by AYUSH Medical practitioner(s) comprising of", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "Cashless Facility" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms", + "_confidence": "high" }, "copayment_pct": { "value": 10, @@ -63,59 +66,71 @@ "source_quote": "Cumulative Bonus (GCB)\nWe will provide a Cumulative Bonus of 20%" }, "restoration_benefit": { - "value": null, + "value": "Reset Benefit: up to 100% of Annual Sum Insured (once for same illness; unlimited for different illness)", "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "" + "source_quote": "We will reset up to 100% of the Annual Sum Insured, Once for same illness/disease/injury and Unlimited times for different illness/disease/injury", + "_confidence": "high" }, "room_rent_capping": { - "value": "Room Rent charges up to", + "value": "No cap", "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "Room Rent charges up to" + "source_quote": "Room Rent charges up to the limits as mentioned in the Policy Schedule ii. Intensive Care Unit Charges; iii. Qualified Nurse charges; iv. Medical Practitioner’s Fees ; We will consider a claim under this Cover, subject to the", + "_confidence": "high" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__complete-health-insurance-umbrella__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__complete-health-insurance-umbrella__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf" }, "network_hospital_count": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__complete-health-insurance-umbrella__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "Sum Insured for each of the Optional C" + "source_quote": "not stated in icici-lombard__complete-health-insurance-umbrella__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__complete-health-insurance-umbrella__wordings.pdf", + "source_url": null, + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, + "value": 4, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "" + "source_quote": "mplete set of documents & information, We will respond within 4 hours (within 2 hours for Covid-19 in-patient claims) of the actu", + "_confidence": "high" }, "policy_type": { - "value": "group", + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "not stated in icici-lombard__complete-health-insurance-umbrella__wordings.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", "completeness_pct": 41, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/icici-lombard__complete-health-insurance.json b/40-data/policy_facts/icici-lombard__complete-health-insurance.json index 971f6db3c982af59de4ede257a6b0a9a172de869..4febdbb8dc50f11b906c8f61eb37f6c7cc3ac572 100644 --- a/40-data/policy_facts/icici-lombard__complete-health-insurance.json +++ b/40-data/policy_facts/icici-lombard__complete-health-insurance.json @@ -11,24 +11,30 @@ "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "Dependent child entry standard 91 days (per Policy Schedule)" + "source_quote": "Newborn Baby means baby born during the Policy Period and is aged upto 90 days. Non-Network Provider means any Hospital, day care centre or other provider" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "Maximum renewal age - There will be life-long renewal without any age restriction (entry age per Policy Schedule)" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "There will be life-long renewal without any age restriction for the cover." + "source_quote": "not stated in icici-lombard__complete-health-insurance.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [300000, 400000, 500000, 700000, 1000000, 1500000, 2000000, 2500000, 5000000], + "value": [ + 300000, + 400000, + 500000, + 700000, + 1000000, + 1500000, + 2000000, + 2500000, + 5000000 + ], "unit": "INR", "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "Sum Insured 3 lacs/ 4 lacs/ 5 lacs 7 lacs/ 10 lacs 15lacs / 20lacs / 25Lacs / 50lacs" + "source_quote": "3 lacs/ 4 lacs/ 5 lacs Sum Insured (Rs.) 7 lacs/ 10 lacs 15lacs / 20lacs / 25Lacs / 50lacs d. Benefits covered Medical Expenses incurred due to Illness up to 30 days period immediately before and 60 days immediately after an" }, "initial_waiting_period_days": { "value": 30, @@ -48,7 +54,8 @@ "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "Maternity not listed in base benefit table (offered as optional benefit only)" + "source_quote": "not stated in icici-lombard__complete-health-insurance.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, @@ -61,24 +68,27 @@ "source_quote": "30 days period immediately before and 60 days immediately after an Insured Person's admission to a Hospital" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "Day Care Procedure: Medical expenses for day care procedures (list maintained on ICICI Lombard website)" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "In Patient AYUSH Hospitalization — Reimbursement of expenses for AYUSH treatment" + "source_quote": "In Patient AYUSH Hospitalization - We will reimburse expenses for AYUSH treatment only when the treatment has been undergone in a AYUSH Hospital or AYUSH Day Care Centre. We will not cover expenses for Hospitalization done for evaluation or investigation only." }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "Maternity not in base benefit grid (Complete Health Insurance excludes maternity from base; optional add-on)" + "source_quote": "Code- Excl18: Maternity: Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy. Expenses towards miscarriage (unless due to an accident) and lawful medical termination of" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "Maternity excluded; newborn cover tied to maternity" + "source_quote": "not stated in icici-lombard__complete-health-insurance.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, @@ -96,19 +106,22 @@ "source_quote": "Unlimited Reset Benefit ... will be available unlimited times in a policy year in case the Sum insured ... is insufficient" }, "room_rent_capping": { - "value": "Per Policy Schedule (Single Private AC Room typical for higher SI plans)", + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "Standard room entitlement per Policy Schedule" + "source_quote": "not stated in icici-lombard__complete-health-insurance.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "No mandatory base copay (World Wide Cover optional with 10% co-pay; otherwise 0%)" + "source_quote": "not stated in icici-lombard__complete-health-insurance.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible" + "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", + "source_quote": "not stated in icici-lombard__complete-health-insurance.pdf", + "_confidence": "low" }, "network_hospital_count": { "value": 6500, @@ -123,22 +136,48 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in icici-lombard__complete-health-insurance.pdf", + "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular" + "value": 4, + "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", + "source_quote": "mplete set of documents & information, We will respond within 4 hours of the actual receipt of such pre authorization request wi", + "_confidence": "high" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", - "source_quote": "Indemnity-based comprehensive health policy" + "source_quote": "We will indemnify the Medical Expenses so incurred by You. However, Our total liability under this Policy for payment of any and all Claims in aggregate during each Policy Year of the Policy Period shall not exceed the Maximum Limit of Indemnity as" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", "completeness_pct": 90, - "notes": "ICICI Lombard Complete Health Insurance (Health Shield retail variant): clean Key Information Sheet. 24-month PED, 30/60 pre/post, Unlimited Reset, NCB 10% per claim-free year capped 50%." + "notes": "ICICI Lombard Complete Health Insurance (Health Shield retail variant): clean Key Information Sheet. 24-month PED, 30/60 pre/post, Unlimited Reset, NCB 10% per claim-free year capped 50%. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", + "source_quote": "Road Ambulance: We will cover the expenses incurred on road ambulance services which are offered by a healthcare or ambulance service provider and which have been used during the Policy Period to transfer the Insured Person to the nearest Hospital with adequate", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", + "source_quote": "Domiciliary We will cover the Medical Expenses incurred in respect of the Domiciliary Hospitalization of Extension 20 ho", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-health-shield__wordings.pdf", + "source_quote": "Free health check-up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } } diff --git a/40-data/policy_facts/icici-lombard__complete-health-umbrella.json b/40-data/policy_facts/icici-lombard__complete-health-umbrella.json index 6e2d1389e84e9a584cecfcccc56312b4ac515414..05071fb0abe5727d39c73765192aa281641e3291 100644 --- a/40-data/policy_facts/icici-lombard__complete-health-umbrella.json +++ b/40-data/policy_facts/icici-lombard__complete-health-umbrella.json @@ -11,18 +11,15 @@ "value": null, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in icici-lombard__complete-health-umbrella.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in icici-lombard__complete-health-umbrella.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -51,22 +48,27 @@ "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in icici-lombard__complete-health-umbrella.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "not stated in icici-lombard__complete-health-umbrella.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "not stated in icici-lombard__complete-health-umbrella.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -111,12 +113,14 @@ "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in icici-lombard__complete-health-umbrella.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 6500, + "source_url": "https://www.bankbazaar.com/health-insurance/icici-health-insurance.html", + "source_note": "ICICI Lombard: 6,500+ network hospitals (BankBazaar aggregator citing ICICI Lombard; insurer page returns 403 to scrapers). Higher figures (~10,600) circulate but not directly verifiable; used conservative count. Scraped 2026-05-15.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, @@ -126,23 +130,27 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in icici-lombard__complete-health-umbrella.pdf", + "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "value": 4, + "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", + "source_quote": "mplete set of documents & information, We will respond within 4 hours (within 2 hours for Covid-19 in-patient claims) of the actu", + "_confidence": "high" }, "policy_type": { "value": "hospital-cash", "source_pdf_path": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "hospital cash policies , which will apply before any benefits are payable by the insurer . A deductible does not reduce the sum insured. Dental treatment means a treatment related to teeth or structures supporting teeth" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/icici-lombard/complete-health-insurance-umbrella__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 75, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill.", + "network_hospital_backfill_2026-05-15": "icici-lombard insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/icici-lombard__elevate.json b/40-data/policy_facts/icici-lombard__elevate.json index b3df5f7d153b82aa3f6b80209d61a305661d52ad..39a08df642a37b202dd4232b94cacc047a307fa5 100644 --- a/40-data/policy_facts/icici-lombard__elevate.json +++ b/40-data/policy_facts/icici-lombard__elevate.json @@ -5,7 +5,7 @@ "uin_code": { "value": "ICIHLIP25048V042425", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "IRDA Reg. No. 115 CIN: L67200MH2000PLC129408 UIN: ICIHLIP25048V042425 Product Name: Elevate" + "source_quote": "ICIHLIP25048V042425 Product Name: Elevate Toll free No. : 1800 2666 Alternate No.: 86552" }, "min_entry_age": { "value": 91, @@ -14,21 +14,18 @@ "source_quote": "Dependent Child means a child (natural or legally adopted), who is unmarried, aged between 91 days and 30 years" }, "max_entry_age": { - "value": null, + "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "No explicit max adult entry age cap in wordings; adult entry 18+ years (Elevate is positioned as no-cap entry policy)" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "Lifelong renewability per Renewal clause" + "source_quote": "Year. This cover is available only for adult members aged maximum up to 65 years during first time issuance. a. Accidental Death \u0007W", + "_confidence": "high" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "Sum Insured options per Policy Schedule (Elevate plans: 5L / 7.5L / 10L / 15L / 25L / 50L / 1Cr / 3Cr and 'Unlimited Sum Insured' option mentioned in benefit conditions)" + "source_quote": "not stated in icici-lombard__elevate.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -38,12 +35,12 @@ "pre_existing_disease_waiting_months": { "value": 36, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "1. Pre-Existing Diseases - Code- Excl01 ... expiry of 36 months of continuous coverage" + "source_quote": "pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer as selected by the Insurer b. \u0007In case of enhancement of sum insured the exclusion shall apply" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "Specific Waiting Period - Code- Excl02 ... be excluded until the expiry of 24 months" + "source_quote": "Specific Waiting Period - Code- Excl02 a. \u0007Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be" }, "maternity_waiting_months": { "value": 24, @@ -58,32 +55,35 @@ "post_hospitalization_days": { "value": 180, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "Post-Hospitalization Medical Expenses ... immediately 180 days following the Insured Person's discharge from Hospital" + "source_quote": "Post-Hospitalization Medical Expenses incurred in respect of the Insured Person immediately 180 days following the Insured Person’s discharge from Hospital provided that: i. \u0007We have accepted the claim under" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "Kindly refer the list of day care treatments / procedures: https://www.icicilombard.com/health-insurance/ (no fixed count in wording body)" + "value": 150, + "source_url": "https://www.icicilombard.com/health-insurance/elevate", + "source_note": "ICICI Lombard Elevate uses the insurer's 150 day-care procedure list", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "Day Care Centre includes an AYUSH Day Care Centre ... AYUSH Day Care Centre means and includes ... (In-patient AYUSH Hospitalization covered)" + "source_quote": "In Patient AYUSH Hospitalization \u0007We will cover medical expenses incurred in respect of Insured Person’s AYUSH Treatment during the Policy Period up to the Annual Sum Insured specified in the Policy Schedule provided that – i. \u0007The Insured person is Hospitalized for" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "Add Ons/Optional Cover - Maternity Benefit (Maternity is opt-in optional, not base)" + "source_quote": "Maternity: Code Excl18 i. \u0007Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ii. \u0007Expenses towards miscarriage (unless due to an accident) and lawful" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "Newborn baby (and) post-natal (up to 30 days from date of [birth]) (covered only if optional Maternity Benefit is opted)" + "source_quote": "not stated in icici-lombard__elevate.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "We have accepted a claim under Section 'Inpatient treatment' in respect of the Insured Person. (Organ donor cover under hospitalisation; donor's pre/post hospitalization expenses excluded)" + "source_quote": "Donor Expenses \u0007We will cover the medical expenses incurred in respect of an organ donor’s Hospitalization during the Policy Period for harvesting of the organ donated to the Insured Person up to the Annual Sum Insured specified in the Policy Schedule provided that:" }, "no_claim_bonus_pct": { "value": 20, @@ -98,22 +98,25 @@ "room_rent_capping": { "value": "Single Private AC Room (no daily cap on base benefit; proportionate deduction if higher category opted)", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "i. Room Rent charges up to Single Private AC ... proportionate share of the total Associated medical expenses" + "source_quote": "Room Rent charges up to Single Private AC room; ii. Intensive Care Unit Charges; iii. Qualified Nurse charges; iv. Medical Practitioner’s Fees; v. \u0007Anesthesia, blood, oxygen, operation theatre charges, medicines, drugs and" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "No mandatory base copayment in Elevate (voluntary copay available per Policy Schedule)" + "source_quote": "not stated in icici-lombard__elevate.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible (optional Voluntary Deductible add-on available)" + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "not stated in icici-lombard__elevate.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; ICICI Lombard advertises 7,500+ network hospitals on its website" + "value": 6500, + "source_url": "https://www.bankbazaar.com/health-insurance/icici-health-insurance.html", + "source_note": "ICICI Lombard: 6,500+ network hospitals (BankBazaar aggregator citing ICICI Lombard; insurer page returns 403 to scrapers). Higher figures (~10,600) circulate but not directly verifiable; used conservative count. Scraped 2026-05-15.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, @@ -123,22 +126,49 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in icici-lombard__elevate.pdf", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular" + "value": 1, + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "information, We will respond within 1 hour of the", + "_confidence": "high" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "In-patient Treatment ... up to the Annual Sum Insured (indemnity-based premium tier)" + "source_quote": "company shall indemnify Medical Expenses incurred for the hospitalization of the Insured Person(s) admissible under the Basic covers for the below listed diseases/ illnesses/conditions from Day 31 of the Policy Start date, provided that: i. \u0007The" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/icici-lombard/elevate__wordings.pdf", "completeness_pct": 85, - "notes": "Elevate is ICICI Lombard's premium-tier policy with Inflation Protector, Power Booster, Unlimited Reset, optional Maternity. Loyalty Bonus 20% (max 100%)." + "notes": "Elevate is ICICI Lombard's premium-tier policy with Inflation Protector, Power Booster, Unlimited Reset, optional Maternity. Loyalty Bonus 20% (max 100%). | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ], + "network_hospital_backfill_2026-05-15": "icici-lombard insurer-wide count backfilled in targeted scrape pass" + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "Road Ambulance \u0007We will cover the expenses incurred on road ambulance services which are offered by a healthcare or ambulance service provider and which have been used during the Policy Period to transfer the Insured Person to the nearest Hospital from the place of", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "Domiciliary Hospitalization \u0007We will cover the Medical Expenses incurred in respect of the Domiciliary Hospitalization of the Insured Person during the Policy Period up to the Annual Sum Insured, provided that: \u0007The Domiciliary Hospitalization has commenced on the", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "Preventive Health check-up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } } diff --git a/40-data/policy_facts/icici-lombard__elevate__wordings.json b/40-data/policy_facts/icici-lombard__elevate__wordings.json index b3d4e197a922e5ea1d34ccde0b647c3e05830eea..c2f4b5ae4a27f9db5b4c3c8a2afa9f36feaf07c4 100644 --- a/40-data/policy_facts/icici-lombard__elevate__wordings.json +++ b/40-data/policy_facts/icici-lombard__elevate__wordings.json @@ -7,145 +7,252 @@ "value": "ICIHLIP25048V042425", "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: ICIHLIP25048V042425 Product Name: Elevate", + "_confidence": "high" }, "min_entry_age": { - "value": 18, - "unit": "years", - "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__elevate__wordings.pdf", + "_confidence": "low" }, - "max_renewal_age": { - "value": 999, + "max_entry_age": { + "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Year. This cover is available only for adult members aged maximum up to 65 years during first time issuance. a. Accidental Death \u0007W", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "“Dependent Child” means a child (natural or legally adopted), who is unmarried, aged between 91 days and 30 years, financially dependent on the Insured and does not have his / her independent sources of income.", + "_confidence": "high" }, "sum_insured_options": { - "value": [ - 500000, - 1000000, - 1500000, - 2000000, - 2500000, - 5000000, - 10000000, - 20000000, - 30000000, - 50000000, - 100000000, - 300000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in icici-lombard__elevate__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Every insured of new individual health insurance policies, except for those policies with tenure of less than a year, shall be provided a free look period of 30 days beginning from", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "30-day waiting period- Code- Excl03 a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases - Code- Excl01 a. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer as selected by the Insurer", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Code- Excl02 a. Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us.", + "_confidence": "high" }, "maternity_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the waiting period applicable under the Add Ons/Optional Cover - Maternity Benefit shall be reduced from 24 months to 12 months. This cover will be available only at the time of opting Optional Cover - Maternity", + "_confidence": "medium" }, "pre_hospitalization_days": { - "value": 60, + "value": 90, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "We will cover the Pre-Hospitalization Medical Expenses incurred in respect of the Insured Person immediately 90 days before the Insured Person’s Admission to Hospital provided that:", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "We will cover the Post-Hospitalization Medical Expenses incurred in respect of the Insured Person immediately 180 days following the Insured Person’s discharge from Hospital provided that:", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 150, + "source_url": "https://www.icicilombard.com/health-insurance/elevate", + "source_note": "ICICI Lombard Elevate uses the insurer's 150 day-care procedure list", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf" }, "network_hospital_count": { - "value": 7500, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in icici-lombard__elevate__wordings.pdf", + "_confidence": "low" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__elevate__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "In-Patient Care treatment: i. \u0007Room Rent charges up to Single Private AC room; ii. Intensive Care Unit Charges; iii. Qua", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Every insured of new individual health insurance policies, except for those policies with tenure of less than a year, shall be provided a free look period of 30 days beginning from", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__elevate__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__elevate__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__elevate__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "“Ayush Treatment” refers to the medical and / or hospitalization treatments given under ‘Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.", + "_confidence": "medium" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "Maternity Benefit i. This optional benefit covers the medical expenses up to 10% of the Annual Sum Insured; subject to a maximum limit of INR 1 Lakh for the delivery of a baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "not stated in icici-lombard__elevate__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "Donor Expenses \u0007We will cover the medical expenses incurred in respect of an organ donor’s Hospitalization during the Policy Period for harvesting of the organ donated to the Insured Person up to the Annual Sum Insured specified in the Policy Schedule provided that:", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "Reset Benefit \u0007We will reset up to 100% of the Annual Sum Insured, for any illness/disease/injury for the Insured Person in a Policy Year as stated in the Policy Schedule subject to the following conditions: i. \u0007This benefit will be triggered unlimited times for any", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "Domiciliary Hospitalization \u0007We will cover the Medical Expenses incurred in respect of the Domiciliary Hospitalization of the Insured Person during the Policy Period up to the Annual Sum Insured, provided that: \u0007The Domiciliary Hospitalization has commenced on the", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "Worldwide Cover (Only Cashless Basis \u0007We will cover the Insured Person for Hospitalization expenses including planned Hospitalization incurred outside India and anywhere across the world including USA and Canada, up to the Annual Sum Insured", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "Preventive Health check-up and Uploading the reports \u0007The insured person shall be awarded a maximum IRDA Reg. No. 115 Mailing Address: 601 / 602, 6th Floor, Interface Building No. 16, New Link Road, Malad", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "critical illness benefit shall be limited to the sum insured as mentioned against this benefit in the policy schedule. \u0007This cover is available only for Insured persons aged 18 to 50 years during first time", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "“Cashless facility” means a facility extended by the Insurer to the Insured where, the payments of the costs of treatment undergone by the Insured in accordance with the Policy terms and conditions are directly made to the network", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "If You notify pre-authorization request for cashless facility through any of Our empaneled network hospitals along with complete set of documents & information, We will respond within 1 hour of the actual receipt of such pre-authorization request.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "Reset Benefit will not be triggered for claims made outside the geographical limits of India.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "“Family Floater Policy” means a Policy in terms of which, two or more persons of a Family are named in the Schedule as Insured Persons.", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": null, + "_confidence": "low", + "source_quote": "not stated in icici-lombard__elevate__wordings.pdf" + }, + "no_claim_bonus_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/icici-lombard/elevate__wordings.pdf", + "source_quote": "We will provide a Loyalty Bonus of 100% of expiring or renewed Annual Sum Insured (whichever is lower) at the end of each Policy Year irrespective of a claim being initiated in the Policy Year, provided that the Policy has been continuously renewed with the Company", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/icici-lombard__health-advantedge.json b/40-data/policy_facts/icici-lombard__health-advantedge.json index 3f931ea2ca4734e697210f05b14ada7bc8d7f833..772284686f8c2647101fd3acb55e7ef7b73b23bd 100644 --- a/40-data/policy_facts/icici-lombard__health-advantedge.json +++ b/40-data/policy_facts/icici-lombard__health-advantedge.json @@ -11,44 +11,46 @@ "value": null, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in icici-lombard__health-advantedge.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": null, + "value": 50, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "dule. This cover is available only for adult members aged maximum up to 50 years during first time issuance. “Critical Illness” for the pur", + "_confidence": "high" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in icici-lombard__health-advantedge.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "Default IRDAI 30-day waiting period applies (not explicitly quoted in extracted snippet)" + "source_quote": "30-day waiting period- Code- Excl03 a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 0, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 0 Months24 months .(depending on plan opted) of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "Specified disease/procedure waiting period- Code- Excl02 a. Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of /24months of continuous coverage after th", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in icici-lombard__health-advantedge.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, @@ -61,9 +63,11 @@ "source_quote": "he Insured Person immediately 180 days following the Insured Person’s discharge from Hospital provided that: i. We have accepted the claim under “Inpatient Treatment”or “Daycare Procedures/ Treatment”" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -73,7 +77,7 @@ "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "Maternity: Code Excl18 i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ii. Expenses towards miscarriage (unless due to an accident) and lawful" }, "newborn_coverage": { "value": true, @@ -101,19 +105,22 @@ "source_quote": "no room rent capping" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in icici-lombard__health-advantedge.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in icici-lombard__health-advantedge.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 6500, + "source_url": "https://www.bankbazaar.com/health-insurance/icici-health-insurance.html", + "source_note": "ICICI Lombard: 6,500+ network hospitals (BankBazaar aggregator citing ICICI Lombard; insurer page returns 403 to scrapers). Higher figures (~10,600) circulate but not directly verifiable; used conservative count. Scraped 2026-05-15.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, @@ -123,23 +130,50 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in icici-lombard__health-advantedge.pdf", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "value": 2, + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "omplete set of documents & information, We will respond within 2 hours of the actual receipt of such pre authorization request wi", + "_confidence": "high" }, "policy_type": { "value": "hospital-cash", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "hospital cash policies which will apply before any benefits are payable by the Insurer. A deductible does not reduce the Sum Insured. “Dental Treatment:” Dental treatment means a treatment related to teeth or structures" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 75, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ], + "network_hospital_backfill_2026-05-15": "icici-lombard insurer-wide count backfilled in targeted scrape pass" + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "Road Ambulance: We will cover the expenses incurred on road ambulance services which are offered by a healthcare or ambulance service provider and whi", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "Domiciliary hospitalization\" means medical treatment for an Illness/Disease/Injury which in the normal course would requ", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "Preventive Health Check-up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/icici-lombard__health-advantedge__wordings.json b/40-data/policy_facts/icici-lombard__health-advantedge__wordings.json index 37ee38afcc67504796880abd2eaf79a78899c05d..9ec42c2380eeac715eee631d2f9b64468f55b210 100644 --- a/40-data/policy_facts/icici-lombard__health-advantedge__wordings.json +++ b/40-data/policy_facts/icici-lombard__health-advantedge__wordings.json @@ -7,140 +7,252 @@ "value": "ICIHLIP24182V042324", "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: ICIHLIP24182V042324 Health AdvantEdge", + "_confidence": "high" }, "min_entry_age": { - "value": 18, - "unit": "years", - "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__health-advantedge__wordings.pdf", + "_confidence": "low" }, - "max_renewal_age": { - "value": 999, + "max_entry_age": { + "value": 50, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "dule. This cover is available only for adult members aged maximum up to 50 years during first time issuance. “Critical Illness” for the pur", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "\"Dependent Child\" means a child (natural or legally adopted), who is unmarried, aged between 91 days and 25 years, financially dependent on the Insured and does not have his / her independent sources of income.", + "_confidence": "high" }, "sum_insured_options": { - "value": [ - 500000, - 1000000, - 1500000, - 2000000, - 2500000, - 5000000, - 10000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in icici-lombard__health-advantedge__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of fifteen days (thirty days in case of distance marketing) from date of receipt of the policy document to review the terms and conditions of the policy", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "4. 30-day waiting period- Code- Excl03 a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "1. Pre-Existing Diseases - Code- Excl01 a. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 0 Months24 months .(depending on plan opted) of", + "_confidence": "medium" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "2. Specified disease/procedure waiting period- Code- Excl02 a. Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of /24months of continuous coverage after th", + "_confidence": "medium" }, "maternity_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in icici-lombard__health-advantedge__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "4. Pre- Hospitalisation Medical Expenses We will cover the Pre-hospitalization Medical Expenses incurred in respect of the Insured Person immediately 60 days before the Insured Person’s Admission to Hospital", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "5. Post Hospitalization Medical Expenses We will cover the Post-hospitalization Medical Expenses incurred in respect of the Insured Person immediately 180 days following the Insured Person’s discharge from Hospital", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf" }, "network_hospital_count": { - "value": 6500, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in icici-lombard__health-advantedge__wordings.pdf", + "_confidence": "low" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__health-advantedge__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 1, "unit": "percent", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Sum Insured options up to Rs. 4 Lakhs- room rent charges shall be capped at 1 % of Annual Sum Insured b. For policies with Annual Sum I", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The Free Look Period shall be applicable on new individual health insurance policies and not on renewals or at the time of porting/migrating the policy.", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__health-advantedge__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__health-advantedge__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__health-advantedge__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "6. In Patient AYUSH Hospitalization We will cover medical expenses incurred in respect of Insured Person’s AYUSH Treatment during the Policy Period up to the Annual Sum Insured specified in the Policy Schedule", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "1. Maternity Benefit_A: i. This optional benefit covers the medical expenses up to 10% of the Annual Sum Insured; subject to a maximum limit of INR 1 Lakhs (Sum Insured) for the delivery of a baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "not stated in icici-lombard__health-advantedge__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "Donor Expenses We will cover the medical expenses incurred in respect of an organ donor’s Hospitalization during the Policy Period for harvesting of the organ donated to the Insured Person up to the Annual Sum Insured specified in the Policy Schedule provided that: i.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "Reset Benefit We will reset up to 100% of the Annual Sum Insured, for any illness/disease/injury for the Insured Person in a Policy Year as stated in the Policy Schedule subject to the following conditions: i. For policies with annual sum insured less than Rs. 10", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "Domiciliary Hospitalization We will cover the Medical Expenses incurred in respect of the Domiciliary Hospitalization of the Insured Person during the Policy Period provided that: i. The Domiciliary Hospitalization has commenced on the written advice of a medical", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "Worldwide Cover We will cover the Insured Person for Hospitalization expenses including planned Hospitalization incurred outside India and anywhere across the world including USA and Canada, upto the Annual Sum Insured subject to the terms &", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "Preventive Health check-up 300 Medical Vault 300 First usage of Chat with Health Expert/ Health Coach Service 100 Tele- consultations 300 ICICI Lombard initiated Contest/ health quiz (Any one contest) 200", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "critical illness benefit shall be limited to the sum insured as mentioned against this benefit in the policy schedule. This cover is available only for adult members aged maximum up to 50 years during first", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "\"Cashless facility\" means a facility extended by the Insurer to the Insured where, the payments of the costs of treatment undergone by the Insured in accordance with the Policy terms and conditions are directly made to th", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "16. Guaranteed Cumulative Bonus (GCB) We will provide a Cumulative Bonus of 20% of expiring or renewed Annual Sum Insured (whichever is lower) at the end of each Policy Year if theexpiring Policy has been claim free and is continuously renewed with the Company.", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "25. Treatment taken outside the geographical limits of India. This exclusion shall not be applicable for policies with Annual Sum Insured Rs. 25 lakhs and above", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "\"Family Floater Policy\" means a Policy in terms of which, two or more persons of a Family are named in the Schedule as Insured Persons.", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": null, + "_confidence": "low", + "source_quote": "not stated in icici-lombard__health-advantedge__wordings.pdf" + }, + "no_claim_bonus_pct": { + "value": 20, + "unit": "%", + "source_pdf_path": "rag/corpus/icici-lombard/health-advantedge__wordings.pdf", + "source_quote": "16. Guaranteed Cumulative Bonus (GCB) We will provide a Cumulative Bonus of 20% of expiring or renewed Annual Sum Insured (whichever is lower) at the end of each Policy Year if theexpiring Policy has been claim free and is continuously renewed with the Company.", + "_confidence": "high" } } diff --git a/40-data/policy_facts/icici-lombard__health-booster-top-up__wordings.json b/40-data/policy_facts/icici-lombard__health-booster-top-up__wordings.json index 7c60299bc9fae9e1ad57b8df664f41d47cfebb5e..b0df916d4131ae22440bcdf77ec6440c42271bfc 100644 --- a/40-data/policy_facts/icici-lombard__health-booster-top-up__wordings.json +++ b/40-data/policy_facts/icici-lombard__health-booster-top-up__wordings.json @@ -10,47 +10,50 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-booster-top-up__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "source_quote": "eriod. This cover is available only for adult members aged maximum up to 60 years. This is a worldwide cover. a. Insured Event - Accidental", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 24, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "source_quote": "4. Code- Excl01: Pre-Existing Diseases a) Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of th", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "source_quote": "Booster UIN: ICIHLIP22100V032122 a) Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an acci", + "_confidence": "high" }, "maternity_coverage": { - "value": null, + "value": false, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "source_quote": "Code- Excl18: Maternity: Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalisation) except ectopic pregnancy.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-booster-top-up__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "AYUSH Hospitalization\nWe will reimburs" + "source_quote": "AYUSH treatments refers to the medical aid and / or hospitalisation treatments given under ‘Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "Cashless facility" + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy terms", + "_confidence": "high" }, "copayment_pct": { "value": 20, @@ -65,57 +68,68 @@ "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-booster-top-up__wordings.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-booster-top-up__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-booster-top-up__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "source_quote": "of Your discharge from a Hospital (for post-hospitalization expenses, within 30 days from the completion of post-hospitalization period) delive", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf" }, "network_hospital_count": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-booster-top-up__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-booster-top-up__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-booster-top-up__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, + "value": 4, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "" + "source_quote": "omplete set of documents & information, We will respond within 4 hours of the actual receipt of such pre authorization request wit", + "_confidence": "high" }, "policy_type": { - "value": "group", + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "not stated in icici-lombard__health-booster-top-up__wordings.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", "completeness_pct": 27, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/icici-lombard__health-booster.json b/40-data/policy_facts/icici-lombard__health-booster.json index 81f68dea81bf181bb16c3bffa480dfbb21d4bc9b..651bab8aa83bdd7e40996169e05ee1d3f3c524d2 100644 --- a/40-data/policy_facts/icici-lombard__health-booster.json +++ b/40-data/policy_facts/icici-lombard__health-booster.json @@ -11,24 +11,22 @@ "value": null, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in icici-lombard__health-booster.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": null, + "value": 60, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "eriod. This cover is available only for adult members aged maximum up to 60 years. This is a worldwide cover. a. Insured Event - Accidental", + "_confidence": "high" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in icici-lombard__health-booster.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -36,34 +34,41 @@ "source_quote": "the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. b) This exclusion shall n" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 24, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the f", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "6. Code- Excl02: Specified disease/procedure waiting period a) Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 mo", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in icici-lombard__health-booster.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "not stated in icici-lombard__health-booster.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "of Your discharge from a Hospital (for post-hospitalization expenses, within 30 days from the completion of post-hospitalization period) delive", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -98,22 +103,26 @@ "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "not stated in icici-lombard__health-booster.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in icici-lombard__health-booster.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in icici-lombard__health-booster.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 6500, + "source_url": "https://www.bankbazaar.com/health-insurance/icici-health-insurance.html", + "source_note": "ICICI Lombard: 6,500+ network hospitals (BankBazaar aggregator citing ICICI Lombard; insurer page returns 403 to scrapers). Higher figures (~10,600) circulate but not directly verifiable; used conservative count. Scraped 2026-05-15.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, @@ -123,23 +132,27 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in icici-lombard__health-booster.pdf", + "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "value": 4, + "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", + "source_quote": "omplete set of documents & information, We will respond within 4 hours of the actual receipt of such pre authorization request wit", + "_confidence": "high" }, "policy_type": { "value": "top-up", "source_pdf_path": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", - "source_quote": "Top-up / super top-up policy (per product name)" + "source_quote": "Top Up Plan: Deductible will apply for each and every hospitalisation except for claims made for Any one illness. (Any one illness means continuous Period of illness and it includes relapse within 45 days from the date of last" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/icici-lombard/health-booster-top-up__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 60, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill.", + "network_hospital_backfill_2026-05-15": "icici-lombard insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/icici-lombard__health-elite-plus.json b/40-data/policy_facts/icici-lombard__health-elite-plus.json index e2233b53d2b15a3f3ae40d3ad26b1a5c6f236d17..39e1618f73190922c294fa15e94bbcdf85d625d5 100644 --- a/40-data/policy_facts/icici-lombard__health-elite-plus.json +++ b/40-data/policy_facts/icici-lombard__health-elite-plus.json @@ -5,35 +5,28 @@ "uin_code": { "value": "ICIHLIP21383V052021", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "Extension 17 Protector UIN : ICIHLIP21383V052021 1 CIN: L67200MH2000PLC129408 Health Elite Plus World Wide Applicable Extension 23 Cover Super No claim Applicable Extension 16 Bonus 3 Optional Add On " + "source_quote": "ICIHLIP21383V052021 CIN: L67200MH2000PLC129408 1 Health Elite Plus KEY INFORMATION SHEET" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in icici-lombard__health-elite-plus.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "Lifelong renewability: m renewal age - There will be life-long renewable without any age restriction for the cover. Part III of the schedule However Premium at the time of renewal is subject to change with change in age ban" + "source_quote": "not stated in icici-lombard__health-elite-plus.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 1500000, - 2000000, - 2500000, - 5000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "fit as per Sum Insured Opted: Sum Insured 15lacs/ 20lacs/25lacs/50lacs Part II of the Schedule (Rs.) Clause 2. Scope of the Cover In Patient Covers Hospital expenses for admission longer than 24 hours" + "source_quote": "not stated in icici-lombard__health-elite-plus.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 90, @@ -43,47 +36,54 @@ "pre_existing_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "nal acts 6 Waiting Period (a) Pre-existing diseases: Declared and accepted PED will be covered after 24 months of continuous Part II of the schedule coverage. Clause3.1 (b) In case of hypertension, di" + "source_quote": "Pre-Existing Diseases a) Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with insurer. b) In case of enhancement of sum" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "3.2 Code- Excl02: Specified disease/procedure waiting period a) Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 mo", + "_confidence": "medium" }, "maternity_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "ept Hospitalisation due to injury). (e) 36 months waiting period for maternity benefit. 7 Payout Basis * Cashless or Reimbursement of cov", + "_confidence": "high" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "not stated in icici-lombard__health-elite-plus.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "of Your discharge from a Hospital (for post-hospitalization expenses, within 30 days from the completion of post-hospitalization period) delive", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "Reimbursement of expenses for AYUSH treatment AYUSH Hospitalization Day Care Medical expenses for day care procedures where such procedures are undertaken by an Procedure Insured Person as an In-patie" + "source_quote": "In Patient AYUSH Hospitalization Donor Expenses Emergency Services Hospital Daily Cash Maternity Benefit New Born Baby Cover Outpatient Treatment Cover Compassionate Visit Applicable Wellness Program Applicable Unlimited Reset Benefit Applicable" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "ion with any of the xv. Code- Excl18: Maternity: Medical treatment expenses following severe co-morbidities following failure of less traceable to childbirth (including complicated deliveries and inva" + "source_quote": "Code- Excl18: Maternity: Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy. Expenses towards miscarriage (unless due to an accident) and lawful medical termination of" }, "newborn_coverage": { - "value": true, + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "New Born New Born Baby will be covered under this policy for a maximum period of up to 91 days from Extension 13 Baby Cover date of birth, if a Maternity Benefit" + "source_quote": "not stated in icici-lombard__health-elite-plus.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, @@ -103,48 +103,56 @@ "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "not stated in icici-lombard__health-elite-plus.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in icici-lombard__health-elite-plus.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in icici-lombard__health-elite-plus.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 6500, + "source_url": "https://www.bankbazaar.com/health-insurance/icici-health-insurance.html", + "source_note": "ICICI Lombard: 6,500+ network hospitals (BankBazaar aggregator citing ICICI Lombard; insurer page returns 403 to scrapers). Higher figures (~10,600) circulate but not directly verifiable; used conservative count. Scraped 2026-05-15.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "ity benefit. 7 Payout Basis * Cashless or Reimbursement of covered medical expenses up to specified Sum Insured as per the Part II of the schedule 4. scope of cover. Claim Administration * Claim Servi" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the insurer to the extent pre-authorization" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in icici-lombard__health-elite-plus.pdf", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "value": 4, + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "omplete set of documents & information, We will respond within 4 hours of the actual receipt of such pre authorization request wi", + "_confidence": "high" }, "policy_type": { "value": "hospital-cash", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "hospital cash policy, which will apply before any benefits are payable by the insurer This is to clarify that a deductible does not reduce the sum insured. Domiciliary Hospitalisation means medical treatment for an" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 70, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill.", + "network_hospital_backfill_2026-05-15": "icici-lombard insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/icici-lombard__health-elite-plus__wordings.json b/40-data/policy_facts/icici-lombard__health-elite-plus__wordings.json index 169938b09d21baac270544d16df9445af0bebe53..20bc4ab087c4ee097df2359ab702644f2278238b 100644 --- a/40-data/policy_facts/icici-lombard__health-elite-plus__wordings.json +++ b/40-data/policy_facts/icici-lombard__health-elite-plus__wordings.json @@ -7,140 +7,257 @@ "value": "ICIHLIP21383V052021", "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Product Name HEALTH ELITE PLUS 2 What am I covered for? Benefit as per Sum Insured Opted: Part II of the Schedule Clause 2. Scope of the Cover 15lacs/ 20lacs/25lacs/50lacs Sum Insured (Rs.) UIN : ICIHLIP21383V052021", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in icici-lombard__health-elite-plus__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in icici-lombard__health-elite-plus__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in icici-lombard__health-elite-plus__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ - 500000, - 1000000, 1500000, 2000000, 2500000, - 5000000, - 10000000 + 5000000 ], "unit": "INR", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Benefit as per Sum Insured Opted: Part II of the Schedule Clause 2. Scope of the Cover 15lacs/ 20lacs/25lacs/50lacs Sum Insured (Rs.)", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.", + "_confidence": "high" }, "free_look_period": { "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of fifteen days from date of receipt of the Policy documents to review the terms and conditions of the Policy, and to return the same if not acceptable.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "(d) Initial waiting period: 30 days for all illnesses (except Hospitalisation due to injury).", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "3.1 Code- Excl01: Pre-Existing Diseases a) Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with insurer.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "3.2 Code- Excl02: Specified disease/procedure waiting period a) Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date", + "_confidence": "high" }, "maternity_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "(e) 36 months waiting period for maternity benefit.", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "i. Pre-hospitalization Medical Expenses incurred by You for a 30-day period immediately prior to Your Hospitalization; and ii. Post-hospitalization Medical Expenses incurred by You for a 60-day period immediately", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "i. Pre-hospitalization Medical Expenses incurred by You for a 30-day period immediately prior to Your Hospitalization; and ii. Post-hospitalization Medical Expenses incurred by You for a 60-day period immediately", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf" }, "network_hospital_count": { - "value": 6500, + "value": 4000, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "available at over 4000+ network hospitals. 9 Renewal Condition (a) Maximum renewal age - There will be life-long renewable without any age restriction for the cover. However Premium at", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__health-elite-plus__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__health-elite-plus__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The Free Look Period shall be applicable on new individual health insurance policies and not on renewals or at the time of porting/migrating the policy.", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__health-elite-plus__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__health-elite-plus__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in icici-lombard__health-elite-plus__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "AYUSH treatments refers to the medical aid and / or hospitalisation treatments given under ‘Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems", + "_confidence": "medium" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "a child, where Insured Person and spouse, both are covered, after a waiting period of 3 years, subject to the following sub-limits: Normal Delivery of Rs.25,000/ Caesarian delivery of Rs.50,000/ Pre-Post Natal Rs.2,000 each.", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "not stated in icici-lombard__health-elite-plus__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "donor expenses up to Sum insured for any of the organ transplant surgery, provided the organ donated is for Insured persons, subject to a limit of Rs.10 Lakhs.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "Reset Benefit Applicable Sum Insured Protector UIN : ICIHLIP21383V052021 CIN: L67200MH2000PLC129408 1 Health Elite Plus KEY INFORMATION SHEET S.No Title Description Refer To Policy Wordings 1 Product Name HEALTH ELITE PLUS 2", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "Domiciliary Hospitalisation means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home under any of the following circumstances: a)", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "World Wide Cover Applicable Super No claim Bonus 3 Optional Add On Covers Critical Illness cover up to 50% of sum insured for specified critical Illnesses/ medical procedures like Cancer of specified", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "health check-up coupon to Insured for every Policy Year, subject to a maximum of 2 coupons per year for floater policies. * Online Chat with Medical Practitioners. * E-opinion (Second opinion). * Diet & Nutrition e-consultation.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "Critical Illness cover up to 50% of sum insured for specified critical Illnesses/ medical procedures like Cancer of specified severity, open chest CABG, First heart attack, major organ/bone marrow transplant, permanent paralysis of limbs, Kidney", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "(a) Cumulative Bonus (Additional Sum Insured) - An Additional Sum Insured of 10% of Annual Sum Insured provided on each renewal for every claim-free year up to a maximum of 50%.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "not stated in icici-lombard__health-elite-plus__wordings.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "(b) Complimentary Health Check Up Coupons: One coupon per individual policy and two coupons per Floater policy will be offered.", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": null, + "_confidence": "low", + "source_quote": "not stated in icici-lombard__health-elite-plus__wordings.pdf" + }, + "no_claim_bonus_pct": { + "value": 10, + "unit": "%", + "source_pdf_path": "rag/corpus/icici-lombard/health-elite-plus__wordings.pdf", + "source_quote": "(a) Cumulative Bonus (Additional Sum Insured) - An Additional Sum Insured of 10% of Annual Sum Insured provided on each renewal for every claim-free year up to a maximum of 50%.", + "_confidence": "high" } } diff --git a/40-data/policy_facts/icici-lombard__health-shield-360-retail__cis.json b/40-data/policy_facts/icici-lombard__health-shield-360-retail__cis.json index 906552ec7565b893ecf1b5c6b46aa204322e3034..f7bffb5b166b2da8350f0d1ccb029545d5b9af12 100644 --- a/40-data/policy_facts/icici-lombard__health-shield-360-retail__cis.json +++ b/40-data/policy_facts/icici-lombard__health-shield-360-retail__cis.json @@ -5,27 +5,26 @@ "uin_code": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__cis.pdf", + "_confidence": "low" }, "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__cis.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 24, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "" + "source_quote": "Pre-Existing Diseases: Declared & accepted Pre-existing diseases will be covered after 12/24 months (as per the plan opted) of continuous coverage.", + "_confidence": "medium" }, "initial_waiting_period_days": { "value": 30, @@ -35,47 +34,54 @@ "maternity_coverage": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "Maternity Cover and New Born Baby Cover: d.B. 7\n24/36 months" + "source_quote": "Maternity Cover and New Born Baby Cover– I. Maternity Cover - Section d.B.1 Section d.B.2 Section d.B.3 Section d. B. 4 Section d. B. 5 Section d. B.6 Section d. B. 7", + "_confidence": "high" }, "maternity_waiting_months": { "value": 36, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "Maternity Cover and New Born Baby Cover: d.B. 7\n24/36 months" + "source_quote": "Maternity Cover and New Born Baby Cover: 24/36 months (as per the plan opted), provided both Insured Person and Spouse are covered under the same Policy. 5. Payment basis  In the event that a claim" }, "ayush_coverage": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "" + "source_quote": "In Patient AYUSH Hospitalization- Covers Medical Expenses incurred for AYUSH treatment in an AYUSH Hospital or AYUSH day care center.", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "Cashless facility" + "source_quote": "In the event that a claim becomes payable under the terms of the Policy, We shall make such payment in a lump sum through Cashless facility or provide Reimbursement of benefits", + "_confidence": "high" }, "copayment_pct": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "" + "value": 10, + "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_quote": "and lead to Policy Cancellation ii. A Co-payment of 10% will be applied to every admissible claim iii. The coverag", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": 20, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "Cumulative bonus - A\nA. 14\nCumulative Bonus of 20%" + "source_quote": "A Cumulative Bonus of 20% of the Annual Sum Insured will be provided at the end of each claim free Policy Year subject to a maximum of 100% of annual sum insured Year if the Policy is continuously renewed with Us. Even in the" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__cis.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": 30, @@ -83,39 +89,45 @@ "source_quote": "Post-hospitalization Medical\nExpenses documents may be provided within\n30 days" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf" }, "network_hospital_count": { "value": 6000, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "6000+\nnetwork hospitals" + "source_quote": "available at over 6000+ network hospitals. For updated list of network providers kindly visit our website. (Note: The above list of Policy exclusions is indicative only. Please refer to", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__cis.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, + "value": 4, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "" + "source_quote": "ation  For Cashless facility claims we will respond within 4 hours (subject to receiving complete set of documents)of the act", + "_confidence": "high" }, "policy_type": { "value": "hospital_cash", "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", - "source_quote": "classified as hospital_cash from PDF heuristics" + "source_quote": "Daily Cash- A daily cash allowance will be provided for each completed day of Hospitalization for 3 consecutive days up to a maximum of 10 days in a policy year.  Nursing at Home Post Hospitalization - Expenses incurred for the medical services of" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/icici-lombard/health-shield-360-retail__cis.pdf", "completeness_pct": 36, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/icici-lombard__health-shield-360-retail__wordings.json b/40-data/policy_facts/icici-lombard__health-shield-360-retail__wordings.json index f30fe9982bbbb849ba98d2dbdfc1d530e246f9aa..c5c4b8c64c22c8f50dfa8308c1f59b6d73724c59 100644 --- a/40-data/policy_facts/icici-lombard__health-shield-360-retail__wordings.json +++ b/40-data/policy_facts/icici-lombard__health-shield-360-retail__wordings.json @@ -10,47 +10,50 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 24, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" + "source_quote": "Code- Excl01: Pre-Existing Diseases a. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 12/24 months (as per the plan opted) of continuous coverage after", + "_confidence": "medium" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" + "source_quote": "Code- Excl03: 30-day waiting period a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an acci", + "_confidence": "high" }, "maternity_coverage": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" + "source_quote": "7. Maternity Cover and New Born Baby Cover: I. Maternity Cover: We will cover the Medical Expenses incurred for delivery of a child, including a caesarean section,", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "AYUSH Medical\nTreatment normally taken on an out-patient basis is not\nPractitioner(s) in charge;\nincluded" + "source_quote": "Ayush Hospital is a healthcare facility wherein medical/surgical/para-surgical treatment procedures and interventions are carried out by AYUSH Medical practitioner(s) comprising of", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "Cashless Facility" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms", + "_confidence": "high" }, "copayment_pct": { "value": 10, @@ -60,62 +63,73 @@ "no_claim_bonus_pct": { "value": 20, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "Cumulative Bonus (GCB) ix. The Cumulative Bonus shall be reduced in the same\nWe will provide a Cumulative Bonus of 20%" + "source_quote": "Cumulative Bonus (GCB) We will provide a Cumulative Bonus of 20% of expiring or renewed Annual Sum Insured (whichever is lower) at the end of each Policy Year if the expiring Policy has been claim free and is continuously renewed with the Company." }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__wordings.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" + "source_quote": "of Your discharge from a Hospital (for post-hospitalisation expenses, within 30 days from the completion of post-hospitalisation period) deliver", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf" }, "network_hospital_count": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "Sum Insured for each of the Optional C" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, + "value": 2, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "" + "source_quote": "omplete set of documents & information, We will respond within 2 hours of the actual receipt of such pre authorization request wit", + "_confidence": "high" }, "policy_type": { - "value": "group", + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "not stated in icici-lombard__health-shield-360-retail__wordings.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", "completeness_pct": 27, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/icici-lombard__health-shield-360.json b/40-data/policy_facts/icici-lombard__health-shield-360.json index 21d7b8870c8f740e4a05769b7063112955fb6b2d..bffa8614a75c98e07801ebf8f871d1d0875dd154 100644 --- a/40-data/policy_facts/icici-lombard__health-shield-360.json +++ b/40-data/policy_facts/icici-lombard__health-shield-360.json @@ -5,35 +5,32 @@ "uin_code": { "value": "ICIHLIP23165V012223", "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "IRDA Reg. No. 115 UIN: ICIHLIP23165V012223 HEALTH SHIELD 360 RETAIL" + "source_quote": "ICIHLIP23165V012223 CIN: L67200MH2000PLC129408 Registered Office Address: ICICI Lombard" }, "min_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "[Newborn baby] aged upto 90 days (Dependent child entry standard 91 days)" + "source_quote": "Newborn Baby means baby born during the Policy Period and is aged upto 90 days. Non- Network Provider means any Hospital, day care centre or other provider" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "Adult entry per Policy Schedule (Health Shield 360 retail typical: 18-65 years)" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "Lifelong renewability per Renewal clause" + "source_quote": "not stated in icici-lombard__health-shield-360.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "Sum Insured options per Policy Schedule (Health Shield 360: 5L/7.5L/10L/15L/25L/50L floater accumulation example referenced)" + "source_quote": "not stated in icici-lombard__health-shield-360.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "30-day waiting period (Code- Excl03) — any illness within 30 days from first policy commencement excluded (standard IRDAI exclusion clause)" + "source_quote": "within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. b. This exclusion shall not, however, apply if the Insured Person has" }, "pre_existing_disease_waiting_months": { "value": 24, @@ -43,42 +40,48 @@ "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "Code- Excl02: Specified Disease/Procedure waiting period ... excluded until the expiry of 24 months of continuous coverage" + "source_quote": "listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident. b." }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "Code- Excl18: Maternity (standard IRDAI exclusion; maternity not a base cover)" + "source_quote": "not stated in icici-lombard__health-shield-360.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "We will cover the Pre-hospitalization Medical Expenses incurred ... immediately before the Insured Person's Admission to Hospital up to the limits as specified in the Policy Schedule (days driven by plan; typical 30/60 days)" + "source_quote": "not stated in icici-lombard__health-shield-360.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "We will cover the Post-hospitalization Medical Expenses ... immediately following the Insured Person's discharge from Hospital up to the limits as specified in the Policy Schedule (typical 60/180 days per plan)" + "source_quote": "of Your discharge from a Hospital (for post-hospitalisation expenses, within 30 days from the completion of post-hospitalisation period) deliver", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "Day Care Procedures/Treatment (list per ICICI Lombard online appendix; not enumerated in wording)" + "value": 150, + "source_url": "https://www.icicilombard.com/docs/default-source/downloads/complete-health-insurance-brochure.pdf", + "source_note": "Per insurer baseline (ICICI Lombard Complete Health iHealth Annexure I; 150 procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "6. In Patient AYUSH Hospitalisation ... at a AYUSH Hospital or AYUSH Day Care Centre." + "source_quote": "In Patient AYUSH Hospitalisation We will cover medical expenses incurred in respect of ICICI Lombard General Insurance Company Limited IRDA Reg. No. 115 Mailing Address: 601 / 602, 6th Floor, Interface Building No. 16, New Link Road, Malad (West), Mumbai - 400 064." }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "Code- Excl18: Maternity (excluded as standard IRDAI exclusion in base Health Shield 360)" + "source_quote": "Code- Excl18: Maternity: i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalisation) except ectopic pregnancy. ii. Expenses towards miscarriage (unless due to an accident) and lawful medical termination" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "Maternity is excluded; newborn coverage tied to maternity" + "source_quote": "not stated in icici-lombard__health-shield-360.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, @@ -96,49 +99,58 @@ "source_quote": "7. Reset Benefit We will reset up to 100% of the Annual Sum Insured, Once [per policy year]" }, "room_rent_capping": { - "value": "Single Private AC Room (per Policy Schedule)", + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "i. Room Rent charges ... (per Policy Schedule entitlement; proportionate deduction clause applies)" + "source_quote": "not stated in icici-lombard__health-shield-360.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "No mandatory base copay in Health Shield 360 (voluntary co-pay add-on available)" + "source_quote": "not stated in icici-lombard__health-shield-360.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible in Health Shield 360" + "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_quote": "not stated in icici-lombard__health-shield-360.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric (ICICI Lombard 7,500+); not extracted" + "value": 6500, + "source_url": "https://www.bankbazaar.com/health-insurance/icici-health-insurance.html", + "source_note": "ICICI Lombard: 6,500+ network hospitals (BankBazaar aggregator citing ICICI Lombard; insurer page returns 403 to scrapers). Higher figures (~10,600) circulate but not directly verifiable; used conservative count. Scraped 2026-05-15.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "Cashless facility ... extended ... (defined in policy wording)" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the insurer to the extent pre-authorization" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric; not extracted" + "source_quote": "not stated in icici-lombard__health-shield-360.pdf", + "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular" + "value": 2, + "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", + "source_quote": "omplete set of documents & information, We will respond within 2 hours of the actual receipt of such pre authorization request wit", + "_confidence": "high" }, "policy_type": { - "value": "indemnity", + "value": null, "source_pdf_path": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", - "source_quote": "In-patient Treatment ... up to the Annual Sum Insured (indemnity-based)" + "source_quote": "not stated in icici-lombard__health-shield-360.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/icici-lombard/health-shield-360-retail__wordings.pdf", "completeness_pct": 75, - "notes": "Health Shield 360 Retail wording does not state pre/post hosp days explicitly (per Policy Schedule). PED 12/24 months depending on plan opted (24 used as default for flagship)." + "notes": "Health Shield 360 Retail wording does not state pre/post hosp days explicitly (per Policy Schedule). PED 12/24 months depending on plan opted (24 used as default for flagship).", + "network_hospital_backfill_2026-05-15": "icici-lombard insurer-wide count backfilled in targeted scrape pass" } } diff --git a/40-data/policy_facts/iffco-tokio__critical-illness-benefit__wordings.json b/40-data/policy_facts/iffco-tokio__critical-illness-benefit__wordings.json index 96140b4e9365805b8981e54af787204feb4f1620..e914e73640ccf169f4bd775f2d7fa02efcab1e71 100644 --- a/40-data/policy_facts/iffco-tokio__critical-illness-benefit__wordings.json +++ b/40-data/policy_facts/iffco-tokio__critical-illness-benefit__wordings.json @@ -7,140 +7,225 @@ "value": "IFFHLIP19036V011920", "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: IFFHLIP19036V011920 \n \nIFFCO-TOKIO CRITICAL ILLNESS BENEFIT POLICY", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 500000, - 1000000, - 1500000, - 2000000, - 2500000, - 5000000, - 10000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period for payment \nof the premium shall be: \na) fifteen days for monthly instalment modes, (wherever applicable) \nb) thirty days for any other instalment modes (wherever applicable) \nc) thirty days for renewal.", + "_confidence": "high" }, "free_look_period": { - "value": 15, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "You/the insured shall be allowed a period of thirty days from date of receipt of the Policy document to \nreview the terms and conditions of the Policy", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Illness or Injury which existed within the first 30 (Thirty) days of commencement of Period \nof Insurance", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-existing or related conditions \nshall be covered after a waiting period of 36 \n(Thirty-six) months", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 380, + "source_url": "https://www.iffcotokio.co.in/health-insurance/family-health-insurance", + "source_note": "Per insurer baseline (IFFCO Tokio family health insurance covers 380+ day care surgeries)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 8000, + "source_url": "https://www.iffcotokio.co.in/", + "source_note": "8,000+ Network Hospitals ('Why Choose IFFCO-TOKIO' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "refund proportionate premium for unexpired policy period, if the term of policy upto one year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" + }, + "maternity_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" + }, + "restoration_benefit": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" + }, + "preventive_health_checkup": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", + "source_quote": "Pre-policy check-up. If such a proposal is accepted and policy has been issued, We would reimburse 50% cost of the diagnostic test charges. ===PAGE 8=== Policy Wording – IFFCO-Tokio Critical Illness Benefit Policy Page 8 of 30 UIN: IFFHLIP19036V011920 DEFINITIONS OF CRITICAL ILLNESSES 1.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", + "source_quote": "We will pay the Sum Insured as mentioned in the schedule, in the event of You/Insured person being first diagnosed with the following critical illnesses, medical events or undergoing surgical procedures as specifically defined below, during the policy period provided that 1.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", + "source_quote": "not stated in iffco-tokio__critical-illness-benefit__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", + "source_quote": "All claims shall be settled in India in Indian Rupees", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "critical_illness", + "unit": "enum", + "source_pdf_path": "rag/corpus/iffco-tokio/critical-illness-benefit__wordings.pdf", + "source_quote": "IFFCO-TOKIO CRITICAL ILLNESS BENEFIT POLICY", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/iffco-tokio__essential-health-plan__wordings.json b/40-data/policy_facts/iffco-tokio__essential-health-plan__wordings.json index fdd1d09f064ad61700f13c9d56f06a51cc55d530..96c0e0e2be2c10a8dbce72ea9cd5b6ee01ea0359 100644 --- a/40-data/policy_facts/iffco-tokio__essential-health-plan__wordings.json +++ b/40-data/policy_facts/iffco-tokio__essential-health-plan__wordings.json @@ -7,143 +7,241 @@ "value": "IFFHLIP25040V022425", "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: IFFHLIP25040V022425 ; Code:", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__essential-health-plan__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__essential-health-plan__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__essential-health-plan__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 200000, - 300000, - 400000, - 500000, - 750000, - 1000000, - 1500000, - 2000000, - 2500000, - 5000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__essential-health-plan__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "i.Grace Period of 15 days would be available for monthly installment mode. \nii.Grace Period of 30 days would be available for all other installment mode.", + "_confidence": "high" }, "free_look_period": { - "value": 15, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "You/the Insured Person shall be allowed a period of thirty days from date of receipt of the Policy document to \nreview the terms and conditions of the Policy", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall \nbe excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "of a pre-existing Disease (PED) and its direct complications shall be \nexcluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__essential-health-plan__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__essential-health-plan__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 30, + "value": 60, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalization Medical Expenses incurred up to 60 days prior to Hospitalization", + "_confidence": "high" }, "post_hospitalization_days": { - "value": 60, + "value": 90, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post Hospitalization Medical Expenses incurred during a period up to 90 days after Hospitalization", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 380, + "source_url": "https://www.iffcotokio.co.in/health-insurance/family-health-insurance", + "source_note": "Per insurer baseline (IFFCO Tokio family health insurance covers 380+ day care surgeries)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 8000, + "source_url": "https://www.iffcotokio.co.in/", + "source_note": "8,000+ Network Hospitals ('Why Choose IFFCO-TOKIO' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 0, + "unit": "%", "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The following Co-pay options are available under the product: \n10%, 20% or 25% .", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 2.0, + "unit": "%", "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "a limit of \n2%of the sum insured on per day basis or actual, \nwhichever is less;", + "_confidence": "medium" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The policy period shall be upto a maximum of 3 years (1 year/ 2 years/ 3 years) as specified in the \npolicy schedule.", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__essential-health-plan__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__essential-health-plan__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__essential-health-plan__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", + "source_quote": "AYUSH hospitalization expenses Incurred in AYUSH Hospitals or AYUSH Day Care Centres. Coverage also includes \npre- hospitalization and post hospitalization expenses.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", + "source_quote": "Maternity Expenses (Code - Excl18): \ni. Medical treatment expenses traceable to childbirth", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", + "source_quote": "not stated in iffco-tokio__essential-health-plan__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", + "source_quote": "Hospitalization expenses of person donating an organ during the course of organ transplant subject to the above sub-limits applicable to the Insured Person and within the sum insured.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home under any of the following circumstances: i.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", + "source_quote": "All medical treatment for the purpose of this insurance will have to be taken in India only and all claims shall be \npayable in Indian currency.", + "_confidence": "medium" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", + "source_quote": "Health check-up: Insured Person(s) shall be entitled to undergo a periodic medical checkup upon renewal of the policy. This benefit is dependent on the Basic sum insured of the policy.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by Us to the Insured Person where the payments, of the costs of \ntreatment", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", + "source_quote": "subject to a maximum of 100% (of basic sum insured of the expiring policy", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", + "source_quote": "All medical treatment for the purpose of this insurance will have to be taken in India only and all claims shall be \npayable in Indian currency.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", + "source_quote": " Family Floater Policy:", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "2% of SI per day or single private AC room (default); variant plans cap to 1.5%/1.25% per day in metro/non-metro cities", + "unit": "text", + "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", + "source_quote": "Room Rent expenses A limit of 2% of the sum insured on per day basis or charges of a Single Standard Air-Conditioned Room, whichever is less I. In respect of class “A” cities, a limit of 1.50% of the sum insured on per day basis or actual, whichever is less. II.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 25, + "unit": "%", + "source_pdf_path": "rag/corpus/iffco-tokio/essential-health-plan__wordings.pdf", + "source_quote": "The Cumulative Bonus shall be increased by 25% of the basic sum insured for the first claim-free Policy Year", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/iffco-tokio__family-health-protector__wordings.json b/40-data/policy_facts/iffco-tokio__family-health-protector__wordings.json index c72b51481511aad662ea3668f0e0d483de35fbaf..726e990daa72800f85fdef03c9004fec8da810cb 100644 --- a/40-data/policy_facts/iffco-tokio__family-health-protector__wordings.json +++ b/40-data/policy_facts/iffco-tokio__family-health-protector__wordings.json @@ -7,142 +7,231 @@ "value": "IFFHLIP26042V062526", "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: IFFHLIP26042V062526 \n \nPOLICY WORDING", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__family-health-protector__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__family-health-protector__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__family-health-protector__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 300000, - 500000, - 750000, - 1000000, - 1500000, - 2000000, - 2500000, - 5000000, - 10000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__family-health-protector__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "b) thirty days for any other installment modes (wherever applicable) \nc) thirty days for renewal.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "You/the insured shall be allowed a period of thirty days from date of receipt of the Policy document to review the \nterms and conditions of the Policy", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall \nbe excluded except claims arising due to an accident", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "of a pre-existing Disease (PED) and its direct complications shall be \nexcluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with \nus.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "3. Specific Waiting Period: (Code- Excl02) \na) Expenses related to the treatment of the following listed conditions, surgeries/treatments shall be excluded \nuntil the expiry of 12/24 months of continuous coverage", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__family-health-protector__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 30, + "value": 60, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalization Medical Expenses incurred up to 60 (Sixty) days prior to Hospitalization", + "_confidence": "high" }, "post_hospitalization_days": { - "value": 60, + "value": 90, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post Hospitalization Medical Expenses incurred during a period up to 90(Ninety) days after \nHospitalization", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 380, + "source_url": "https://www.iffcotokio.co.in/health-insurance/family-health-insurance", + "source_note": "Per insurer baseline (IFFCO Tokio family health insurance covers 380+ day care surgeries)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 8000, + "source_url": "https://www.iffcotokio.co.in/", + "source_note": "8,000+ Network Hospitals ('Why Choose IFFCO-TOKIO' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 0, + "unit": "%", "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The following Co-pay options are available: 10%, 20% or 25% under the product.", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 2.0, + "unit": "%", "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "In respect of other than class “A” cities, a limit of 2% (two percent) of the sum insured on per day basis or \nactual, whichever is less;", + "_confidence": "medium" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "refund proportionate premium for unexpired policy period, if the term of policy upto one year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__family-health-protector__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__family-health-protector__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__family-health-protector__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", + "source_quote": "AYUSH hospitalization expenses including pre-hospitalization and post hospitalization expenses upto the limit of \nthe Sum Insured of the insured person per policy period.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", + "source_quote": "Hospitalization expenses of person donating an organ during the course of organ transplant subject to the above sub-limits applicable to the insured person and within the sum insured/extended sum insured (if applicable).", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", + "source_quote": "Domiciliary Hospitalization if medically necessary Upto a maximum aggregate sub-limit of 20% (twenty percent) of the Sum Insured. Note 1: i.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", + "source_quote": "All medical treatment for the purpose of this insurance will have to be taken in India only and all claims shall be \npayable in Indian currency.", + "_confidence": "medium" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", + "source_quote": "health check-up: Insured person(s) shall be entitled to undergo a periodic medical checkup upon renewal of the policy. This benefit is dependent on the sum insured of the policy.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", + "source_quote": "Cashless facility \nIt means a facility extended by us to Insured person where the payments, of the costs of treatment undergone by \ninsured person(s)", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", + "source_quote": "subject to a maximum of 100% (one hundred percent) of basic sum \ninsured of the expiring policy.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", + "source_quote": "All medical treatment for the purpose of this insurance will have to be taken in India only and all claims shall be \npayable in Indian currency.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", + "source_quote": "FAMILY HEALTH PROTECTOR (FHP) \nUIN: IFFHLIP26042V062526", + "_confidence": "medium" + }, + "maternity_coverage": { + "value": false, + "_confidence": "high", + "source_quote": "8.Maternity Expenses (Code - Excl 18): \ni) \nMedical treatment expenses traceable to childbirth", + "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf" + }, + "room_rent_capping": { + "value": "2% of SI per day or single private AC room; 1.5% / 1.25% per day variants by city tier", + "unit": "text", + "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", + "source_quote": "For Normal Room Rent Expenses: - I. In respect of class “A” cities, a limit of 1.50% (one and half of a percent) of the sum insured on per day basis or actual, whichever is less. II.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 25, + "unit": "%", + "source_pdf_path": "rag/corpus/iffco-tokio/family-health-protector__wordings.pdf", + "source_quote": "The Cumulative Bonus shall accrue at 25% (twenty-five percent) of the basic sum insured for the first claim-free \nrenewal", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/iffco-tokio__health-protector-assure__wordings.json b/40-data/policy_facts/iffco-tokio__health-protector-assure__wordings.json index 1a1b185d5541a68ec8fe9cb594207905f81dcbe9..8b69f92c76c4cdceb16a31d0ae965d55baedc578 100644 --- a/40-data/policy_facts/iffco-tokio__health-protector-assure__wordings.json +++ b/40-data/policy_facts/iffco-tokio__health-protector-assure__wordings.json @@ -7,142 +7,229 @@ "value": "IFFHLIP24131V012324", "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "HEALTH PROTECTOR ASSURE (HPA) \n UIN: IFFHLIP24131V012324", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__health-protector-assure__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__health-protector-assure__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__health-protector-assure__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 500000, - 1000000, - 1500000, - 2000000, - 2500000, - 5000000, - 10000000, - 20000000, - 50000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__health-protector-assure__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The grace period for payment of the premium shall be: \na) fifteen days for monthly installment modes, (wherever appli", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "You/the insured shall be allowed a period of thirty days from date of receipt of the Policy document to review the \nterms and conditions of the Policy", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be \nexcluded except claims arising due to an accident", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "of a pre-existing Disease (PED) and its direct complications shall be excluded \nuntil the expiry of 36 months of continuous coverage after the date of inception of the first policy with us.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "3. \nSpecific Waiting Period: (Code- Excl02) \na) \nExpenses related to the treatment of the following listed conditions, surgeries/treatments shall be excluded \nuntil the expiry of 12/ 24 months of continuous coverage", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__health-protector-assure__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalization and Post Hospitalization expenses for 60 and 90 days respectively as defined under the \nPolicy will also be reimbursed", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalization and Post Hospitalization expenses for 60 and 90 days respectively as defined under the \nPolicy will also be reimbursed", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 380, + "source_url": "https://www.iffcotokio.co.in/health-insurance/family-health-insurance", + "source_note": "Per insurer baseline (IFFCO Tokio family health insurance covers 380+ day care surgeries)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 8000, + "source_url": "https://www.iffcotokio.co.in/", + "source_note": "8,000+ Network Hospitals ('Why Choose IFFCO-TOKIO' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 0, + "unit": "%", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The following Co-pay options are available: 10%, 20% or 25% under the product.", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__health-protector-assure__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "refund proportionate premium for unexpired policy period, if the term of policy upto one year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__health-protector-assure__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__health-protector-assure__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__health-protector-assure__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", + "source_quote": "AYUSH hospitalization expenses Incurred in AYUSH Hospitals or AYUSH Day Care Centres. Coverage also includes \npre- hospitalization and post hospitalization expenses.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", + "source_quote": "Hospitalization expenses of person donating an organ during the course of organ transplant will also be payable subject to the limit of overall Sum Insured of the Insured Person or floater Sum Insured of family.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", + "source_quote": "not stated in iffco-tokio__health-protector-assure__wordings.pdf", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness/disease/injury which in the normal course \nwould require care and treatment at a hospital but is actually taken while confined at home", + "_confidence": "medium" + }, + "preventive_health_checkup": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", + "source_quote": "not stated in iffco-tokio__health-protector-assure__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by Us to the insured where the payments, of the costs of treatment \nundergone by the insured", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", + "source_quote": "not stated in iffco-tokio__health-protector-assure__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", + "source_quote": "All medical treatment for the purpose of this insurance will have to be taken in India only and all claims shall be payable \nin Indian currency.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", + "source_quote": "HEALTH PROTECTOR ASSURE (HPA)", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "No cap", + "_confidence": "high", + "source_quote": "Room Rent (including Boarding and Nursing expense etc.) on actuals. 2. Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees (including consultation through telemedicine as per prevailing Telemedicine Practice Guideline) whether paid directly to the treating doctor / surgeon or" + }, + "maternity_coverage": { + "value": false, + "_confidence": "high", + "source_quote": "9. \nMaternity Expenses (Code - Excl18): \ni. Medical treatment expenses traceable to childbirth", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-assure__wordings.pdf", + "source_quote": "not stated in iffco-tokio__health-protector-assure__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/iffco-tokio__health-protector-plus__wordings.json b/40-data/policy_facts/iffco-tokio__health-protector-plus__wordings.json index 7b5017f1fdc56f8506e9a0584fa705c24c240370..6e3d55422b3ffcd643b59f0b7b1f0fdd852a9c98 100644 --- a/40-data/policy_facts/iffco-tokio__health-protector-plus__wordings.json +++ b/40-data/policy_facts/iffco-tokio__health-protector-plus__wordings.json @@ -7,142 +7,216 @@ "value": "IFFHLIP21328V022021", "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "HEALTH PROTECTOR PLUS \nUIN: IFFHLIP21328V022021", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__health-protector-plus__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__health-protector-plus__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__health-protector-plus__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 300000, - 500000, - 700000, - 1000000, - 1500000, - 2000000, - 2500000, - 5000000, - 10000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__health-protector-plus__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "b) thirty days for any other installment modes (wherever applicable) \nc) thirty days for renewal.", + "_confidence": "high" }, "free_look_period": { - "value": 15, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "You/the insured shall be allowed a period of thirty days from date of receipt of the Policy document to review \nthe terms and conditions of the Policy", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any \nillness within 30 days from the first policy \ncommencement date shall be excluded \nexcept claims arising due to an accident", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "a pre-\nexisting Disease (PED) and its direct \ncomplications shall be excluded until the \nexpiry of 36 months of continuous coverage \nafter the date of inception of the first policy \nwith us.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "4. Specific Waiting Period: (Code- Excl02) \na) Expenses related to the treatment of the \nfollowing \nlisted \nconditions, \nsurgeries/treatments shall be excluded until \nthe expiry of 24 months of continuous \ncoverage", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__health-protector-plus__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalization and Post Hospitalization \nexpenses for 60(Sixty) and 90(Ninety) days \nrespectively as defined under the Policy will \nalso be reimbursed", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalization and Post Hospitalization \nexpenses for 60(Sixty) and 90(Ninety) days \nrespectively as defined under the Policy will \nalso be reimbursed", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 380, + "source_url": "https://www.iffcotokio.co.in/health-insurance/family-health-insurance", + "source_note": "Per insurer baseline (IFFCO Tokio family health insurance covers 380+ day care surgeries)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 8000, + "source_url": "https://www.iffcotokio.co.in/", + "source_note": "8,000+ Network Hospitals ('Why Choose IFFCO-TOKIO' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__health-protector-plus__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__health-protector-plus__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "refund premium for the unexpired policy period, in respect of policies with term more than 1 year and risk \ncoverage for such policy years has not commenced.", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__health-protector-plus__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__health-protector-plus__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__health-protector-plus__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", + "source_quote": "AYUSH hospitalization expenses Incurred in \nAYUSH Hospitals or AYUSH Day Care Centres. \nCoverage also includes pre- hospitalization \nand post hospitalization expenses.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", + "source_quote": "15. Maternity Expenses (Code - Excl18): \ni. \nMedical treatment expenses traceable to \nchildbirth", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", + "source_quote": "not stated in iffco-tokio__health-protector-plus__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", + "source_quote": "Hospitalization expenses of person donating an organ during the course of organ transplant will also be payable subject to the limit of overall Sum Insured of the Insured Person or floater Sum Insured of family. For the Donor, no payment will be made towards Pre and Post Hospitalization expenses.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", + "source_quote": "Domiciliary Hospitalisation, if Medically Necessary and at Reasonable and Customary Charges up to a maximum aggregate sub- limit of 20% (Twenty percent) of the Sum Insured.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", + "source_quote": "All medical treatment for the purpose of this insurance will have to be taken in India only and all claims \nshall be payable in Indian currency.", + "_confidence": "medium" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by Us to the insured where the payments, of the costs of \ntreatment undergone by the insured", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", + "source_quote": "All medical treatment for the purpose of this insurance will have to be taken in India only and all claims \nshall be payable in Indian currency.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/iffco-tokio/health-protector-plus__wordings.pdf", + "source_quote": "The deductible shall be applicable on a per event basis in case of “Top Up” policy and on per year \nbasis in case of “Super Top Up” policies.", + "_confidence": "high" + }, + "room_rent_capping": { + "value": "No cap", + "_confidence": "medium", + "source_quote": "We will pay Reasonable and Customary Charges of the following Hospitalization expenses: 1. Room Rent (including Boarding and Nursing expense etc.) 2." } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/iffco-tokio__individual-health-protector__wordings.json b/40-data/policy_facts/iffco-tokio__individual-health-protector__wordings.json index 25095d1cfc774830aa4894a06393d773d4ac98b8..468dc09e23a5da26c38abb0cf37ffefbb09d679b 100644 --- a/40-data/policy_facts/iffco-tokio__individual-health-protector__wordings.json +++ b/40-data/policy_facts/iffco-tokio__individual-health-protector__wordings.json @@ -7,143 +7,243 @@ "value": "IFFHLIP26041V062526", "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "HEALTH PROTECTOR (IHP) \n \n UIN: IFFHLIP26041V062526", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__individual-health-protector__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__individual-health-protector__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__individual-health-protector__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 200000, - 300000, - 500000, - 750000, - 1000000, - 1500000, - 2000000, - 2500000, - 5000000, - 10000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in iffco-tokio__individual-health-protector__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "b) thirty days for any other installment modes (wherever applicable) \nc) thirty days for renewal.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "You/the insured shall be allowed a period of thirty days from date of receipt of the Policy document to review the \nterms and conditions of the Policy", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date \nshall be excluded except claims arising due to an accident", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "of a pre-existing Disease (PED) and its direct complications shall be \nexcluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy \nwith us.", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": 12, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "3. Specific Waiting Period: (Code- Excl02) \na) Expenses related to the treatment of the following listed conditions, surgeries/treatments shall be excluded \nuntil the expiry of 12 months of continuous coverage", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__individual-health-protector__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalization Medical Expenses incurred up to 60 (Sixty) days prior to Hospitalization on \ndisease/illness/injury sustained", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post Hospitalization Medical Expenses incurred during period up to 90(Ninety) days after Hospitalization on \ndisease/illness/injury sustained", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 380, + "source_url": "https://www.iffcotokio.co.in/health-insurance/family-health-insurance", + "source_note": "Per insurer baseline (IFFCO Tokio family health insurance covers 380+ day care surgeries)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 8000, + "source_url": "https://www.iffcotokio.co.in/", + "source_note": "8,000+ Network Hospitals ('Why Choose IFFCO-TOKIO' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 0, + "unit": "%", "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The following Co-pay options are available: 10%, 20% or 25% under the product.", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "1(b)below will be payable according to actual expenses without any room rent expenses capping limits. b) In respect of sum insured less than Rs.5(five) lakh", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "refund proportionate premium for unexpired policy period, if the term of policy upto one year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__individual-health-protector__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__individual-health-protector__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in iffco-tokio__individual-health-protector__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", + "source_quote": "AYUSH expenses including pre-hospitalization and post hospitalization expenses up to the limit of the Sum \nInsured of the insured person per policy period.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", + "source_quote": "Hospitalization expenses of person donating an organ during the course of organ transplant subject to the above sub-limits applicable to the insured person and within the extended sum insured (if applicable) of the insured person.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", + "source_quote": "Reinstatement of Basic Sum insured: After the occurrence of a claim under the policy, the basic sum insured under the policy will be reinstated by the amount of claim so that the full basic sum insured is available for the policy period subject to the following: a) Reinstatement of Basic Sum", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", + "source_quote": "Domiciliary Hospitalization if Medically Necessary up to a maximum aggregate sub-limit of 20% (twenty percent) of the Sum Insured. Note 1: 1.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", + "source_quote": "Extension of policy period :In case the insured person(s) who is/are covered under ‘Health Protector Policy’ has/have to go abroad for a minimum of 30(thirty) days and accordingly he/she/they buy a Travel insurance policy from IFFCO-Tokio General Insurance Co. Ltd.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", + "source_quote": "health check-up: Insured person(s) shall be entitled to undergo a periodic medical checkup upon renewal of the policy. This benefit is dependent on the sum insured of the policy.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", + "source_quote": "If the insured person(s) is/are diagnosed during the period of insurance as suffering from a critical illness as defined under the policy, we shall reimburse medically necessary and reasonable and customary charges incurred on expenses as listed under ‘’WHAT IS COVERED “up to an additional sum", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", + "source_quote": "Cashless facility \nIt means a facility extended by us to Insured person where the payments, of the costs of treatment undergone by \ninsured person(s)", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", + "source_quote": "subject to a maximum of 100% (one hundred percent) of \nbasic sum insured of the expiring policy.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", + "source_quote": "All medical treatment for the purpose of this insurance will have to be taken in India only and all claims shall \nbe payable in Indian currency.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", + "source_quote": "HEALTH PROTECTOR (IHP)", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "No cap for sum insured Rs.5 lakhs and above; for sum insured below Rs.5 lakhs, 1.75% of SI per day in class A cities and 1.50% in other cities, whichever is less", + "_confidence": "medium", + "source_quote": "Room Rent Expenses: a) In respect of sum insured of Rs. 5(five) lakhs and above (excluding the higher sum insured for critical illness but including cumulative bonus), the room-rent expenses as mentioned in 1(b)below will be payable according to actual expenses without any room rent expenses" + }, + "maternity_coverage": { + "value": false, + "_confidence": "high", + "source_quote": "8. Maternity Expenses (Code - Excl 18): \ni) \nMedical treatment expenses traceable to childbirth", + "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf" + }, + "no_claim_bonus_pct": { + "value": 25, + "unit": "%", + "source_pdf_path": "rag/corpus/iffco-tokio/individual-health-protector__wordings.pdf", + "source_quote": "The Cumulative Bonus shall accrue at 25% (twenty-five percent) of the basic sum insured for the first \nclaim-free renewal", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/indusind-general__group-mediclaim__wordings.json b/40-data/policy_facts/indusind-general__group-mediclaim__wordings.json index 63583e62871dab16648d4b47066376205bd999f8..361cba6a5e89b46fa30082d6ff8105f5f7daa86d 100644 --- a/40-data/policy_facts/indusind-general__group-mediclaim__wordings.json +++ b/40-data/policy_facts/indusind-general__group-mediclaim__wordings.json @@ -2,138 +2,194 @@ "policy_id": "indusind-general__group-mediclaim__wordings", "policy_name": "IndusInd Group Mediclaim", "insurer_slug": "indusind-general", - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", "uin_code": { "value": "RELHLGP21523V022021", "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "o. 103. UIN: RELHLGP21523V022021", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "not stated in group-mediclaim__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "not stated in group-mediclaim__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "not stated in group-mediclaim__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "not stated in group-mediclaim__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "grace period of fifteen days (where premium is paid on a monthly instalments) and thirty days (where premium is paid in quarterly/half-yearly/annual instalments)", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 30, "unit": "days", - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "The Insured Person shall be allowed free look period of thirty days from date of receipt of the policy document to review the terms and conditions of the Policy, and to return the same if not acceptable.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "treatment of any illness within 30 days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "Pre-Existing Diseases - Code- Excl01 a) Expenses related to the treatment of a preexisting Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of contin", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": 12, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "Specified disease/procedure waiting period- Code-Excl02 a. Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 12 months of contin", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "not stated in group-mediclaim__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 30, + "value": null, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "not stated in indusind-general__group-mediclaim__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 60, + "value": null, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "not stated in indusind-general__group-mediclaim__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.indusind.bank.in/in/en/personal/insurance/indusInd-health-gain-insurance.html", + "source_note": "Per insurer baseline (IndusInd Health Gain covers all day-care up to SI; ~540 standard)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 10000, + "source_url": "https://www.indusindinsurance.com/", + "source_note": "10,000+ Network Hospitals (homepage 'Find nearest hospital' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "not stated in group-mediclaim__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "not stated in group-mediclaim__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "not stated in indusind-general__group-mediclaim__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "not stated in group-mediclaim__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "not stated in group-mediclaim__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/group-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "legacy_issuer": "Reliance General Insurance" -} \ No newline at end of file + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "not stated in group-mediclaim__wordings.pdf", + "_confidence": "low" + }, + "legacy_issuer": "Reliance General Insurance", + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "AYUSH Treatment refers to the medical and / or hospitalization treatments given under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "Domiciliary Hospitalisation means medical treatment for a period exceeding three days for disease/ injury which in the normal course would require care and treatment at a hospital/nursing home but is actually taken whilst c", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "\"Cashless Facility\" means a facility extended by the company to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly ma", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "Treatment availed outside India. iv. Treatment at a healthcare facility which is NOT an AYUSH Hospital", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "group", + "unit": "enum", + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "o. 103. UIN: RELHLGP21523V022021", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "As per group policy schedule", + "unit": "text", + "source_pdf_path": "rag/corpus/indusind-general/group-mediclaim__wordings.pdf", + "source_quote": "The Insured Person chooses a room category in which the room rent charges are more than the applicable Sum Insured sub-limit (in percentage or Rupee terms) on the room rent as per the Policy term", + "_confidence": "medium" + } +} diff --git a/40-data/policy_facts/indusind-general__health-gain__wordings.json b/40-data/policy_facts/indusind-general__health-gain__wordings.json index 6ce651b39e4a63ce0ac448a5d3ccda874ee26359..e324e4a698468f9d042c7374de0c671d960f94bb 100644 --- a/40-data/policy_facts/indusind-general__health-gain__wordings.json +++ b/40-data/policy_facts/indusind-general__health-gain__wordings.json @@ -2,138 +2,212 @@ "policy_id": "indusind-general__health-gain__wordings", "policy_name": "IndusInd HealthGain Policy", "insurer_slug": "indusind-general", - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", "uin_code": { "value": "INIHLIP26040V042526", "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "IN No.: INIHLIP26040V042526", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "not stated in indusind-general__health-gain__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "not stated in health-gain__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": 90, "unit": "days", - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "born during the Policy Period and is aged upto 90 days", + "_confidence": "high" }, "sum_insured_options": { - "value": null, + "value": [ + 500000, + 1000000, + 1500000, + 2000000, + 2500000, + 3000000, + 5000000, + 10000000, + 30000000, + 50000000 + ], "unit": "INR", - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "New Business Base Sum Insured (in lakhs) Plus: 5 Power: 10, 15, 20 Prime: 25, 30, 50, 100, 300, 500", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "grace period for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases", + "_confidence": "medium" }, "free_look_period": { "value": 30, "unit": "days", - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "sured Person shall be allowed free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "treatment of any illness within 30 days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "4.1.1. Pre-Existing Diseases (Code- Excl 01) i. Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36months of continuous coverage after the", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "the treatment of the following listed conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage, as may b", + "_confidence": "high" }, "maternity_waiting_months": { - "value": null, + "value": 24, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "This benefit shall become available only after the expiry of the waiting periods mentioned below: Policy Period 1 and 2 years Waiting Period* 24 months", + "_confidence": "medium" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "not stated in indusind-general__health-gain__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 90, + "value": null, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "not stated in indusind-general__health-gain__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.indusind.bank.in/in/en/personal/insurance/indusInd-health-gain-insurance.html", + "source_note": "Per insurer baseline (IndusInd Health Gain covers all day-care up to SI; ~540 standard)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 10000, + "source_url": "https://www.indusindinsurance.com/", + "source_note": "10,000+ Network Hospitals (homepage 'Find nearest hospital' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "not stated in health-gain__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "not stated in health-gain__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "not stated in indusind-general__health-gain__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "not stated in health-gain__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "not stated in health-gain__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/health-gain__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "legacy_issuer": "Reliance General Insurance" -} \ No newline at end of file + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "not stated in health-gain__wordings.pdf", + "_confidence": "low" + }, + "legacy_issuer": "Reliance General Insurance", + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "If the Insured Person is diagnosed with any Illness or suffers any Injury that requires Hospitalization, (including Hospitalization under AYUSH Treatment), during the Policy Period, then the Company shall pay Medical Expenses incurred by the Policyholder/Insured", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "Maternity Expenses means i. Medical Treatment Expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization)", + "_confidence": "medium" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the Company to the Insured where the payments, of the costs of treatment undergone by the Insured in accordance with the Policy Terms and Conditions, are directly ma", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "the Insured(s) travels outside India during the Policy Year, they may choose to pause this Policy", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "in respect of that Insured Person (on Individual basis) or all Insured Persons (on Floater basis) during the Policy Year", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": null, + "unit": "text", + "source_pdf_path": "rag/corpus/indusind-general/health-gain__wordings.pdf", + "source_quote": "not stated in indusind-general__health-gain__wordings.pdf", + "_confidence": "low" + } +} diff --git a/40-data/policy_facts/indusind-general__hospi-care__wordings.json b/40-data/policy_facts/indusind-general__hospi-care__wordings.json index 5ecdc8aeafb0d73625db4aedc0eed8832dca15d8..d0f6a2fa945e91dafbbaeb1ab06021d924aed79f 100644 --- a/40-data/policy_facts/indusind-general__hospi-care__wordings.json +++ b/40-data/policy_facts/indusind-general__hospi-care__wordings.json @@ -2,138 +2,187 @@ "policy_id": "indusind-general__hospi-care__wordings", "policy_name": "IndusInd Hospi Care Insurance", "insurer_slug": "indusind-general", - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", "uin_code": { "value": "RELHLIP20027V012021", "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "urance. UIN: RELHLIP20027V012021", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "not stated in hospi-care__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "not stated in hospi-care__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "not stated in hospi-care__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": null, + "value": [ + 100000, + 200000, + 300000, + 400000, + 500000, + 1000000 + ], "unit": "INR", - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "Sum Insured per Insured Person per Policy Year [All figures in INR] Upto 90 days 100,000 200,000 300,000 400,000 500,000 10,00,000", + "_confidence": "high" }, "grace_period": { - "value": null, + "value": 30, "unit": "days", - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "All applications for Renewal must be received by Us before the end of the Policy Period. Grace Period of 30 days for renewing the policy is provided under this Policy.", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 30, "unit": "days", - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "You have a period of 30 days from the date of receipt of the Policy document to review the terms and conditions of this Policy.", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 90, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "A waiting period of 90 days from the Policy Commencement Date shall apply to all claims under the Policy. This waiting period will not apply for any Insured Person for subsequent and continuous Renewals of the Policy with Us.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": ") Pre-existing Waiting Period Pre-Existing Diseases shall not be covered until the completion of 48 months of continuous coverage, since inception of the first IndusInd Hospi Care Insurance Policy", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": null, + "value": 24, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "The Illnesses and treatments listed below will be covered subject to a waiting period of 24 months from the Policy Commencement Date as long as in the third Policy Year the Insured Person has been insured under IndusInd Hospi Care Insurance Policy continuously and without any break:", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "not stated in hospi-care__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "not stated in hospi-care__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "not stated in hospi-care__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.indusind.bank.in/in/en/personal/insurance/indusInd-health-gain-insurance.html", + "source_note": "Per insurer baseline (IndusInd Health Gain covers all day-care up to SI; ~540 standard)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 10000, + "source_url": "https://www.indusindinsurance.com/", + "source_note": "10,000+ Network Hospitals (homepage 'Find nearest hospital' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "not stated in hospi-care__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "not stated in hospi-care__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "not stated in indusind-general__hospi-care__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "not stated in hospi-care__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "not stated in hospi-care__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/hospi-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "legacy_issuer": "Reliance General Insurance" -} \ No newline at end of file + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "not stated in hospi-care__wordings.pdf", + "_confidence": "low" + }, + "legacy_issuer": "Reliance General Insurance", + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "t of an Accident or Illness), maternity or child birth (including caesarean section), except in the case of ectopic pregnancy", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "Treatment availed outside India. ii. Treatment at a healthcare facility which is not a Hospital", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "Treatment availed outside India. ii. Treatment at a healthcare facility which is not a Hospital", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/indusind-general/hospi-care__wordings.pdf", + "source_quote": "not stated in indusind-general__hospi-care__wordings.pdf", + "_confidence": "low" + } +} diff --git a/40-data/policy_facts/manipalcigna__prohealth-insurance-all-variants__wordings.json b/40-data/policy_facts/manipalcigna__prohealth-insurance-all-variants__wordings.json index 7505ea9034ca96a67cf0d5f07d0a9a9eb53d80e5..39236aa9d0dc1812380fc4388d6b96df1822c1c3 100644 --- a/40-data/policy_facts/manipalcigna__prohealth-insurance-all-variants__wordings.json +++ b/40-data/policy_facts/manipalcigna__prohealth-insurance-all-variants__wordings.json @@ -5,117 +5,137 @@ "uin_code": { "value": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in manipalcigna__prohealth-insurance-all-variants__wordings.pdf", + "_confidence": "low" }, "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in manipalcigna__prohealth-insurance-all-variants__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in manipalcigna__prohealth-insurance-all-variants__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "" + "source_quote": "Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of applicable months (24 months for Preferred, Premier plan/ 36 months for Plus, Accumulate plan/ 48 months for Protect plan)", + "_confidence": "medium" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "" + "source_quote": "Code-E.I.3 a) Expenses related to the treatment of any illness within 30 days of continuous coverage from the first policy commencemen", + "_confidence": "high" }, "maternity_coverage": { "value": true, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "maternity waiting period\u2019\nPlan Name Coverage Validity\nwhere the limit will be relaxed to 24 months" + "source_quote": "We will cover Maternity Expenses up to limits for Maternity Sum insured specified in the Schedule for the delivery of a child", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "maternity waiting period\u2019\nPlan Name Coverage Validity\nwhere the limit will be relaxed to 24 months" + "source_quote": "under this", + "_confidence": "medium" }, "ayush_coverage": { - "value": false, + "value": true, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "AYUSH Medical Practitioner in charge round II The following are excluded" + "source_quote": "Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy Systems.", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Cashless Facility" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured", + "_confidence": "high" }, "copayment_pct": { "value": 20, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Co-pay\nhours.\nA compulsory Co-payment of 20%" + "source_quote": "A compulsory Co-paym", + "_confidence": "high" }, "no_claim_bonus_pct": { - "value": 50, + "value": 200, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "cumulative bonus shall\nunder Section G.I.4 & G.I.5.\nUp to 50 %" + "source_quote": "Cumulative", + "_confidence": "medium" }, "restoration_benefit": { - "value": "Restoration of Sum Insured\nFacilities and services availed for pleasure or rejuv", + "value": "100% restoration of Sum Insured, any number of times in a Policy Year", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Restoration of Sum Insured\nFacilities and services availed for pleasure or rejuvenation or as a\nWe will provide for a 10" + "source_quote": "Restoration of Sum Insured We will provide for a 100% restor", + "_confidence": "high" }, "room_rent_capping": { - "value": "Room Rent for\ntreatment.\naccommodation in Hospital room up to", + "value": "any Room Category except Suite or higher category (Sum Insured ₹7.5 Lacs and Above)", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Room Rent for\ntreatment.\naccommodation in Hospital room up to" + "source_quote": "For Sum Insured ₹7.5 Lacs and ", + "_confidence": "medium" }, "pre_hospitalization_days": { - "value": 30, + "value": 60, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Pre-hospitalization, Post-hospitalization Medical\nf. Intra vitreal injections Expenses up to 30 days" + "source_quote": "Pre-hospitalization Medical Expenses Cov", + "_confidence": "high" }, "post_hospitalization_days": { - "value": 30, + "value": 90, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Post-hospitalization Medical\nf. Intra vitreal injections Expenses up to 30 days" + "source_quote": "Post- hospitalization Medical Expenses C", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "" + "value": 540, + "source_url": "https://www.manipalcigna.com/blog/what-is-day-care-treatment-in-health-insurance-", + "source_note": "Per insurer baseline (ManipalCigna publishes 500+ day care procedures; 540 standard)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf" }, "network_hospital_count": { - "value": null, + "value": 8500, + "source_url": "https://www.policyx.com/health-insurance/network-hospitals/manipalcigna/", + "source_note": "ManipalCigna ProHealth plan disclosure: 8,500+ cashless hospitals (PolicyX aggregator and ManipalCigna ProHealth plan description). Insurer's own /network-hospitals page does not state aggregate count. Scraped 2026-05-15.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "sum_insured_options": { - "value": null, + "value": "2.5 Lacs, ₹3.5 Lacs, ₹4.5 Lacs, ₹5.5 Lacs", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "" + "source_quote": "ests Protect Plus & Accumulate Plan Sum Insured ₹2.5 Lacs, ₹3.5 Lacs, ₹4.5 Lacs, ₹5.5 Lacs, >18 years Vitals, ECG, Total Cholesterol, FBS, Sr. Creat", + "_confidence": "medium" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in manipalcigna__prohealth-insurance-all-variants__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, + "value": 48, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "" + "source_quote": "zation for medical treatment. ii. The Network Provider shall forward the request for authorization within 48 hours of admission to the Hospital as per the process under Secti", + "_confidence": "medium" }, "policy_type": { - "value": "hospital_cash", + "value": "indemnity", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "classified as hospital_cash from PDF heuristics" + "source_quote": "D.I.1. Inpatient Hospitalizati", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", "completeness_pct": 50, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF", + "network_hospital_backfill_2026-05-15": "manipalcigna insurer-wide count backfilled in targeted scrape pass" } } \ No newline at end of file diff --git a/40-data/policy_facts/manipalcigna__prohealth-prime.json b/40-data/policy_facts/manipalcigna__prohealth-prime.json index f73b1ae591b486db715fcb6108b57d8fea46fb07..39e735d59a0505b9eff72dc08ae334a5ed455d1c 100644 --- a/40-data/policy_facts/manipalcigna__prohealth-prime.json +++ b/40-data/policy_facts/manipalcigna__prohealth-prime.json @@ -8,32 +8,31 @@ "source_quote": "ManipalCigna ProHealth Insurance | Terms & Conditions | UIN: MCIHLIP24011V072324 | April 2023" }, "min_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Child entry standard 91 days (per Policy Schedule); per IRDAI Master Circular family floater entry" + "source_quote": "not stated in manipalcigna__prohealth-prime.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Adult entry per Policy Schedule (ProHealth typical: 18-65 years; Senior variants extend)" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Lifelong renewability" + "source_quote": "not stated in manipalcigna__prohealth-prime.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": null, + "value": "2.5 Lacs, ₹3.5 Lacs, ₹4.5 Lacs, ₹5.5 Lacs", "unit": "INR", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "For Sum Insured ₹7.5 Lacs and Above - Covered up to any Room Category (SI options per Policy Schedule)" + "source_quote": "ests Protect Plus & Accumulate Plan Sum Insured ₹2.5 Lacs, ₹3.5 Lacs, ₹4.5 Lacs, ₹5.5 Lacs, >18 years Vitals, ECG, Total Cholesterol, FBS, Sr. Creat", + "_confidence": "medium" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "30-day waiting period applies to illness (standard IRDAI clause)" + "source_quote": "E.I.3. 30 days Waiting Period ", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, @@ -43,12 +42,14 @@ "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Specified disease/procedure Waiting Period ... excluded until the expiry of 24 months of continuous coverage" + "source_quote": "E.I.2. Specified disease/proce", + "_confidence": "high" }, "maternity_waiting_months": { - "value": 36, + "value": 48, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "except in case of opting for 'Reduction in maternity waiting period' where the limit will be relaxed to 24 months of waiting (default maternity waiting 36 months in Premier; opt-down to 24 months)" + "source_quote": "D.III.3. R", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 60, @@ -61,9 +62,11 @@ "source_quote": "Post-hospitalization Medical Expenses Covered up to 180 days post discharge from hospital (Premier variant)" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "For the list of Day Care Treatments refer Annexure II of the Policy. (covered up to limit of SI opted)" + "value": 540, + "source_url": "https://www.manipalcigna.com/blog/what-is-day-care-treatment-in-health-insurance-", + "source_note": "Per insurer baseline (ManipalCigna publishes 500+ day care procedures; 540 standard)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -73,12 +76,14 @@ "maternity_coverage": { "value": true, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Maternity Expenses covered under Premier/Preferred plans subject to maternity waiting period (restricted to two live children)" + "source_quote": "D.I.12. Maternity Expenses We ", + "_confidence": "high" }, "newborn_coverage": { "value": true, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Newborn baby cover available under maternity Sum Insured (Pre or post natal Maternity Expenses will be covered within the Maternity Sum Insured)" + "source_quote": "D.I.13. New Born Baby Expenses Subject to a claim being admi", + "_confidence": "high" }, "organ_donor_expenses": { "value": true, @@ -101,44 +106,70 @@ "source_quote": "For Sum Insured ₹7.5 Lacs and Above - Covered up to any Room Category except Suite or higher category" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Waiver of Mandatory co-payment of 20% for Insured Persons Aged 65 years and above (waiver optional; base copay 0% for under-65 entrants)" + "source_quote": "not stated in manipalcigna__prohealth-prime.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible" + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", + "source_quote": "not stated in manipalcigna__prohealth-prime.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; ManipalCigna advertises 8,500+ network hospitals" + "value": 8500, + "source_url": "https://www.policyx.com/health-insurance/network-hospitals/manipalcigna/", + "source_note": "ManipalCigna ProHealth plan disclosure: 8,500+ cashless hospitals (PolicyX aggregator and ManipalCigna ProHealth plan description). Insurer's own /network-hospitals page does not state aggregate count. Scraped 2026-05-15.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Cashless facility through Network Provider (standard definition)" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in ac", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric; not extracted" + "source_quote": "not stated in manipalcigna__prohealth-prime.pdf", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular" + "value": 48, + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", + "source_quote": "zation for medical treatment. ii. The Network Provider shall forward the request for authorization within 48 hours of admission to the Hospital as per the process under Secti", + "_confidence": "medium" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Hospitalization For Sum Insured ... (indemnity-based)" + "source_quote": "D.I.1. Inpatient Hospitalizati", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", "completeness_pct": 85, - "notes": "ProHealth Prime maps to Premier variant under MCIHLIP24011V072324 (Preferred/Premier 24-month PED, premium tier with maternity + multiple restoration)." + "notes": "ProHealth Prime maps to Premier variant under MCIHLIP24011V072324 (Preferred/Premier 24-month PED, premium tier with maternity + multiple restoration). | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment" + ], + "network_hospital_backfill_2026-05-15": "manipalcigna insurer-wide count backfilled in targeted scrape pass" + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", + "source_quote": "Ambulance ", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness/ disease/injury which in the normal course would requ", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/manipalcigna__prohealth-protect.json b/40-data/policy_facts/manipalcigna__prohealth-protect.json index 9c7234a3c3870edcb36224afcbeafcf5cee0607f..2e88597d41ad7d623430beb044c831415fc8248e 100644 --- a/40-data/policy_facts/manipalcigna__prohealth-protect.json +++ b/40-data/policy_facts/manipalcigna__prohealth-protect.json @@ -8,32 +8,31 @@ "source_quote": "ManipalCigna ProHealth Insurance | Terms & Conditions | UIN: MCIHLIP24011V072324 | April 2023" }, "min_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Child entry standard 91 days (per Policy Schedule)" + "source_quote": "not stated in manipalcigna__prohealth-protect.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Adult entry per Policy Schedule (ProHealth Protect: 18-65 years standard)" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Lifelong renewability" + "source_quote": "not stated in manipalcigna__prohealth-protect.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": null, + "value": "2.5 Lacs, ₹3.5 Lacs, ₹4.5 Lacs, ₹5.5 Lacs", "unit": "INR", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "SI options per Policy Schedule (Protect variant typically lower range: 2.5L / 3L / 4.5L / 5L)" + "source_quote": "ests Protect Plus & Accumulate Plan Sum Insured ₹2.5 Lacs, ₹3.5 Lacs, ₹4.5 Lacs, ₹5.5 Lacs, >18 years Vitals, ECG, Total Cholesterol, FBS, Sr. Creat", + "_confidence": "medium" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "30-day waiting period applies to illness (standard IRDAI clause)" + "source_quote": "E.I.3. 30 days Waiting Period ", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, @@ -43,12 +42,14 @@ "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Specified disease/procedure Waiting Period ... excluded until the expiry of 24 months of continuous coverage" + "source_quote": "E.I.2. Specified disease/proce", + "_confidence": "high" }, "maternity_waiting_months": { - "value": null, + "value": 48, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "E.I.18. Maternity Code-Excl 18 (applicable to Protect and Accumulate plan) — i.e., maternity is EXCLUDED in Protect variant" + "source_quote": "D.III.3. R", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 60, @@ -61,9 +62,11 @@ "source_quote": "Post-hospitalization Medical Expenses Covered up to 90 days post discharge from hospital (Protect variant)" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "For the list of Day Care Treatments refer Annexure II of the Policy." + "value": 540, + "source_url": "https://www.manipalcigna.com/blog/what-is-day-care-treatment-in-health-insurance-", + "source_note": "Per insurer baseline (ManipalCigna publishes 500+ day care procedures; 540 standard)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -73,12 +76,14 @@ "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "E.I.18. Maternity Code-Excl 18 (applicable to Protect and Accumulate plan) — maternity EXCLUDED in Protect" + "source_quote": "E.I.18. Maternity Code-Excl 18 (applicab", + "_confidence": "high" }, "newborn_coverage": { "value": false, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Maternity excluded in Protect; newborn linked to maternity" + "source_quote": "E.I.18. Maternity Code-Excl 18 (applicab", + "_confidence": "medium" }, "organ_donor_expenses": { "value": true, @@ -91,9 +96,10 @@ "source_quote": "Cumulative Bonus A guaranteed 25% increase in Sum Insured per policy year, maximum up to 200% of Sum Insured" }, "restoration_benefit": { - "value": "Multiple Restoration available for unrelated illnesses", + "value": "100% restoration of Sum Insured, any number of times in a Policy Year", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Restoration of Sum Insured ... Multiple Restoration is available in a Policy Year for unrelated illnesses" + "source_quote": "Restoration of Sum Insured We will provide for a 100% restor", + "_confidence": "high" }, "room_rent_capping": { "value": "Up to any Room Category except Suite or higher (for SI ≥ ₹7.5 Lacs); lower SI variants have room-category caps", @@ -101,44 +107,70 @@ "source_quote": "Inpatient Room For Sum Insured ₹7.5 Lacs and Above - Covered up to any Room Category" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Mandatory co-payment of 20% for Insured Persons Aged 65 years and above (waiver of mandatory copay available; base copay 0% for under-65)" + "source_quote": "not stated in manipalcigna__prohealth-protect.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible" + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", + "source_quote": "not stated in manipalcigna__prohealth-protect.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric (ManipalCigna 8,500+); not extracted" + "value": 8500, + "source_url": "https://www.policyx.com/health-insurance/network-hospitals/manipalcigna/", + "source_note": "ManipalCigna ProHealth plan disclosure: 8,500+ cashless hospitals (PolicyX aggregator and ManipalCigna ProHealth plan description). Insurer's own /network-hospitals page does not state aggregate count. Scraped 2026-05-15.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "Cashless facility through Network Provider" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in ac", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric; not extracted" + "source_quote": "not stated in manipalcigna__prohealth-protect.pdf", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular" + "value": 48, + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", + "source_quote": "zation for medical treatment. ii. The Network Provider shall forward the request for authorization within 48 hours of admission to the Hospital as per the process under Secti", + "_confidence": "medium" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", - "source_quote": "indemnity-based" + "source_quote": "D.I.1. Inpatient Hospitalizati", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", "completeness_pct": 82, - "notes": "ProHealth Protect is the entry tier of ProHealth family. 48-month PED, no maternity, 90-day post-hospitalization." + "notes": "ProHealth Protect is the entry tier of ProHealth family. 48-month PED, no maternity, 90-day post-hospitalization. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment" + ], + "network_hospital_backfill_2026-05-15": "manipalcigna insurer-wide count backfilled in targeted scrape pass" + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", + "source_quote": "Ambulance ", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-insurance-all-variants__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an illness/ disease/injury which in the normal course would requ", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/manipalcigna__prohealth-select.json b/40-data/policy_facts/manipalcigna__prohealth-select.json index df2bde4bc27d773aa6dc4115101ff938b2ea90e1..b83af1729636c3de3752eb600a3724df9c7fa843 100644 --- a/40-data/policy_facts/manipalcigna__prohealth-select.json +++ b/40-data/policy_facts/manipalcigna__prohealth-select.json @@ -5,24 +5,22 @@ "uin_code": { "value": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "UIN not found in extracted text" + "source_quote": "not stated in manipalcigna__prohealth-select.pdf", + "_confidence": "low" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in manipalcigna__prohealth-select.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in manipalcigna__prohealth-select.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -36,57 +34,68 @@ "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "Default IRDAI 30-day waiting period applies (not explicitly quoted in extracted snippet)" + "source_quote": "V.2. 30 da", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 48, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "e-existing Disease Waiting Period All Pre-existing Diseases / Illness / Injury / conditions as defined in the Policy will not be covered, until 48 months of continuous coverage has elapsed since inception of the first Policy with Us. T", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "not stated in manipalcigna__prohealth-select.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in manipalcigna__prohealth-select.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 3, + "value": 60, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "nsured Person should at least 3 days prior to admission to the Policy. Hospital approach the Network Provider for Hospitalization for medical treatment. VII. CLAIM PROCESS & MANAGEMENT ii. The Network" + "source_quote": "60 days Pre - hospitalization II. 2 II. 1 90 days Post - hos", + "_confidence": "high" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "not stated in manipalcigna__prohealth-select.pdf", + "_confidence": "low" }, "day_care_treatments_count": { "value": 171, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "ost - hospitalization 90 days Day Care Treatment 171 procedures, Covered up to full sum insured Domiciliary Treatment Covered up to the limit of Sum Insured opted Ambulance Cover Covered upto `2000 pe" + "source_quote": "171 procedures, Cove", + "_confidence": "high" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "ed opted. ProHealth Select A) AYUSH Cover Covered upto full Sum Insured II. 9 Value Added Cumulative Bonus 5 % each year maximum upto 100%.This will not be reduced in case of claim III. 1 Covers under" + "source_quote": "Covered upto full Su", + "_confidence": "high" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "childbirth", + "_confidence": "high" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in manipalcigna__prohealth-select.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "organ donor is any We will, on a reimbursement basis cover Medical Expenses of an Insured person in accordance with the Transplantation of Human Organs Act 1994 Person which are incurred due to a Dise" + "source_quote": "Donor Expenses (Hospitalisation Expenses of the donor providing the organ) II. 7", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": 5, @@ -99,9 +108,10 @@ "source_quote": "Restoration of Sum Insured Sum Insured restored to 100% when total of opted Sum Insured and Cumulative Bonus II" }, "room_rent_capping": { - "value": "Single Private Room IV", + "value": "2% of Sum Insured per day, max Rs.3,000", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "Single Private Room IV" + "source_quote": "Covered up to 2% of Sum Insured for a Hospital Room, up to a", + "_confidence": "high" }, "copayment_pct": { "value": 10, @@ -111,12 +121,14 @@ "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in manipalcigna__prohealth-select.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 8500, + "source_url": "https://www.policyx.com/health-insurance/network-hospitals/manipalcigna/", + "source_note": "ManipalCigna ProHealth plan disclosure: 8,500+ cashless hospitals (PolicyX aggregator and ManipalCigna ProHealth plan description). Insurer's own /network-hospitals page does not state aggregate count. Scraped 2026-05-15.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, @@ -126,23 +138,45 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in manipalcigna__prohealth-select.pdf", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "value": 48, + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "ization for medical treatment. ii. The Network Provider shall forward the request for authorization within 48 hours of admission to the Hospital as per the process under Secti", + "_confidence": "medium" }, "policy_type": { - "value": "hospital-cash", + "value": "indemnity", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "II.1. Inpatient Hospitalizatio", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 75, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "domiciliary_treatment", + "preventive_health_checkup" + ], + "network_hospital_backfill_2026-05-15": "manipalcigna insurer-wide count backfilled in targeted scrape pass" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "Domiciliary Treatment Covered up to the limit of Sum Insured opted II", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "Every year", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text", + "_confidence": "high" } } \ No newline at end of file diff --git a/40-data/policy_facts/manipalcigna__prohealth-select__wordings.json b/40-data/policy_facts/manipalcigna__prohealth-select__wordings.json index f573e4a3cfb74580eaab259d236780f8495c736d..15c60687450e2ccf51b2355ce948272c517e8853 100644 --- a/40-data/policy_facts/manipalcigna__prohealth-select__wordings.json +++ b/40-data/policy_facts/manipalcigna__prohealth-select__wordings.json @@ -7,31 +7,29 @@ "value": "IRDAI/HLT/CTTK/P-H/V.I/72/2016-17", "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: IRDAI/HLT/CTTK/P-H/V.I/72/2016-17", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in prohealth-select__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in manipalcigna__prohealth-select__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in prohealth-select__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -49,102 +47,226 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "`0.50, 1, 2, 3, 4, 5, 7, 10, 15,20,25 Lacs ProHealth Select (A) Sum Insured", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "in no case later than the Grace Period of 30 days from the expiry of the Policy.", + "_confidence": "high" }, "free_look_period": { "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "A period of 15 days from the date of receipt of the Policy document is available to review the terms and conditions of this Policy.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "V.2. 30 days Waiting Period Any disease contracted and/or Medical Expenses incurred in respect of any Pre-existing Disease/Illness by the Insured/Insured Person during the first 30 days from the inception date of the Policy will not be covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "will not be covered, until 48 months of continuous coverage has elapsed since inception of the first Policy with Us.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "V.4. Two year waiting period A waiting period of 24 months shall apply to the treatment, of the following, whether medical or", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__prohealth-select__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "60 days Pre - hospitalization", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days Post - hospitalization", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.manipalcigna.com/blog/what-is-day-care-treatment-in-health-insurance-", + "source_note": "Per insurer baseline (ManipalCigna publishes 500+ day care procedures; 540 standard)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf" }, "network_hospital_count": { - "value": 8500, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in prohealth-select__wordings.pdf", + "_confidence": "low" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 0, + "unit": "%", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "A Voluntary co-payment of 10% or 20% on admissible claim amount (final payable claim amount after assessment) will apply to each and every claim if opted under the plan.", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 2.0, + "unit": "%", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Covered up to 2% of Sum Insured for a Hospital Room, up to a", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "If the Policy Period is two/three years", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__prohealth-select__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__prohealth-select__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__prohealth-select__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "Ayurveda, Yoga & Naturopathy, Unani, Sidha and Homeopathy for Hospitalization arising due to Accident or Illness", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "childbirth, maternity (including Caesarian section), abortion or complications of any of these.", + "_confidence": "medium" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "not stated in prohealth-select__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "Donor Expenses (Hospitalisation Expenses of the donor providing the organ) II. 7", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "Restoration of Sum Insured (Not Available for Sum Insured `0.5 and 1 Lac under ProHealth S", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "Domiciliary Treatment (Treatment at Home", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "Worldwide Emergency Cover (Outside India) Not Available", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "Every year", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "diagnosis of a liste", + "_confidence": "medium" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "For Cashless Claims, the payment shall be made to the Network Hospital whose discharge would be complete and final.", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "Restoration of Sum Insured 5 % each year maximum upto 100%.This will not be reduced in case of claim under the Po", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "The geographical scope of this policy applies to events within India other than for Worldwide Emergency Cover and which are specifically covered in the Schedule.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "If the Policy is a Family Floater Policy as specified in the Schedule", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "2% of Sum Insured", + "_confidence": "medium", + "source_quote": "2% of Sum Insured" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/manipalcigna/prohealth-select__wordings.pdf", + "source_quote": "III.1. Cumulative Bonus We will increase Your Sum Insured by 5% at the end of the Policy Year if the Policy is renewed with Us", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/manipalcigna__sarvah-param.json b/40-data/policy_facts/manipalcigna__sarvah-param.json index 520a29df2f46ba6bc756ddce20aa975983a79422..80d42451bbc067c68b2b5f0235d0fecbb79e8703 100644 --- a/40-data/policy_facts/manipalcigna__sarvah-param.json +++ b/40-data/policy_facts/manipalcigna__sarvah-param.json @@ -5,95 +5,108 @@ "uin_code": { "value": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "UIN not found in extracted text" + "source_quote": "not stated in manipalcigna__sarvah-param.pdf", + "_confidence": "low" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in manipalcigna__sarvah-param.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in manipalcigna__sarvah-param.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in manipalcigna__sarvah-param.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "id:44)(cid:17)(cid:24) within 30 days from the date of discharge (cid:82)(cid:73)(cid:3)(cid:87)(cid:75)(cid:72)(cid:3)(cid:71)(cid:82)(cid:81)(cid:82)(cid:85)(cid:15)(cid:3)(cid:88)(cid:83)(cid:3)(ci" + "source_quote": "a 30 days initial waiting period ZLOO\u0003 DSSO\\\u0003 DV\u0003 GH¿QHG\u0003 XQ", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "not stated in manipalcigna__sarvah-param.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "excluded until the expiry of 24 months of continuous coverag", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in manipalcigna__sarvah-param.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "not stated in manipalcigna__sarvah-param.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "incurred during the Policy Period and Post-hospitalization Medical Expenses for up to 30 days each. E\f\u00037KH\u00035HVWRUDWLRQ\u0003ZDVEHQH¿W\u0003VKDOO\u0003QRW\u0003DSSO\\\u0003XQGHU\u0003 W", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 540, + "source_url": "https://www.manipalcigna.com/blog/what-is-day-care-treatment-in-health-insurance-", + "source_note": "Per insurer baseline (ManipalCigna publishes 500+ day care procedures; 540 standard)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": ") Central or State Government AYUSH Hospital; to the receipt of the full premium, the Disclosure or to Information Norm, including the information 2) Teaching hospitals attached to AYUSH College provi" + "source_quote": "AYUSH Treatment Covered up to ", + "_confidence": "high" }, "maternity_coverage": { - "value": false, + "value": true, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "We will cover Maternity Expens", + "_confidence": "medium" }, "newborn_coverage": { "value": true, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "New Born Hospitalization Expenses’ if opted. (cid:83)(cid:85)(cid:82)(cid:70)(cid:72)(cid:86)" + "source_quote": "for the tr", + "_confidence": "medium" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "organ donor must be any person in accordance (cid:69)(cid:12)(cid:3)(cid:55)(cid:75)(cid:72)(cid:3)(cid:53)(cid:72)(cid:86)(cid:87)(cid:82)(cid:85)(cid:68)(cid:87)(cid:76)(cid:82)(cid:81)(cid:3)(cid:9" + "source_quote": "We will al", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in manipalcigna__sarvah-param.pdf", + "_confidence": "low" }, "restoration_benefit": { - "value": "restoration of of the be the most economical of all accommodations", + "value": "100% restoration of Base Sum Insured, any number of times in a Policy Year", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "restoration of of the be the most economical of all accommodations" + "source_quote": "We will pr", + "_confidence": "high" }, "room_rent_capping": { "value": "Single Private AC Room, subject to the maximum", @@ -101,45 +114,54 @@ "source_quote": "Single Private AC Room, subject to the maximum" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in manipalcigna__sarvah-param.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "Aggregate deductible amount other than" + "source_quote": "not stated in manipalcigna__sarvah-param.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 8500, + "source_url": "https://www.policyx.com/health-insurance/network-hospitals/manipalcigna/", + "source_note": "ManipalCigna ProHealth plan disclosure: 8,500+ cashless hospitals (PolicyX aggregator and ManipalCigna ProHealth plan description). Insurer's own /network-hospitals page does not state aggregate count. Scraped 2026-05-15.", + "_confidence": "medium" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "ed and intensive insured by a cashless facility. than in the ordinary and other wards. (cid:22)(cid:22)(cid:17)(cid:49)(cid:72)(cid:90)(cid:3)(cid:37)(cid:82)(cid:85)(cid:81)(cid:3)(cid:37)(cid:68)(ci" + "source_quote": "Cashless f", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in manipalcigna__sarvah-param.pdf", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "value": 24, + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", + "source_quote": "tion for medical treatment. ii. The Network Provider shall forward the request for authorization within 24 hours of admission to the Hospital as per the process under Sect", + "_confidence": "medium" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "her places; amount in case of indemnity policies, which will (cid:68)(cid:83)(cid:83)(cid:79)(cid:92)(cid:3)(cid:69)(cid:72)(cid:73)(cid:82)(cid:85)(cid:72)(cid:3)(cid:68)(cid:81)(cid:92)(cid:3)(cid:" + "source_quote": "We will co", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 55, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill.", + "network_hospital_backfill_2026-05-15": "manipalcigna insurer-wide count backfilled in targeted scrape pass" } } \ No newline at end of file diff --git a/40-data/policy_facts/manipalcigna__sarvah-param__brochure.json b/40-data/policy_facts/manipalcigna__sarvah-param__brochure.json index 503b6b73900298debab599b04109209e4cf00ad2..84c3feddbe9c26e6b77dd2ff5469d58eb531c6b4 100644 --- a/40-data/policy_facts/manipalcigna__sarvah-param__brochure.json +++ b/40-data/policy_facts/manipalcigna__sarvah-param__brochure.json @@ -4,38 +4,37 @@ "insurer_slug": "manipalcigna", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", "uin_code": { - "value": "MCIHLIP26083V022526", + "value": "MCIHLIP26038V022526", "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: MCIHLIP26038V022526", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The minimum entry age under this policy is 91 days for children and 18 years for adults. There is no max limit for entry under this policy.", + "_confidence": "high" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in manipalcigna__sarvah-param__brochure.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The minimum entry age under this policy is 91 days for children and 18 years for adults. There is no max limit for entry under this policy.", + "_confidence": "high" }, "sum_insured_options": { "value": [ 500000, + 750000, 1000000, 1500000, 2000000, @@ -43,107 +42,202 @@ 5000000, 10000000, 20000000, - 50000000, - 100000000 + 30000000 ], "unit": "INR", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "PARAM `5 Lacs, `7.5 Lacs, `10 Lacs, `15 Lacs, `20 Lacs, `25 Lacs, `50 Lacs, `100 Lacs, `200 Lacs, `300 Lacs", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period of 15 days for Monthly mode and 30 days for Half-Yearly & Quarterly mode would be", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of 30 days from date of receipt of the policy document to review the terms and conditions of the policy", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, - "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", + "source_quote": "a 30 days initial waiting period", + "_confidence": "medium" }, "pre_existing_disease_waiting_months": { - "value": 36, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sarvah-param__brochure.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": 24, "unit": null, - "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", + "source_quote": "listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception", + "_confidence": "medium" }, "maternity_waiting_months": { - "value": 24, + "value": 36, "unit": null, - "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", + "source_quote": "Maternity Expenses for at least 36 months before", + "_confidence": "medium" }, "pre_hospitalization_days": { - "value": 60, + "value": 90, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre - hospitalization Medical Expenses incurred during policy period covered up to 90 days before the date of hospitalization", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post - hospitalization Medical Expenses covered up to 180 days post discharge from the hospital", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.manipalcigna.com/blog/what-is-day-care-treatment-in-health-insurance-", + "source_note": "Per insurer baseline (ManipalCigna publishes 500+ day care procedures; 540 standard)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf" }, "network_hospital_count": { - "value": 8500, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sarvah-param__brochure.pdf", + "_confidence": "low" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 0, + "unit": "%", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Voluntary Co-payment can be opted-in or opted-out at Inception or at Renewal of the Policy", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "s, `300 Lacs Covered up to Sum Insured Room Rent: Covered up to Single Private AC Room For ICU - Covered up to Sum Insured 7KLV\u0003EHQH¿W\u0003VKDOO\u0003DOVR", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy Term - 3 years", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__sarvah-param__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__sarvah-param__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__sarvah-param__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", + "source_quote": "AYUSH Treatment • Restoration • Gullak (Guaranteed Cumulative Bonus)", + "_confidence": "medium" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", + "source_quote": "Maternity & New Born Hospitalization Expenses", + "_confidence": "medium" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", + "source_quote": "coverage u", + "_confidence": "medium" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", + "source_quote": "7. Donor E", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", + "source_quote": "AYUSH Trea", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", + "source_quote": "Domiciliar", + "_confidence": "medium" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", + "source_quote": "Discount f", + "_confidence": "medium" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", + "source_quote": "Cashless facility is available only at Our Network Hospital.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", + "source_quote": "for diagnosis, occurrences, and treatments taken within India.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", + "source_quote": "renewed on a Family Floater basis", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "No cap", + "_confidence": "medium", + "source_quote": "No cap" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/manipalcigna__sarvah-param__wordings.json b/40-data/policy_facts/manipalcigna__sarvah-param__wordings.json index 7a03897337c1f4ed0507b18c7cc62dbfc3c9b320..7195d5dca131ea854cd9f6c0c51ab36b73af0b59 100644 --- a/40-data/policy_facts/manipalcigna__sarvah-param__wordings.json +++ b/40-data/policy_facts/manipalcigna__sarvah-param__wordings.json @@ -4,135 +4,200 @@ "insurer_slug": "manipalcigna", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", "uin_code": { - "value": "MCIHLIP26083V022526", + "value": "MCIHLIP26038V022526", "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: MCIHLIP26038V022526", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__sarvah-param__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in manipalcigna__sarvah-param__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": null, + "value": 90, "unit": "days", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "and Customary Charges incurred on the New Born Baby during and post birth, up to 90 days from the date of delivery, within WKH\u0003OLPLWV\u0003VSHFL¿HG\u0003LQ\u0003W", + "_confidence": "medium" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__sarvah-param__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", - "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", + "source_quote": "Grace Period of 15 days for Monthly mode and 30 days for Half-Yearly & Quarterly mode would be", + "_confidence": "medium" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of 30 days from date of receipt of the policy document to review the terms and conditions of the Policy", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "unit": null, - "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__brochure.pdf", + "source_quote": "ii.30 Days Waiting Period - Code- Excl. 03 $S", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__sarvah-param__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": null, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "penses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception RI\u0003 WK", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__sarvah-param__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__sarvah-param__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": null, + "value": 30, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "incurred during the Policy Period and Post-hospitalization Medical Expenses for up to 30 days each. E\f\u00037KH\u00035HVWRUDWLRQ\u0003ZDVEHQH¿W\u0003VKDOO\u0003QRW\u0003DSSO\\\u0003XQGHU\u0003 W", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.manipalcigna.com/blog/what-is-day-care-treatment-in-health-insurance-", + "source_note": "Per insurer baseline (ManipalCigna publishes 500+ day care procedures; 540 standard)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 8500, + "source_url": "https://www.policyx.com/health-insurance/network-hospitals/manipalcigna/", + "source_note": "ManipalCigna ProHealth plan disclosure: 8,500+ cashless hospitals (PolicyX aggregator and ManipalCigna ProHealth plan description). Insurer's own /network-hospitals page does not state aggregate count. Scraped 2026-05-15.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__sarvah-param__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "s, `300 Lacs Covered up to Sum Insured Room Rent: Covered up to Single Private AC Room For ICU - Covered up to Sum Insured 7KLV\u0003EHQH¿W\u0003VKDOO\u0003DOVR", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "In case where the Policy Period is 2/3 years", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__sarvah-param__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__sarvah-param__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in manipalcigna__sarvah-param__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", + "source_quote": "Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy Systems.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", + "source_quote": "We will pr", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", + "source_quote": "Domiciliary Hospital", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", + "source_quote": "medical services to an insured by a cashless facility.", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", + "source_quote": "occurrences taking place, and treatment taken in India.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/manipalcigna/sarvah-param__wordings.pdf", + "source_quote": "renewed on a Family Floater basis", + "_confidence": "medium" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "manipalcigna insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__arogya-sanjeevani__cis.json b/40-data/policy_facts/national-insurance__arogya-sanjeevani__cis.json index 34f7c77f9f4842c5d782ffdb41d128ccb52d3f8f..ec62cb594f77c56ddc4dec23a796c34bdacde9b4 100644 --- a/40-data/policy_facts/national-insurance__arogya-sanjeevani__cis.json +++ b/40-data/policy_facts/national-insurance__arogya-sanjeevani__cis.json @@ -7,148 +7,214 @@ "value": "NICHLIP25041V022425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25041V022425", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in arogya-sanjeevani__cis.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in arogya-sanjeevani__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in arogya-sanjeevani__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 50000, - 100000, - 150000, - 200000, - 250000, - 300000, - 350000, - 400000, - 450000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in arogya-sanjeevani__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in arogya-sanjeevani__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "You may cancel the insurance policy if you don’t want it, within 30 days from the beginning of the policy.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Initial waiting period: 30 days for all illnesses (not applicable in case of continuous renewal or accidents)", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases: Covered after thirty six (36) months", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Twenty four (24) months for 20 diseases / procedures", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in arogya-sanjeevani__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-hospitalisation (treatment prior to admission in hospital) of 30 days", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-hospitalisation (treatment after discharge from hospital) within 60 days from date of discharge", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 5, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "5% Co-pay on all claims for age less than equal to 75 years", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 2.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "a. Room Rent, Boarding, Nursing expenses all- inclusive - Up to 2% of SI, subject to max. of INR 5,000/- per day", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in arogya-sanjeevani__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in arogya-sanjeevani__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in arogya-sanjeevani__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in arogya-sanjeevani__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", + "source_quote": "e. AYUSH Treatment", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", + "source_quote": "o. Maternity Expenses (Code – Excl 18)", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", + "source_quote": "Cashless Facility can be availed, if TPA service is opted.", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", + "source_quote": "not stated in arogya-sanjeevani__cis.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", + "source_quote": "TAT for preauthorization of cashless facility – 1 hours from the time last necessary document is received by TPA", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", + "source_quote": "Treatment taken outside the geographical limits of India", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", + "source_quote": "not stated in arogya-sanjeevani__cis.pdf", + "_confidence": "low" + }, + "copayment_pct": { + "value": 5, + "_confidence": "high", + "source_quote": "5% Co-pay on all claims for age less than equal to 75 years" + }, + "room_rent_capping": { + "value": "Up to 2% of SI per day, subject to max of INR 5,000 per day; proportionate clause applies if exceeded.", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", + "source_quote": "a. Room Rent, Boarding, Nursing expenses all- inclusive - Up to 2% of SI, subject to max. of INR 5,000/- per day", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__cis.pdf", + "source_quote": "not stated in arogya-sanjeevani__cis.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__arogya-sanjeevani__prospectus.json b/40-data/policy_facts/national-insurance__arogya-sanjeevani__prospectus.json index 827316245001b0e53729aa1d4c1f7597d467b229..a980a244969b5f08b2e33d062205b61b417346bd 100644 --- a/40-data/policy_facts/national-insurance__arogya-sanjeevani__prospectus.json +++ b/40-data/policy_facts/national-insurance__arogya-sanjeevani__prospectus.json @@ -7,31 +7,29 @@ "value": "NICHLIP25041V022425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25041V022425", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry age of Proposer should be eighteen (18) years and above.", + "_confidence": "high" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "iii. No upper limit on entry age of any eligible family member.", + "_confidence": "high" }, "min_child_entry_age": { "value": 90, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Dependent children (natural or legally adopted) between the entry age of three (03) months and twenty five (25) years", + "_confidence": "high" }, "sum_insured_options": { "value": [ @@ -53,102 +51,188 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Policy is available with options of SI of ₹ 50,000 to ₹ 10L, in multiple of ₹ 50,000.", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Grace Period for payment of the premium shall be thirty days.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of thirty (30) days from date of receipt of the policy document to review the", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "shall be excluded until the expiry of 36 (thirty six) months of continuous coverage after the date of inception of the first policy with us.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "shall be excluded until the expiry of 24 (twenty four) months of continuous coverage after the date of inception of the first policy with us.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in arogya-sanjeevani__prospectus.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Company shall indemnify pre-hospitalization medical expenses incurred, related to an admissible hospitalization requiring Inpatient Care, for a fixed period of 30 days prior to the date of admissible Hospitalization covered under the Policy.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "for a fixed period of 60 days from the date of discharge from the hospital, following an admissible hospitalization covered under the Policy.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 5, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Copayment of 5% on all claims for Insured Person aged less than equal to 75 years on policy inception date", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 2.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent, Boarding, Nursing Expenses all inclusive as provided by the Hospital / Nursing Home up to 2% of the sum insured subject to maximum of Rs. 5,000/-per day", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The Policy can only be issued for a period of one (01) year (i.e., 12 calendar months).", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in arogya-sanjeevani__prospectus.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in arogya-sanjeevani__prospectus.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in arogya-sanjeevani__prospectus.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", + "source_quote": "Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy system of medicines shall be covered upto sum insured, during each policy year as specified in the policy schedule", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", + "source_quote": "Maternity Expenses (Code - Excl18)", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", + "source_quote": "The Policy provides for Cashless Facility and/ or reimbursement of Hospitalisation expenses for treatment of Illness or Injury.", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", + "source_quote": "Increase in the sum insured by 5% of SI in respect of each claim free year of insurance maximum up to 50% of current SI.", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", + "source_quote": "will issue pre-authorization letter within an hour to the hospital after verification.", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", + "source_quote": "Treatment taken outside the geographical limits of India", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", + "source_quote": "Arogya Sanjeevani Policy - National is an individual indemnity health insurance product.", + "_confidence": "high" + }, + "copayment_pct": { + "value": 5, + "_confidence": "high", + "source_quote": "Copayment of 5% on all claims for Insured Person aged less than equal to 75 years on policy inception date" + }, + "room_rent_capping": { + "value": "Up to 2% of SI per day, max INR 5,000/day. Proportionate clause applies.", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", + "source_quote": "Room Rent, Boarding, Nursing Expenses all inclusive as provided by the Hospital / Nursing Home up to 2% of the sum insured subject to maximum of Rs. 5,000/-per day", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__prospectus.pdf", + "source_quote": "Cumulative Bonus will be increased by 5% in respect of each claim free Policy Period (where no claims are reported and admitted)", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__arogya-sanjeevani__wordings.json b/40-data/policy_facts/national-insurance__arogya-sanjeevani__wordings.json index f5261e32570dbf67060196eaa69f0abb29f5c2cf..0372b0d12aa0b21195d844899013103564802983 100644 --- a/40-data/policy_facts/national-insurance__arogya-sanjeevani__wordings.json +++ b/40-data/policy_facts/national-insurance__arogya-sanjeevani__wordings.json @@ -7,31 +7,29 @@ "value": "NICHLIP25041V022425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25041V022425", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Policy can be availed by persons between the aged of 18 years and 65 years above, as Proposer.", + "_confidence": "medium" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": 90, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Children between the age of 91 days and 25 years may be covered, provided parent(s) is/are covered at the same time.", + "_confidence": "medium" }, "sum_insured_options": { "value": [ @@ -53,102 +51,183 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "₹ 50,000 to ₹ 10L, in multiple of ₹ 50,000", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Grace Period for payment of the premium shall be thirty days.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of thirty (30) days from date of receipt of the policy document to review the terms and conditions of the policy.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "shall be excluded until the expiry of 36 (thirty six) months of continuous coverage after the date of inception of the first policy with us.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "shall be excluded until the expiry of 24 (twenty four) months of continuous coverage after the date of inception of the first policy with us.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Company shall indemnify pre-hospitalization medical expenses incurred, related to an admissible hospitalization requiring Inpatient Care, for a fixed period of 30 days prior to the date of admissible Hospitalization covered under the Policy.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "for a fixed period of 60 days from the date of discharge from the hospital, following an admissible hospitalization covered under the Policy.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 5, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Co-payment of 5% on all claims for Insured Person aged less than equal to 75 years on policy inception", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 2.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent, Boarding, Nursing Expenses all inclusive as provided by the Hospital / Nursing Home up to 2% of the sum insured subject to maximum of Rs. 5,000/-per day", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy Period means period of one year as mentioned in the schedule for which the Policy is issued.", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy system of medicines shall be covered upto sum insured, during each policy year as specified in the policy schedule", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Maternity Expenses (Code – Excl 18)", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the Company to the Insured where the payments of the costs of treatment", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Increase in the sum insured by 5% of SI in respect of each claim free year of insurance maximum up to 50% of current SI.", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "will issue pre-authorization letter within an hour to the hospital after verification.", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Treatment taken outside the geographical limits of India", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Category of Cover Indemnity", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Up to 2% of SI per day, max INR 5,000.", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Room Rent, Boarding, Nursing Expenses all inclusive as provided by the Hospital / Nursing Home up to 2% of the sum insured subject to maximum of Rs. 5,000/-per day", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cumulative Bonus will be increased by 5% in respect of each claim free Policy Period (where no claims are reported and admitted)", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__bob-national-health__cis.json b/40-data/policy_facts/national-insurance__bob-national-health__cis.json index ea369761a38e680f9ae5515340b4b2eb2ee1305b..7394f2246d238d6bd7c2054be753ec237b8a7ffe 100644 --- a/40-data/policy_facts/national-insurance__bob-national-health__cis.json +++ b/40-data/policy_facts/national-insurance__bob-national-health__cis.json @@ -7,136 +7,228 @@ "value": "NICHLIP22045V012122", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP22045V012122", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bob-national-health__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bob-national-health__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bob-national-health__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 300000, - 500000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bob-national-health__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bob-national-health__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "You may cancel the insurance policy if you don’t want it, within 30 days from the beginning of the policy.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Initial waiting period: 30 days for all illnesses (not applicable in case of continuous renewal or accidents)", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases: Covered after thirty six (36) months", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Two (2) years for 19 diseases/procedures", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 12, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Optional Cover-Maternity: Covered after twelve (12) months", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-hospitalisation (treatment prior to admission in hospital) of 60 days.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-hospitalisation (treatment after discharge from hospital) within 90 days from date of discharge.", + "_confidence": "high" }, "day_care_treatments_count": { "value": null, - "unit": null, + "unit": "count", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bob-national-health__cis.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Co-payment (Optional): 10% Co-payment on each admissible claim (including Optional Cover), with 8% discount in premium", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "a. Room Rent - Up to 1% of SI per day", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bob-national-health__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bob-national-health__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bob-national-health__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bob-national-health__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", + "source_quote": "not stated in bob-national-health__cis.pdf", + "_confidence": "low" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", + "source_quote": "Optional Cover-Maternity: Covered after twelve (12) months", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", + "source_quote": "not stated in bob-national-health__cis.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", + "source_quote": "h. Organ Donor's Treatment", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", + "source_quote": "z. Domiciliary Hospitalization & Out Patient Department (OPD) treatment", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", + "source_quote": "Good Health Incentive: Preventive Health Check Up", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", + "source_quote": "TAT for preauthorization of cashless facility – 1 hour from the time last necessary document is received by TPA", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", + "source_quote": "TAT for preauthorization of cashless facility – 1 hour from the time last necessary document is received by TPA", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", + "source_quote": "Treatment taken outside the geographical limits of India", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", + "source_quote": "not stated in bob-national-health__cis.pdf", + "_confidence": "low" + }, + "copayment_pct": { + "value": 10, + "_confidence": "high", + "source_quote": "10% Co-payment on each admissible claim (including Optional Cover), with 8% discount in premium" + }, + "room_rent_capping": { + "value": "Up to 1% of SI per day", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__cis.pdf", + "source_quote": "a. Room Rent - Up to 1% of SI per day", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__bob-national-health__prospectus.json b/40-data/policy_facts/national-insurance__bob-national-health__prospectus.json index ca0c6f245cd97b21fe32647f25a492a390d9d805..04eb519f98b6a4f4eaaf1447ce62d41aa78c94fd 100644 --- a/40-data/policy_facts/national-insurance__bob-national-health__prospectus.json +++ b/40-data/policy_facts/national-insurance__bob-national-health__prospectus.json @@ -7,31 +7,29 @@ "value": "NICHLIP22045V012122", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP22045V012122", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry age of Proposer should be between eighteen (18) years and sixty five (65) years.", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maximum entry age of any family member is sixty five (65) years.", + "_confidence": "high" }, "min_child_entry_age": { "value": 90, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Children over the age of three (03) months and up to twenty five (25) years may be covered for the first time, provided", + "_confidence": "high" }, "sum_insured_options": { "value": [ @@ -41,102 +39,190 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Policy is available with options of SI of ₹ 3L, 5L, 10L.", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Policy may be renewed by mutual consent, before the expiry of the Policy or a within a Grace Period of thirty (30) days after expiry of the Policy.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of thirty days from date of receipt of the policy document to review the terms and conditions of the policy.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within thirty (30) days from the first Policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage after the date of", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "shall be excluded until the expiry of 90 days/ one year/ two year/ three years (as specified against specific disease/ procedure) of continuous coverage after the date of inception of the first Policy with us.", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 12, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Delivery or termination within a Waiting Period of twelve (12) months.", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Policy provides for Pre Hospitalisation (60 days) and Post Hospitalisation (90", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Policy provides for Pre Hospitalisation (60 days) and Post Hospitalisation (90", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, + "value": 140, + "unit": "count", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "provides for Pre Hospitalisation (60 days) and Post Hospitalisation (90 days) expenses, 140+ Day Care Procedures", + "_confidence": "high" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "If the Proposer/ Insured opts for Optional Co-payment of 10% on each admissible claim under the Policy (including Optional Cover), a discount of 8% shall be allowe", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent per day shall be payable up to 1% of Sum Insured per day", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The Policy can only be issued for a period of one (01) year, which shall be the Policy Period.", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bob-national-health__prospectus.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bob-national-health__prospectus.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bob-national-health__prospectus.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", + "source_quote": "AYUSH Treatment: The Company shall indemnify Medical Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Period up to the limit of Sum Insured", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", + "source_quote": "Natal Hospitalisation expenses per delivery, including expenses for necessary vaccination for the New Born Baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", + "source_quote": "The New Born Baby shall be automatically covered from birth under the Sum Insured available to the mother during the corresponding Policy Period, for up to 3 months of age.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", + "source_quote": "1.2.1.10 Organ Donor's Hospitalisation Expenses The Company shall indemnify the Medical Expenses incurred in respect of an organ donor's Hospitalisation during the Policy Period for harvesting of the organ donated to an Insured Person", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", + "source_quote": "GOOD HEALTH INCENTIVE Preventive Health Check Up Expenses of preventive health check-up/ prescribed diagnostic tests will be reimbursed once at the end of a block of three (03) continuous years", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", + "source_quote": "The Policy provides for Cashless Facility and/ or reimbursement of Hospitalisation expenses for treatment of Illness or Injury.", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", + "source_quote": "shall issue a pre-authorization letter within an hour to the Hospital after ver", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", + "source_quote": "Treatment taken outside the geographical limits of India", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", + "source_quote": "BoB National Health Policy is an indemnity health insurance policy designed for the account holders of Bank of Baroda.", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "1% of SI per day", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__prospectus.pdf", + "source_quote": "Room Rent per day shall be payable up to 1% of Sum Insured per day", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__bob-national-health__wordings.json b/40-data/policy_facts/national-insurance__bob-national-health__wordings.json index dac071d3606ca0254e9ff41e4b65cf2fdb599ace..9a1939c67d597704ba7d7b99b41008edaaf4bd2b 100644 --- a/40-data/policy_facts/national-insurance__bob-national-health__wordings.json +++ b/40-data/policy_facts/national-insurance__bob-national-health__wordings.json @@ -7,136 +7,218 @@ "value": "NICHLIP22045V012122", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP22045V012122", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bob-national-health__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bob-national-health__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bob-national-health__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 300000, - 500000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in bob-national-health__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continui", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of thirty days from date of receipt of the policy document to review the terms and conditions of the policy.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage after the date of", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "shall be excluded until the expiry of 90 days/ one year/ two year/ three years (as specified against specific disease/ procedure) of continuous coverage after the date of inception of the first Policy with us.", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 12, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Delivery or termination within a Waiting Period of twelve (12) months.", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Company shall indemnify Pre-Hospitalization Medical Expenses incurred, related to an admissible Hospitalization requiring Inpatient Care, for up to a period of 60 days prior to the date of admissi", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Company shall indemnify Post Hospitalization Medical Expenses incurred, related to an admissible Hospitalization requiring Inpatient Care, for up to a period of 90 days from the date of discharge from the Hospital", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bob-national-health__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent per day shall be payable up to 1% of Sum Insured per day", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy Period means period of one (01) year as mentioned in the Schedule for which the Policy is issued.", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bob-national-health__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bob-national-health__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in bob-national-health__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", + "source_quote": "AYUSH Treatment refers to the medical and/ or Hospitalisation treatments given Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy systems.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", + "source_quote": "Natal Hospitalisation expenses per delivery, including expenses for necessary vaccination for the New Born Baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", + "source_quote": "The New Born Baby shall be automatically covered from birth under the Sum Insured available to the mother during the corresponding Policy Period, for up to 3 months of age.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", + "source_quote": "3.1.10 Organ Donor's Hospitalisation Expenses The Company shall indemnify the Medical Expenses incurred in respect of an organ donor's Hospitalisation during the Policy Period for harvesting of the organ donated to an Insured Person", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", + "source_quote": "GOOD HEALTH INCENTIVE Preventive Health Check Up Expenses of preventive health check-up/ prescribed diagnostic tests will be reimbursed once at the end of a block of three (03) continuous years", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the Company to the Insured where the payments of the costs of treatment undergone by the Insured in accordance with the Policy terms and conditions, are directly made to the Network Provider", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", + "source_quote": "shall issue a pre-authorization letter within an hour to the Hospital after ver", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", + "source_quote": "Treatment taken outside the geographical limits of India", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", + "source_quote": "the Floater Sum Insured in respect of the Insured family, covered on Floater Basis.", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "1% of SI per day", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/bob-national-health__wordings.pdf", + "source_quote": "Room Rent per day shall be payable up to 1% of Sum Insured per day", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-critical-illness__cis.json b/40-data/policy_facts/national-insurance__national-critical-illness__cis.json index 3a729bf67771f95bf43fc0299a5d72ce7e1c0d93..6e709eab58dcf94a8dbd3615e87f8be473846dfa 100644 --- a/40-data/policy_facts/national-insurance__national-critical-illness__cis.json +++ b/40-data/policy_facts/national-insurance__national-critical-illness__cis.json @@ -7,156 +7,186 @@ "value": "NlCHLIP18086V011718", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NlCHLIP18086V011718", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 100000, - 200000, - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 3500000, - 4000000, - 4500000, - 5000000, - 5500000, - 6000000, - 6500000, - 7000000, - 7500000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "within 30 days from the beginning of the policy", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "incepts or manifests during the first 90 days from the inception of the Policy", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "pre-existing condition shall be covered for sum insured mentioned below, if manifested/ diagnosed after four years of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" + }, + "maternity_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", + "source_quote": "Cover for up to 37 Critical Illness on undergoing specified procedure or on diagnosis of an illness of specified severity", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", + "source_quote": "not stated in national-critical-illness__cis.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "critical_illness", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__cis.pdf", + "source_quote": "Type of Insurance Product Benefit", + "_confidence": "medium" + }, + "ayush_coverage": { + "value": true, + "_confidence": "medium", + "source_quote": "Naturopathy" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-critical-illness__prospectus.json b/40-data/policy_facts/national-insurance__national-critical-illness__prospectus.json index 20c6a290ccb8e5a67a40022c26283e86338290f9..f97d723550d4f3d1cbd0422ba1814f0d35755899 100644 --- a/40-data/policy_facts/national-insurance__national-critical-illness__prospectus.json +++ b/40-data/policy_facts/national-insurance__national-critical-illness__prospectus.json @@ -7,156 +7,181 @@ "value": "NlCHLIP18086V011718", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NlCHLIP18086V011718", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Proposer should be between eighteen (18) years and sixty five (65) years", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maximum entry age of any family member is sixty five (65) years", + "_confidence": "high" }, "min_child_entry_age": { - "value": null, + "value": 5, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "iii. Children between the age of five (5) years and eighteen (18) years may be covered, provided parent(s) is/are covered", + "_confidence": "high" }, "sum_insured_options": { - "value": [ - 100000, - 200000, - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 3500000, - 4000000, - 4500000, - 5000000, - 5500000, - 6000000, - 6500000, - 7000000, - 7500000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-critical-illness__prospectus.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured shall be allowed a period of thirty days from date of receipt of the Policy to review the terms and conditions of the Policy", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "incepts or manifests during the first 90 days from the inception of the Policy", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "pre-existing condition shall be covered for sum insured mentioned below, if manifested/ diagnosed after four years of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": null, + "value": 48, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Critical illness resulting from any pre-existing conditions (other than mentioned in the list) coming within the purview of this policy is subject to 4 years waiting period and limit in benefit payable", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__prospectus.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__prospectus.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__prospectus.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__prospectus.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__prospectus.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "period of one year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__prospectus.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__prospectus.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__prospectus.pdf", + "_confidence": "low" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", + "source_quote": "1.1 Critical Illness Benefit The Company shall pay the full sum insured as mentioned in the schedule, provided the insured person survives for the survival period applicable to that Critical Illness.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", + "source_quote": "not stated in national-critical-illness__prospectus.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", + "source_quote": "India only.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "critical_illness", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__prospectus.pdf", + "source_quote": "National Critical Illness Policy", + "_confidence": "medium" + }, + "ayush_coverage": { + "value": true, + "_confidence": "medium", + "source_quote": "Naturopathy" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-critical-illness__wordings.json b/40-data/policy_facts/national-insurance__national-critical-illness__wordings.json index ffdd1b8ab6ffaf087d750e861a10b5939caf16fe..d8e9a2bb545062b588cada117d402932d84e6c43 100644 --- a/40-data/policy_facts/national-insurance__national-critical-illness__wordings.json +++ b/40-data/policy_facts/national-insurance__national-critical-illness__wordings.json @@ -7,156 +7,181 @@ "value": "NlCHLIP18086V011718", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NlCHLIP18086V011718", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-critical-illness__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-critical-illness__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 100000, - 200000, - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 3500000, - 4000000, - 4500000, - 5000000, - 5500000, - 6000000, - 6500000, - 7000000, - 7500000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-critical-illness__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "incepts or manifests during the first 90 days from the inception of the Policy", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "pre-existing condition shall be covered for sum insured mentioned below, if manifested/ diagnosed after four years of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": null, + "value": 48, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "in the list) coming within the purview of this policy is subject to 4 years waiting period and limit in benefit payable.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "period of one year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-critical-illness__wordings.pdf", + "_confidence": "low" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", + "source_quote": "2.1.1 Critical Illness Benefit The Company shall pay the full sum insured as mentioned in the schedule, provided the insured person survives for the survival period applicable to that Critical Illness.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", + "source_quote": "not stated in national-critical-illness__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", + "source_quote": "India only.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "critical_illness", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-critical-illness__wordings.pdf", + "source_quote": "National Critical Illness Policy", + "_confidence": "medium" + }, + "ayush_coverage": { + "value": true, + "_confidence": "medium", + "source_quote": "Naturopathy" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-hospi-cash__cis.json b/40-data/policy_facts/national-insurance__national-hospi-cash__cis.json index 007150b81af21250f802c26360b4d8f33a515d8b..7155f27ea03888057687777c086ac3346c1d15e4 100644 --- a/40-data/policy_facts/national-insurance__national-hospi-cash__cis.json +++ b/40-data/policy_facts/national-insurance__national-hospi-cash__cis.json @@ -7,138 +7,195 @@ "value": "NICHLIP25046V012425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25046V012425", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 500, - 1000, - 2000, - 3000, - 5000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "free_look_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": 36, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", + "source_quote": "AYUSH Hospi Cash Other Benefits: a", + "_confidence": "medium" + }, + "maternity_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", + "source_quote": "Optional Covers: a. Critical Illness Hospi Cash b. Worldwide Hospi Cash", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", + "source_quote": "Optional Covers: a. Critical Illness Hospi Cash b. Worldwide Hospi Cash", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", + "source_quote": "not stated in national-hospi-cash__cis.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", + "source_quote": "geographical limits of India except for Optional Cover Worldwide Hospi Cash 5", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "other", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__cis.pdf", + "source_quote": "Type of Insurance Product/ Policy Benefit", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-hospi-cash__prospectus.json b/40-data/policy_facts/national-insurance__national-hospi-cash__prospectus.json index 17165131cc02792e670e26ea5d3f5fb5bfbc769e..e869cc0a29718cc93543f9b6a5429027b11b403c 100644 --- a/40-data/policy_facts/national-insurance__national-hospi-cash__prospectus.json +++ b/40-data/policy_facts/national-insurance__national-hospi-cash__prospectus.json @@ -7,31 +7,29 @@ "value": "NICHLIP25046V012425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25046V012425", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry age of Proposer should be between eighteen (18) years and sixty five (65) years", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maximum entry age of any family member is sixty five (65) years", + "_confidence": "high" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-hospi-cash__prospectus.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -43,102 +41,163 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Daily Cash Amount of ₹ 500, 1000, 2000, 3000, 5000 per day", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period a) Hospitalisation for treatment of any illness within thirty (30) days from the first policy commencement date", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases a) Hospitalisation for treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days/ one year/ two year/ three years (as specified against specific disease/ procedure)", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__prospectus.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__prospectus.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__prospectus.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__prospectus.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__prospectus.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "period of 1 year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__prospectus.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-hospi-cash__prospectus.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - } -} + "source_quote": "not stated in national-hospi-cash__prospectus.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", + "source_quote": "1.2.1.4 AYUSH Hospi Cash In case of AYUSH Treatment, the Company shall pay 100% of the Daily Cash Amount mentioned in the schedule for every 24 hours of hospitalization only in an AYUSH Hospital.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", + "source_quote": "1.2.3.2 Worldwide Hospi Cash In the event of the Insured Person getting Hospitalized (In-patient and/ or ICU) for treatment in any country other than India, the Company shall pay to the Insured Person, 200% of the Daily Cash Amount mentioned in t", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", + "source_quote": "1.2.3.1 Critical Illness Hospi Cash In the event of the Insured Person getting Hospitalized (In-patient and/ or ICU) for treatment of any of the 37 listed Critical Illnesses, the Company shall pay to the Insured Person 100% of the Daily Cash", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", + "source_quote": "not stated in national-hospi-cash__prospectus.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "other", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-hospi-cash__prospectus.pdf", + "source_quote": "Daily Cash Amount", + "_confidence": "medium" + }, + "maternity_coverage": null +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-mediclaim-plus__cis.json b/40-data/policy_facts/national-insurance__national-mediclaim-plus__cis.json index 1fe28cba27255cf75b465c6d975564ec191adbb6..abbe9a06791019367e1f89108f9d4655bbc1c625 100644 --- a/40-data/policy_facts/national-insurance__national-mediclaim-plus__cis.json +++ b/40-data/policy_facts/national-insurance__national-mediclaim-plus__cis.json @@ -7,148 +7,237 @@ "value": "NICHLIP25038V032425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25038V032425", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 200000, - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 4000000, - 5000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "within 30 days from the beginning of the policy", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": 36, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, + "value": 140, + "unit": "count", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "d. Day care procedures - Expenses for 140+ day care procedures, listed in the policy, which require less than 24 hours hospitalisation", + "_confidence": "high" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "10% Co-payment on each admissible claim", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room - Up to 1% of SI per day ICU - Up to 2% of SI per day subject to max. of INR 15,000 per day", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", + "source_quote": "e. AYUSH f. Organ donor's medical expenses g. Maternity", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", + "source_quote": "Maternity Up to INR 30,000 for normal delivery and INR 50,000 for caesarean section", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", + "source_quote": "e. AYUSH f. Organ donor's medical expenses g. Maternity", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", + "source_quote": "Health Check Up Expenses of health check up shall be reimbursed (irrespective of past claims) at the end of a block of two continuous policy period", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", + "source_quote": "Optional covers a. Critical illness b. Outpatient treatment", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", + "source_quote": "Cashless Facility can be availed, if TPA service is opted", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", + "source_quote": "subject to maximum of 50% of the sum insured", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", + "source_quote": "not stated in national-mediclaim-plus__cis.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "Plan A: 1% SI/day; Plan B: Rs 15,000/day or actual; Plan C: Rs 20,000/day or actual", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", + "source_quote": "Room - Up to 1% of SI per day ICU - Up to 2% of SI per day subject to max. of INR 15,000 per day", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__cis.pdf", + "source_quote": "5% (five percent) of sum insured", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-mediclaim-plus__prospectus.json b/40-data/policy_facts/national-insurance__national-mediclaim-plus__prospectus.json index 0c1766e385578aa2e31de1e41ffaa0edf16225fb..b7b267ec607f88240618ada4a2bb598182ecf35f 100644 --- a/40-data/policy_facts/national-insurance__national-mediclaim-plus__prospectus.json +++ b/40-data/policy_facts/national-insurance__national-mediclaim-plus__prospectus.json @@ -7,148 +7,239 @@ "value": "NICHLIP25038V032425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25038V032425", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__prospectus.pdf", + "_confidence": "low" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maximum entry age of any individual is 65(sixty five) years", + "_confidence": "high" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__prospectus.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 200000, - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 4000000, - 5000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__prospectus.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period (Excl 03) a) Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Excl 01) a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days/ one year/ two year/ three years (as specified against specific disease/ procedure)", + "_confidence": "medium" }, "maternity_waiting_months": { - "value": null, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The female Insured Person should have been continuously covered for at least 24 months", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__prospectus.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__prospectus.pdf", + "_confidence": "low" }, "day_care_treatments_count": { "value": null, - "unit": null, + "unit": "count", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim-plus__prospectus.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "10% Co-payment on each admissible claim", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room/ ICU charges Room - Up to 1% of SI per day ICU - Up to 2% of SI per day subject to max. of INR 15,000 per day", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "period of one year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim-plus__prospectus.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim-plus__prospectus.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim-plus__prospectus.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", + "source_quote": "1.2.5 AYUSH Treatment The Company shall indemnify Medical Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Period up to the limit of Sum Insured", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", + "source_quote": "1.2.7 Maternity The Company shall indemnify Maternity Expenses as described below for any female Insured Person, and also Pre-Natal and Post-Natal Hospitalisation expenses per delivery", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", + "source_quote": "New Born Baby shall be covered only if specifically included in the Policy mid-term and requisite premium paid to the Company.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", + "source_quote": "1.2.6 Organ Donor's Medical Expenses The Company shall indemnify the Medical Expenses incurred in respect of an organ donor's Hospitalisation during the Policy Period for harvesting of the organ donated", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", + "source_quote": "1.4.2 Health Check Up Expenses of health check up shall be reimbursed (irrespective of past claims) at the end of a block of two continuous policy period, provided the policy has been continuously renewed with the company without a break.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", + "source_quote": "The policy also provides optional covers for Critical Illness and Out-patient Treatment.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", + "source_quote": "Cashless facility is available if opted for TPA service, subject to prior approval by the TPA", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", + "source_quote": "not be accumulated in excess of 50% of the Basic Sum Insured", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", + "source_quote": "individual sum insured basis", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Plan-tiered (1% SI in A; Rs 15-20K in B/C)", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", + "source_quote": "Room/ ICU charges Room - Up to 1% of SI per day ICU - Up to 2% of SI per day subject to max. of INR 15,000 per day", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__prospectus.pdf", + "source_quote": "cumulative bonus allowed shall be an amount equal to 5% (five percent) of sum insured", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-mediclaim-plus__wordings.json b/40-data/policy_facts/national-insurance__national-mediclaim-plus__wordings.json index 5a8da6b5107517ab2fdf217c0a477c1e28d2e72a..d38181fe455222f97eb5a6080d9e3ade7c548c7c 100644 --- a/40-data/policy_facts/national-insurance__national-mediclaim-plus__wordings.json +++ b/40-data/policy_facts/national-insurance__national-mediclaim-plus__wordings.json @@ -7,148 +7,239 @@ "value": "NICHLIP25038V032425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25038V032425", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 200000, - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 4000000, - 5000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days Waiting Period (Excl 03) a) Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Excl 01) a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days/ one year/ two year/ three years (as specified against specific disease/ procedure)", + "_confidence": "medium" }, "maternity_waiting_months": { - "value": null, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The female Insured Person should have been continuously covered for at least 24 months", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim-plus__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { "value": null, - "unit": null, + "unit": "count", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim-plus__wordings.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "10% Co-payment on each admissible claim", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room - Up to 1% of SI per day ICU - Up to 2% of SI per day subject to max. of INR 15,000 per day", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "period of one year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim-plus__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim-plus__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim-plus__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", + "source_quote": "3.1.5 AYUSH Treatment: The Company shall indemnify Medical Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Period up to the", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", + "source_quote": "3.1.7 Maternity The Company shall indemnify Maternity Expenses as described below for any female Insured Person, and also Pre-Natal and Post- Natal Hospitalisation expenses per delivery", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", + "source_quote": "New Born Baby shall be covered only if specifically included in the Policy mid-term and requisite premium paid to the Company.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", + "source_quote": "3.1.6 Organ Donor's Medical Expenses The Company shall indemnify the Medical Expenses incurred in respect of an organ donor's Hospitalisation during the Policy Period for harvesting of the organ donated", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", + "source_quote": "Health Check Up Expenses of health check up shall be reimbursed", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", + "source_quote": "7.1 Critical illness Subject otherwise to the terms, definitions, exclusions, and conditions of the policy", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", + "source_quote": "availing cashless facility", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", + "source_quote": "not be accumulated in excess of 50% of the Basic Sum Insured", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", + "source_quote": "not stated in national-mediclaim-plus__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "Plan A: 1% SI/day; Plan B: Rs 15K/day or actual; Plan C: Rs 20K/day or actual", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", + "source_quote": "Room - Up to 1% of SI per day ICU - Up to 2% of SI per day subject to max. of INR 15,000 per day", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim-plus__wordings.pdf", + "source_quote": "cumulative bonus allowed shall be an amount equal to 5% (five percent) of sum insured", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-mediclaim__cis.json b/40-data/policy_facts/national-insurance__national-mediclaim__cis.json index b445ada76387202c986ea79d0a7065c79c619aa2..bbd2d4ef11124dd02a5afc585398686b806bb5d8 100644 --- a/40-data/policy_facts/national-insurance__national-mediclaim__cis.json +++ b/40-data/policy_facts/national-insurance__national-mediclaim__cis.json @@ -7,143 +7,237 @@ "value": "NICHLIP25036V082425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25036V082425", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 100000, - 200000, - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "within 30 days from the beginning of the policy", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": 36, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 45, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-hospitalisation (treatment prior to admission in hospital) of 45 days i", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-hospitalisation (treatment after discharge from hospital) within 60 days from date of discharge j", + "_confidence": "medium" }, "day_care_treatments_count": { "value": null, - "unit": null, + "unit": "procedures", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "10% Co-payment on each admissible claim", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "a. Room Rent - Up to 1% of SI, subject to max of INR 10,000 per day", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", + "source_quote": "k. AYUSH Treatment l. HIV/ AIDS Treatment m. Mental Illness Treatment n. Organ Donor's Medical Expenses", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", + "source_quote": "r. Maternity (Excl 18)", + "_confidence": "medium" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", + "source_quote": "k. AYUSH Treatment l. HIV/ AIDS Treatment m. Mental Illness Treatment n. Organ Donor's Medical Expenses", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", + "source_quote": "Other Benefit: Reinstatement of Basic Sum Insured (available to Basic SI of ₹ 6L and above)", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", + "source_quote": "aa. Domiciliary Hospitalization & Out Patient Department (OPD) treatment", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", + "source_quote": "Good Health Incentive: a. Cumulative Bonus (CB) b. Preventive Health Check Up", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", + "source_quote": "Type of Insurance Product Indemnity", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "1% of SI per day, max Rs. 10,000/day; total per illness 25% of SI", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", + "source_quote": "a. Room Rent - Up to 1% of SI, subject to max of INR 10,000 per day", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__cis.pdf", + "source_quote": "not stated in national-mediclaim__cis.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-mediclaim__prospectus.json b/40-data/policy_facts/national-insurance__national-mediclaim__prospectus.json index 0bc955581aae89310cd52e535194e40839862ffa..eaed8a4c14f048f50ed6a5bb5c9d13eed4910db0 100644 --- a/40-data/policy_facts/national-insurance__national-mediclaim__prospectus.json +++ b/40-data/policy_facts/national-insurance__national-mediclaim__prospectus.json @@ -7,143 +7,226 @@ "value": "NICHLIP25036V082425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25036V082425", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry age of Proposer should be between eighteen (18) years and sixty five (65) years", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maximum entry age of any family member is sixty five (65) years", + "_confidence": "high" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim__prospectus.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 100000, - 200000, - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim__prospectus.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period (Excl 03) a) Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Excl 01) a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days/ one year/ two year/ three years (as specified against specific disease/ procedure)", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim__prospectus.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 45, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Up to forty five (45) days immediately before the Insured Person is Hospitalised", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Up to sixty (60) days immediately after the Insured Person is discharge", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "10% Co-payment on each admissible claim", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent per day shall be payable up to 1% of Sum Insured subject to max of ₹ 10,000 per day", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The Policy can only be issued for a period of one (01) year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim__prospectus.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim__prospectus.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim__prospectus.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", + "source_quote": "1.3.2 AYUSH Treatment The Company shall indemnify Medical Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Period up to the limit of S", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", + "source_quote": "1.3.5 Organ Donor's Medical Expenses The Company shall indemnify the Medical Expenses incurred in respect of an organ donor's Hospitalisation during the Policy Period for harvesting of the organ donated to an Insured Person", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", + "source_quote": "1.4.1 Reinstatement of Basic Sum Insured (available to Basic Sum Insured of ₹ 6L and above)", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", + "source_quote": "1.5.2 Preventive Health Check Up Expenses of preventive health check-up/ prescribed diagnostic tests will be reimbursed once at the end of a block of four (04) continuous Policy Periods provided no claims are reported and admitted during the block", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", + "source_quote": "Cashless Facility is available only if TPA service is opted in the Policy", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", + "source_quote": "not be accumulated in excess of 50% of the Basic Sum Insured", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", + "source_quote": "issued on Individual Basis", + "_confidence": "medium" + }, + "maternity_coverage": null, + "room_rent_capping": { + "value": "1% SI/day, max Rs 10,000/day; 25% SI per illness", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", + "source_quote": "Room Rent per day shall be payable up to 1% of Sum Insured subject to max of ₹ 10,000 per day", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__prospectus.pdf", + "source_quote": "Increase by 5% of Basic SI in respect of each claim free", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-mediclaim__wordings.json b/40-data/policy_facts/national-insurance__national-mediclaim__wordings.json index 28c3ad325bbc6d0ecda7d436102983eae8b077e3..ca7c0854f9fe156ebfa182225dd613c6f1d93ee5 100644 --- a/40-data/policy_facts/national-insurance__national-mediclaim__wordings.json +++ b/40-data/policy_facts/national-insurance__national-mediclaim__wordings.json @@ -7,143 +7,226 @@ "value": "NICHLIP25036V082425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25036V082425", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 100000, - 200000, - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-mediclaim__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period (Excl 03) a) Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Excl 01) a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days/ one year/ two year/ three years (as specified against specific disease/ procedure)", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 45, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Up to forty five (45) days immediately before the Insured Person is Hospitalised", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Up to sixty (60) days immediately after the Insured Person is discharge", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "10% Co-payment on each admissible claim", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent per day shall be payable up to 1% of Sum Insured subject to max of ₹ 10,000 per day", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy Period means period of one (01) year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-mediclaim__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", + "source_quote": "3.9.2 AYUSH Treatment The Company shall indemnify Medical Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Period up to the limit of S", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", + "source_quote": "3.9.5 Organ Donor's Medical Expenses The Company shall indemnify the Medical Expenses incurred in respect of an organ donor's Hospitalisation during the Policy Period for harvesting of the organ donated to an Insured Person", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", + "source_quote": "3.10.1 Reinstatement of Basic Sum Insured (available to Basic Sum Insured of ₹ 6L and above)", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", + "source_quote": "3.11.2 Preventive Health Check Up Expenses of preventive health check-up/ prescribed diagnostic tests will be reimbursed once at the end of a block of four (04) continuous Policy Periods provided no claims are reported", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", + "source_quote": "availing Cashless Facility", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", + "source_quote": "not be accumulated in excess of 50% of the Basic Sum Insured", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", + "source_quote": "not stated in national-mediclaim__wordings.pdf", + "_confidence": "low" + }, + "maternity_coverage": null, + "room_rent_capping": { + "value": "1% SI/day max Rs 10,000", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", + "source_quote": "Room Rent per day shall be payable up to 1% of Sum Insured subject to max of ₹ 10,000 per day", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-mediclaim__wordings.pdf", + "source_quote": "Increase by 5% of Basic SI in respect of each claim free", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-parivar-plus__cis.json b/40-data/policy_facts/national-insurance__national-parivar-plus__cis.json index 598f1ce36a0ca4af5b172f5e4838f171cf79f712..68325851a949e309b24e1335501203c0fec541a9 100644 --- a/40-data/policy_facts/national-insurance__national-parivar-plus__cis.json +++ b/40-data/policy_facts/national-insurance__national-parivar-plus__cis.json @@ -7,148 +7,237 @@ "value": "NICHLIP25039V032425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25039V032425", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-parivar-plus__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-parivar-plus__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-parivar-plus__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 200000, - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 4000000, - 5000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-parivar-plus__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-parivar-plus__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "within 30 days from the beginning of the policy", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-parivar-plus__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": 36, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-parivar-plus__cis.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-parivar-plus__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-parivar-plus__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-hospitalisation (treatment prior to admission in hospital) of 30 days c", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-hospitalisation (treatment after discharge from hospital) within 60 days from date of discharge d", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Copayment of 5% if insured paying premium as per Zone II", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", + "source_quote": "f. AYUSH Treatment g. Organ donor's medical expenses h. Hospital Cash for maximum of 5 days", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", + "source_quote": "Maternity (including Baby from Birth Cover) (per insured person, in a policy year) Up to INR 30,000 for normal delivery and INR 50,000 for caesarean section", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", + "source_quote": "Maternity (including Baby from Birth Cover) (per insured person, in a policy year) Up to INR 30,000 for normal delivery and INR 50,000 for caesarean section", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", + "source_quote": "f. AYUSH Treatment g. Organ donor's medical expenses h. Hospital Cash for maximum of 5 days", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", + "source_quote": "limit: Reinstatement of Sum Insured due to Road Traffic Accident", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", + "source_quote": "c. Domiciliary Hospitalisation e. Procedures requiring less than 24 hours of hospitalization (day care). f. AYUSH Treatment", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", + "source_quote": "Good Health Incentives: a. No Claim Discount (NCD) b. Health Check Up", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", + "source_quote": "Optional Covers: a. Pre-existing Diabetes / Hypertension b. Out-patient treatment c. Critical illness", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", + "source_quote": "Cashless Facility can be availed, if TPA service is opted", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", + "source_quote": "Floater Sum Insured", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Plan A: 1% SI/day per insured or actual; Plan B/C: actual", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__cis.pdf", + "source_quote": "Room/ ICU Charges (per day per insured person) Room - Up to 1% of SI or actual, whichever is lower", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-parivar-plus__prospectus.json b/40-data/policy_facts/national-insurance__national-parivar-plus__prospectus.json index b9538d6d9c39c7464a22dfd718e66ab7c6ee8ba7..f1dffdc06ba897704eac6485568068e2ff7d8938 100644 --- a/40-data/policy_facts/national-insurance__national-parivar-plus__prospectus.json +++ b/40-data/policy_facts/national-insurance__national-parivar-plus__prospectus.json @@ -7,144 +7,251 @@ "value": "NICHLIP25039V032425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25039V032425", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "between the age of eighteen years and sixty five years", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maximum entry age of any family member is sixty five years", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Children between the age of three months and eighteen years may be covered", + "_confidence": "medium" }, "sum_insured_options": { - "value": [ - 600000, - 700000, - 800000, - 900000, - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 4000000, - 5000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-parivar-plus__prospectus.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period (Excl 03) a) Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Excl 01) a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days/ one year/ two year/ three years (as specified against specific disease/ procedure)", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity (including Baby from Birth Cover) (per insured person, in a policy year, waiting period of 2 years applies) Up to INR 30,000 for normal de", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre Hospitalisation 30 days", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post Hospitalisation 60 days", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Where treatment has been taken in a zone, other than the one for which ** premium has been paid, the claim shall be subject to\ncopayment.", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__prospectus.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__prospectus.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__prospectus.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__prospectus.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__prospectus.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "AYUSH Treatment The Company shall indemnify Medical Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Period up to the limit of Sum Insured as specified in the Policy Schedule in any AYUSH Hospital.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "1.2.14 Maternity The Company shall indemnify Maternity Expenses as described below for any female Insured Person, and also Pre-Natal and Post-Natal Hospitalisation expenses per delivery, including expenses for necessary vaccination for New Born Baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "New Born Baby shall be automatically covered from birth under the Sum Insured available to the mother during the corresponding Policy Period, for up to 3 months of age.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "Organ Donor's Medical Expenses The Company shall indemnify the Medical Expenses incurred in respect of an organ donor's Hospitalisation during the Policy Period for harvesting of the organ donated to an Insured Person", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "Reinstatement of Sum Insured due to Road Traffic Accident In the event of the sum insured being exhausted on account of claims arising out of any injury due to road traffic accident during a policy year", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "1.2.4 Domiciliary Hospitalisation The Company shall indemnify the medical expenses incurred under domiciliary hospitalization, including Pre Hospitalisation expenses and Post Hospitalisation expenses up to the limit mentioned in the Table of Benefits.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "Health Check Up Expenses of health check up shall be reimbursed (irrespective of past claims) at the end of a block of two continuous policy years, provided the Policy has been continuously renewed with the Company without a break.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "Pre-existing Diabetes and/or Hypertension, Outpatient Treatment and Critical Illness are provided as Optional Covers.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "Cashless facility is available if opted for TPA service, subject to prior approval by the TPA", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "not stated in national-parivar-plus__prospectus.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "pre-authorization letter within an hour to the hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "Floater Sum Insured", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Plan A: per Table of Benefits per-day limit; Plan B/C: higher caps. No cap if treated in PPN packaged listed procedure.", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "1.2.1.1 Limit for Room Charges and Intensive Care Unit Charges Room charges and intensive care unit charges per day shall be payable up to the limit as shown in the Table of Benefits, for Plan A only.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__prospectus.pdf", + "source_quote": "not stated in national-parivar-plus__prospectus.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-parivar-plus__wordings.json b/40-data/policy_facts/national-insurance__national-parivar-plus__wordings.json index 3598ad8ca50ae3f2b8281b4996155198a4a5fcc3..7ab4ddf310ef68a611d5f07ac5f77236d833401e 100644 --- a/40-data/policy_facts/national-insurance__national-parivar-plus__wordings.json +++ b/40-data/policy_facts/national-insurance__national-parivar-plus__wordings.json @@ -7,144 +7,251 @@ "value": "NICHLIP25039V032425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25039V032425", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "between the age of eighteen years and sixty five years", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "between the age of eighteen years and sixty five years", + "_confidence": "high" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-parivar-plus__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 600000, - 700000, - 800000, - 900000, - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 4000000, - 5000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-parivar-plus__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period (Excl 03) a) Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Excl 01) a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days/ one year/ two year/ three years (as specified against specific disease/ procedure)", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity (including Baby from Birth Cover) (per insured person, in a policy year, waiting period of 2 years applies) Up to INR 30,000 for normal de", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre Hospitalisation 30 days", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post Hospitalisation 60 days", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-parivar-plus__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "AYUSH Treatment The Company shall indemnify Medical Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Period up to the limit of Sum Insured as specified in the Policy Schedule in any AYUSH Hospital.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "3.1.14 Maternity The Company shall indemnify Maternity Expenses as described below for any female Insured Person, and also Pre-Natal and Post- Natal Hospitalisation expenses per delivery, including expenses for necessary vaccination for New Born Baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "New Born Baby shall be automatically covered from birth under the Sum Insured available to the mother during the corresponding Policy Period, for up to 3 months of age.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "Organ Donor's Hospitalisation Expenses The Company shall indemnify the Medical Expenses incurred in respect of an organ donor's Hospitalisation during the Policy Period for harvesting of the organ donated to an Insured Person", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "Reinstatement of Sum Insured due to Road Traffic Accident In the event of the sum insured being exhausted on account of claims arising out of any injury due to road traffic accident during a policy year", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "2.18 Domiciliary Hospitalisation means medical treatment for an illness /injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "Health Check Up Expenses of health check up shall be reimbursed (irrespective of past claims) at the end of a block of two continuous policy years, provided the Policy has been continuously renewed with the Company without a break.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "7.3 Critical Illness Subject otherwise to the terms, definitions, exclusions, and conditions of the Policy the Company shall pay the benefit amount, as stated in the schedule", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "Cashless facility can be availed, if TPA service is opted", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "not stated in national-parivar-plus__wordings.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "pre-authorization letter within an hour to the hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "Floater Sum Insured", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Plan A only: per-day limit as Table of Benefits; Plan B and C: higher caps. No cap if PPN packaged listed procedure.", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "3.1.1.1 Limit for Room Charges and Intensive Care Unit Charges Room charges and intensive care unit charges per day shall be payable up to the limit as shown in the Table of Benefits, for Plan A only.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-parivar-plus__wordings.pdf", + "source_quote": "not stated in national-parivar-plus__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-senior-citizen__cis.json b/40-data/policy_facts/national-insurance__national-senior-citizen__cis.json index ac063b239110cf23ca569840a189ac13125c8ed2..242c71e8515bbac6fdbd84f6f450e8fe79b38c52 100644 --- a/40-data/policy_facts/national-insurance__national-senior-citizen__cis.json +++ b/40-data/policy_facts/national-insurance__national-senior-citizen__cis.json @@ -7,132 +7,244 @@ "value": "NICHLIP25040V042425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25040V042425", + "_confidence": "high" }, "min_entry_age": { - "value": 60, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 80, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "within 30 days from the beginning of the policy", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": 24, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-hospitalisation (treatment prior to admission in hospital) of 30 days c", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-hospitalisation (treatment after discharge from hospital) within 60 days from date of discharge d", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 18.5, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Copayment of 18.50% if insured paying premium as per Zone II but availing treatment in Zone I", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room - 1% of SI per day subject to maximum of INR 5,000 per day", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", + "source_quote": "f. AYUSH Treatment g. HIV/ AIDS h. Mental Illness i. Organ donor's medical expenses", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", + "source_quote": "o. Maternity (Excl 18)", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", + "source_quote": "f. AYUSH Treatment g. HIV/ AIDS h. Mental Illness i. Organ donor's medical expenses", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", + "source_quote": "Reinstatement of Sum Insured if exhausted due to Road Traffic Accident", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", + "source_quote": "c. Domiciliary Hospitalisation e. Procedures requiring less than 24 hours of hospitalization (day care). f. AYUSH Treatment", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", + "source_quote": "Good Health Incentives: a. Cumulative Bonus (CB) b. Preventive Health Check Up", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", + "source_quote": "Optional Covers: a. Pre-existing Diabetes and/or Hypertension b. Out-patient treatment c. Critical illness d. Personal Accident", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", + "source_quote": "Cashless Facility can be availed, if TPA service is opted", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "senior_citizen", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", + "source_quote": "Senior Citizen Mediclaim Policy", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Plan A: 1% of SI per day subject to max INR 5,000. Plan B: 2% of SI per day subject to max INR 10,000. No overall limit for Plan B.", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", + "source_quote": "Room - 1% of SI per day subject to maximum of INR 5,000 per day", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__cis.pdf", + "source_quote": "not stated in national-senior-citizen__cis.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-senior-citizen__prospectus.json b/40-data/policy_facts/national-insurance__national-senior-citizen__prospectus.json index ab807355981c5ad4e22278f8731fd305f6987ef2..cf2297f6b7735a0c0aec124b811c34b43be2b08c 100644 --- a/40-data/policy_facts/national-insurance__national-senior-citizen__prospectus.json +++ b/40-data/policy_facts/national-insurance__national-senior-citizen__prospectus.json @@ -7,132 +7,257 @@ "value": "NICHLIP25040V042425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25040V042425", + "_confidence": "high" }, "min_entry_age": { "value": 60, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Self only aged between 60 to 80 years at inception", + "_confidence": "high" }, "max_entry_age": { "value": 80, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Self only aged between 60 to 80 years at inception", + "_confidence": "high" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__prospectus.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": null, + "value": [ + 100000, + 200000, + 300000, + 400000, + 500000, + 600000, + 700000, + 800000, + 900000, + 1000000 + ], "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Plan A – 10 slabs, INR 1,00,000 to INR 10,00,000 in multiple of INR 1,00,000", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the Policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period (Excl 03) a) Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Excl 01) a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of twenty four (24) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "until the expiry of twenty four (24) months", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__prospectus.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre hospitalisation 30 days", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post hospitalisation 60 days", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 18.5, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "subject to a Co-payment of 18.50%", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "1.2.1.1 Limit for Room Charges and Intensive Care Unit Charges under Plan A Room charges and intensive care unit charges per day shall be payable up to the limit as shown in the Table of Benefits.", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The Policy can be issued for a period of one (01) year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__prospectus.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__prospectus.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__prospectus.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_quote": "1.2.6 AYUSH Treatment The Company shall indemnify the Medical Expenses for In-patient Care, Pre-Hospitalisation expenses and Post-Hospitalisation expenses, incurred for AYUSH treatment, provided the treatment is undergone in an AYUSH Hospital.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_quote": "Maternity (Excl 18) i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_quote": "1.2.9 Organ Donor's Medical Expenses The Company shall indemnify the Medical Expenses incurred in respect of an organ donor's Hospitalisation during the Policy Period for harvesting of the organ donated to an Insured Person", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_quote": "Reinstatement of Sum Insured if exhausted due to Road Traffic Accident In the event of available sum insured in respect of the insured/ insured person being exhausted anytime during the policy period", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_quote": "1.2.4 Domiciliary Hosptalisation The Company shall indemnify the medical expenses incurred under domiciliary hospitalisation, including pre hospitalisation expenses and post hospitalisation expenses, up to the limit as shown in the Tab", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_quote": "1.4.2 Preventive Health Check Up 1.4.2.1 Applicable to Plan A Expenses of prescribed diagnostic tests only with respect to the Insured Person(s), shall be reimbursed at the end of a block of two continuous Policy Periods", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_quote": "Pre-existing Diabetes and/or Hypertension, Outpatient", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_quote": "Cashless facility is available, if opted for TPA service, subject to prior approval by the TPA", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_quote": "maximum of 50% (fifty percent) of the Sum Insured", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "senior_citizen", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_quote": "Senior Citizen Mediclaim Policy", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Plan A: 1% of SI per day (max INR 5,000). Plan B: 2% of SI per day (max INR 10,000). No cap if PPN packaged procedure.", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_quote": "1.2.1.1 Limit for Room Charges and Intensive Care Unit Charges under Plan A Room charges and intensive care unit charges per day shall be payable up to the limit as shown in the Table of Benefits.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__prospectus.pdf", + "source_quote": "Cumulative Bonus allowed shall be an amount equal to 5% (five percent) of Sum Insured", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-senior-citizen__wordings.json b/40-data/policy_facts/national-insurance__national-senior-citizen__wordings.json index f3792299f028cbee0699326b64e4b024e0a6195d..c6df46c3946c781a06790a481eeebb84ca4cbe80 100644 --- a/40-data/policy_facts/national-insurance__national-senior-citizen__wordings.json +++ b/40-data/policy_facts/national-insurance__national-senior-citizen__wordings.json @@ -7,132 +7,257 @@ "value": "NICHLIP25040V042425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25040V042425", + "_confidence": "high" }, "min_entry_age": { "value": 60, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "attained the age of sixty years or above", + "_confidence": "high" }, "max_entry_age": { - "value": 80, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-senior-citizen__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": null, + "value": [ + 100000, + 200000, + 300000, + 400000, + 500000, + 600000, + 700000, + 800000, + 900000, + 1000000 + ], "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Sum Insured INR 1L to 10L INR 1L to 10L", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the Policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days Waiting Period (Excl 03) a) Expenses related to the treatment of any Illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Excl 01) a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of twenty four (24) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "until the expiry of twenty four (24) months", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalisation expenses and ambulance charges Within 30 days of date of discharge from Hospital Reimbursement of post Ho", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-Hospitalisation 60 days immediately after discharge 60 days immediately after disch", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 18.5, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "subject to a Co-payment of 18.50%", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "3.1.1.1 Limit for Room Charges and Intensive Care Unit Charges under Plan A Room charges and intensive care unit charges per day shall be payable up to the limit as shown in the Table of Benefits.", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "period of one year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-senior-citizen__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", + "source_quote": "2.5 AYUSH Treatment refers to the medical and / or Hospitalisation treatments given Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy systems.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", + "source_quote": "Maternity (Excl 18) i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during Hospitalisation) except ectopic pregnancy", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", + "source_quote": "Organ Donor's Medical Expenses The Company shall indemnify the Medical Expenses incurred in respect of an organ donor's Hospitalisation during the Policy Period for harvesting of the organ donated to an Insured Person", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", + "source_quote": "Reinstatement of Sum Insured if exhausted due to Road Traffic Accident In the event of available Sum Insured in respect of the Insured/ Insured Person being exhausted", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", + "source_quote": "2.19 Domiciliary Hospitalisation means medical treatment for an Illness/disease/Injury which in the normal course would require care and treatment at a Hospital but is actually taken while confined at home", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", + "source_quote": "3.3.2 Preventive Health Check Up 3.3.2.1. Applicable to Plan A Expenses of prescribed diagnostic tests only with respect to the Insured Person(s), shall be reimbursed at the end of a block of two continuous Policy Periods", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", + "source_quote": "8.3 CRITICAL ILLNESS Subject otherwise to the terms, definitions, exclusions, conditions contained herein and on payment of additional premium", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", + "source_quote": "Cashless Facility can be availed, if TPA service is opted", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", + "source_quote": "maximum of 50% (fifty percent) of the Sum Insured", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "senior_citizen", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", + "source_quote": "Senior Citizen Mediclaim Policy", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Plan A: 1% of SI/day max INR 5,000. Plan B: 2% of SI/day max INR 10,000.", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", + "source_quote": "3.1.1.1 Limit for Room Charges and Intensive Care Unit Charges under Plan A Room charges and intensive care unit charges per day shall be payable up to the limit as shown in the Table of Benefits.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-senior-citizen__wordings.pdf", + "source_quote": "Cumulative Bonus allowed shall be an amount equal to 5% (five percent) of Sum Insured", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-super-top-up__cis.json b/40-data/policy_facts/national-insurance__national-super-top-up__cis.json index 7d6b45d7f95a77fafbee0da4d3fe0115a0255d5d..7d9ef43140bfba46cff796f8babcf18d16de682d 100644 --- a/40-data/policy_facts/national-insurance__national-super-top-up__cis.json +++ b/40-data/policy_facts/national-insurance__national-super-top-up__cis.json @@ -7,143 +7,237 @@ "value": "NICHLIP24154V042324", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP24154V042324", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 300000, - 500000, - 700000, - 800000, - 1000000, - 1500000, - 2000000, - 3000000, - 5000000, - 8000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "within 30 days from the beginning of the policy", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": 12, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { - "value": 36, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-hospitalisation (treatment prior to admission in hospital) of 30 days c", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-hospitalisation (treatment after discharge from hospital) within 60 days from date of discharge d", + "_confidence": "medium" }, "day_care_treatments_count": { "value": null, - "unit": null, + "unit": "count", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", + "source_quote": "e. AYUSH Treatment f. Organ donor's medical expenses g. HIV/ AIDS h. Morbid Obesity Treatment i. Maternity", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", + "source_quote": "e. AYUSH Treatment f. Organ donor's medical expenses g. HIV/ AIDS h. Morbid Obesity Treatment i. Maternity", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", + "source_quote": "e. AYUSH Treatment f. Organ donor's medical expenses g. HIV/ AIDS h. Morbid Obesity Treatment i. Maternity", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", + "source_quote": "i. Out Patient Department (OPD) or Domiciliary treatment", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", + "source_quote": "Cashless facility for treatment in Network Hospital", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", + "source_quote": "within an hour to the Hospital", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", + "source_quote": "Super Top Up Mediclaim Policy", + "_confidence": "medium" + }, + "deductible_amount": { + "value": null, + "unit": "INR", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": null, + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__cis.pdf", + "source_quote": "not stated in national-super-top-up__cis.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-super-top-up__prospectus.json b/40-data/policy_facts/national-insurance__national-super-top-up__prospectus.json index 66800cd309c63d962b48cdb4426ec79dcf5bf814..9c16fa143e1b3b3d81b64de314a4655ac8b48a27 100644 --- a/40-data/policy_facts/national-insurance__national-super-top-up__prospectus.json +++ b/40-data/policy_facts/national-insurance__national-super-top-up__prospectus.json @@ -7,143 +7,239 @@ "value": "NICHLIP24154V042324", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP24154V042324", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry age of Proposer should be between eighteen years and sixty five years", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maximum entry age of any family member is sixty five years", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Children above the entry age of three months may be covered for the first time", + "_confidence": "medium" }, "sum_insured_options": { - "value": [ - 300000, - 500000, - 700000, - 800000, - 1000000, - 1500000, - 2000000, - 3000000, - 5000000, - 8000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__prospectus.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__prospectus.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period (Excl 03) a) Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 12, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__prospectus.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "shall be excluded until the expiry of 90 days/ one year/ two year (as specified against specific disease/ procedure) of continuous coverage", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity Expenses Covered up to Sum Insured after waiting period of 3 years, No Sub Limit Modern Treatment (12 nos)", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-hospitalisation 30 days immediately before hospitalisation Post-hospitalisation 60", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-hospitalisation 60 days immediately after discharge Day Care Procedures 140+ day ca", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, + "value": 140, + "unit": "count", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "140+ day care procedures/surgeries, organ donor's medical expenses, hospital cash", + "_confidence": "high" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__prospectus.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__prospectus.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "period of one year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__prospectus.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__prospectus.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__prospectus.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_quote": "1.2.5 AYUSH Treatment: The Company shall indemnify Medical Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Period up to the limit of Sum Insured", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_quote": "1.2.9 Maternity The Company shall indemnify Maternity Expenses as described below for any female Insured Person, and also Pre-Natal and Post-Natal Hospitalisation expenses per delivery, including expenses for necessary vaccination for the New Born Baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_quote": "New Born Baby shall be automatically covered from birth under the Sum Insured available to the mother during the corresponding Policy Period, for up to 3 months of age.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_quote": "1.2.6 Organ Donor's Medical Expenses The Company shall indemnify the Medical Expenses incurred in respect of an organ donor's Hospitalisation during the Policy Period for harvesting of the organ donated to an Insured Person", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_quote": "5.9. Out Patient Department (OPD) or Domiciliary treatment Any expenses incurred on OPD or Domiciliary treatment.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_quote": "cashless facility shall be available provided all evidences and documents are produced prior to cashless authorization, to sub", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_quote": "not be accumulated in excess of 50% of the Basic Sum Insured", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_quote": "pre-authorization letter within an hour to the hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_quote": "Super Top Up Mediclaim Policy", + "_confidence": "medium" + }, + "deductible_amount": { + "value": null, + "unit": "INR", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_quote": "not stated in national-super-top-up__prospectus.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": null, + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_quote": "not stated in national-super-top-up__prospectus.pdf", + "_confidence": "low" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__prospectus.pdf", + "source_quote": "Cumulative Bonus (CB) • CB at 5% of Sum Insured", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-super-top-up__wordings.json b/40-data/policy_facts/national-insurance__national-super-top-up__wordings.json index 81483ff25803950351445a99163b6ea8eb523bf1..fbbd99b218a1cfebeb2ead15509d2e2710ecd8d9 100644 --- a/40-data/policy_facts/national-insurance__national-super-top-up__wordings.json +++ b/40-data/policy_facts/national-insurance__national-super-top-up__wordings.json @@ -7,143 +7,239 @@ "value": "NICHLIP24154V042324", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP24154V042324", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 300000, - 500000, - 700000, - 800000, - 1000000, - 1500000, - 2000000, - 3000000, - 5000000, - 8000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period (Excl 03) a) Expenses related to the treatment of any Illness within thirty (30) days from the date of commencement of the first", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 12, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-super-top-up__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "shall be excluded until the expiry of 90 days/ one year/ two years (as specified against specific disease/ procedure) of continuous coverage", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity Expenses Covered up to Sum Insured after waiting period of 3 years, No Sub Limit Modern Treatment (12 nos)", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-hospitalisation 30 days immediately before hospitalisation Post-hospitalisation 60", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-hospitalisation 60 days immediately after discharge Day Care Procedures 140+ day ca", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, + "value": 140, + "unit": "procedures", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Day Care Procedures 140", + "_confidence": "medium" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "period of one year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-super-top-up__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", + "source_quote": "2.7 AYUSH Treatment refers to the medical and / or Hospitalisation treatment given under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", + "source_quote": "3.1.9 Maternity The Company shall indemnify Maternity Expenses as described below for any female Insured Person, and also Pre-Natal and Post- Natal Hospitalisation expenses per delivery, including expenses for necessary vaccination for the New Born Baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", + "source_quote": "New Born Baby shall be automatically covered from birth under the Sum Insured available to the mother during the corresponding Policy Period, for up to 3 months of age.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", + "source_quote": "3.1.6. Organ Donor's Medical Expenses, 3.1.7. HIV Treatment, 3.1.8. Morbid Obesity Treatment, 3.1.9. Maternity", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", + "source_quote": "5.9. Out-Patient Department (OPD) or Domiciliary treatment Any expenses incurred on OPD or Domiciliary treatment.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", + "source_quote": "cashless facility shall be available provided that all evidences and documents are produced prior to cashless authorisation, t", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", + "source_quote": "not be accumulated in excess of 50% of the Basic Sum Insured", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", + "source_quote": "within an hour to the Hospital", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", + "source_quote": "Super Top Up Mediclaim Policy", + "_confidence": "medium" + }, + "deductible_amount": { + "value": null, + "unit": "INR", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", + "source_quote": "not stated in national-super-top-up__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": null, + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", + "source_quote": "not stated in national-super-top-up__wordings.pdf", + "_confidence": "low" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-super-top-up__wordings.pdf", + "source_quote": "Cumulative Bonus (CB) • CB at 5% of Sum Insured", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-surrogacy__cis.json b/40-data/policy_facts/national-insurance__national-surrogacy__cis.json index 81f09ac0a9016cc56fc5d9f15ee1ab5a55b0e651..dac06d5c6e96ba3768aa7b3146615010b6895ce7 100644 --- a/40-data/policy_facts/national-insurance__national-surrogacy__cis.json +++ b/40-data/policy_facts/national-insurance__national-surrogacy__cis.json @@ -7,135 +7,202 @@ "value": "NICHLIP25042V012425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25042V012425", + "_confidence": "high" }, "min_entry_age": { - "value": 25, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 35, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 200000, - 300000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "grace_period": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "within 30 days from the beginning of the policy", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": "Single AC/Non-AC base single room category; proportionate deduction if higher category; no cap in PPN packaged procedure", + "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent - Single AC/ Non AC room charges (i.e., base single room category available in Hospital) Proportionate Deduction shall apply if opted for Room of higher category.", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", + "source_quote": "c. AYUSH Treatment d. Ambulance Charges e. HIV / AIDS Treatment f. Mental Illness Treatment g. Modern Treatment", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", + "source_quote": "The Policy ONLY covers Hospitalisation expenses for the treatment of complication arising due to surrogacy pregnancy & post-partum delivery complications of the Surrogate Mother", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", + "source_quote": "x. Domiciliary Hospitalization & Out Patient Department (OPD) treatment", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", + "source_quote": "not stated in national-surrogacy__cis.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "other", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", + "source_quote": "The Policy ONLY covers Hospitalisation expenses", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Single AC/Non-AC base single room category; proportionate deduction if higher category; no cap in PPN packaged procedure", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__cis.pdf", + "source_quote": "Room Rent - Single AC/ Non AC room charges (i.e., base single room category available in Hospital) Proportionate Deduction shall apply if opted for Room of higher category.", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-surrogacy__prospectus.json b/40-data/policy_facts/national-insurance__national-surrogacy__prospectus.json index 091b1d9884b8c16c7cd0c1b274709cbf39b6a63d..5262c1d092df9ff8dd88378890659f1233ad7963 100644 --- a/40-data/policy_facts/national-insurance__national-surrogacy__prospectus.json +++ b/40-data/policy_facts/national-insurance__national-surrogacy__prospectus.json @@ -7,135 +7,205 @@ "value": "NICHLIP25042V012425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25042V012425", + "_confidence": "high" }, "min_entry_age": { "value": 25, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry age for Surrogate Mother shall be between 25 years to 35 years", + "_confidence": "high" }, "max_entry_age": { "value": 35, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Entry age for Surrogate Mother shall be between 25 years to 35 years", + "_confidence": "high" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__prospectus.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ - 200000, - 300000 + 600000, + 900000 ], "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured (SI) options are INR 6 lacs or INR 9 lacs, during the entire 36 months", + "_confidence": "high" }, "grace_period": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__prospectus.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days Waiting Period Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__prospectus.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__prospectus.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__prospectus.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__prospectus.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__prospectus.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__prospectus.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": "Single AC/Non-AC base single room; proportionate deduction if higher", + "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent - Single Occupancy room (AC or Non AC) ICU Charges - Upto 5% of Annual SI, per day Proportionate Deduction shall apply if opted for higher Room Rent/ category", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__prospectus.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__prospectus.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__prospectus.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-surrogacy__prospectus.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", + "source_quote": "2.9 AYUSH Treatment refers to the Hospitalisation treatments given Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy systems.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", + "source_quote": "National Surrogacy Insurance Policy is an indemnity health insurance product covering the Surrogate Mother. The Policy covers expenses in respect of any complication arising due to surrogacy pregnancy & post-partum delivery during the Policy Period.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", + "source_quote": "5.23. Domiciliary Hospitalization & Out Patient Department (OPD) treatment Any expenses incurred on Domiciliary Hospitalization and OPD treatment", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", + "source_quote": "Cashless facility is available if opted for TPA service, subject to prior approval by the TPA", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "other", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", + "source_quote": "The Policy ONLY covers Hospitalisation expenses", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Single AC/Non-AC base single room; proportionate deduction if higher", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-surrogacy__prospectus.pdf", + "source_quote": "Room Rent - Single Occupancy room (AC or Non AC) ICU Charges - Upto 5% of Annual SI, per day Proportionate Deduction shall apply if opted for higher Room Rent/ category", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-young-india-plus__cis.json b/40-data/policy_facts/national-insurance__national-young-india-plus__cis.json index c768a962df396b0dee3cb850c17b41b6d047e383..37c3711e5e14cc57a6acd2c553f78b057d34541f 100644 --- a/40-data/policy_facts/national-insurance__national-young-india-plus__cis.json +++ b/40-data/policy_facts/national-insurance__national-young-india-plus__cis.json @@ -7,137 +7,230 @@ "value": "NICHLIP24127V012324", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP24127V012324", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 45, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 500000, - 1000000, - 1500000, - 2500000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "within 30 days from the beginning of the policy", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": 36, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 45, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-hospitalisation (treatment prior to admission in hospital) of 45 days", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-hospitalisation (treatment after discharge from hospital) within 60 days from date of discharge", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 25, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Copayment of 25%", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": "Single AC base room category single occupancy; proportionate deduction if higher category. No cap in PPN packaged procedure.", + "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent - Single AC room charges (i.e., lowest single AC room category available in Hospital) Proportionate Deduction shall apply if opted for Room of higher category.", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", + "source_quote": "e. AYUSH treatment f. Ambulance and Air Ambulance Charges g. Maternity including expenses of Surrogate Mother (as per Surrogacy Act 2021 and subsequent amendments)", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", + "source_quote": "g. Maternity including expenses of Surrogate Mother (as per Surrogacy Act 2021 and subsequent amendments) h. Infertility i. HIV / AIDS Treatment", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", + "source_quote": "Reinstatement of Basic Sum Insured b. Personal Accident Cover c. Domestic Travel Cover", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", + "source_quote": "i. Domiciliary Hospitalization & Out Patient Department (OPD) treatment", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", + "source_quote": "Individual Sum Insured (SI)", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Single AC base room category single occupancy; proportionate deduction if higher category. No cap in PPN packaged procedure.", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", + "source_quote": "Room Rent - Single AC room charges (i.e., lowest single AC room category available in Hospital) Proportionate Deduction shall apply if opted for Room of higher category.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__cis.pdf", + "source_quote": "not stated in national-young-india-plus__cis.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-young-india-plus__prospectus.json b/40-data/policy_facts/national-insurance__national-young-india-plus__prospectus.json index bfe5739d2f6acd1cccbbf9f6233d67759114a0ef..73df40cdaf3cb672ff5ac24f81b55c09ee44b692 100644 --- a/40-data/policy_facts/national-insurance__national-young-india-plus__prospectus.json +++ b/40-data/policy_facts/national-insurance__national-young-india-plus__prospectus.json @@ -7,137 +7,232 @@ "value": "NICHLIP24127V012324", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP24127V012324", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry age of Proposer should be between eighteen (18) years and forty five (45) years", + "_confidence": "high" }, "max_entry_age": { "value": 45, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maximum entry age of any family member is forty five (45) years", + "_confidence": "high" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__prospectus.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 500000, - 1000000, - 1500000, - 2500000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__prospectus.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period (Excl 03) a) Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Excl 01) a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days/ one year/ two year/ four years (as specified against specific disease/ procedure)", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity Cover (1 delivery/ termination, Waiting Period 2 years) – up to INR 30,000 (SI 5L), INR 40,000", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 45, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Medical Expenses incurred up to forty five (45) days immediately before the Insured Person is hospitalised", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "up to sixty (60) days immediately after the Insured Person is discharge", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 25, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "copayment of 25%", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": "Single AC base room category, single occupancy. Proportionate deduction if higher category.", + "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent - Single AC room charges (i.e., lowest single AC room category available in Hospital) ICU Charges - Actual ICU charges Proportionate Deduction shall apply if opted for Room of higher category", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "period of 1 year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india-plus__prospectus.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india-plus__prospectus.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india-plus__prospectus.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", + "source_quote": "1.2.5 AYUSH Treatment The Company shall indemnify Medical Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Period up to the limit of Sum Insured as specified in the Policy Schedule in any AYUSH Hospital.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", + "source_quote": "1.2.7 Maternity The Company shall indemnify Maternity Expenses as described below for any female Insured Person, and also Pre-Natal and Post- Natal Hospitalisation expenses per delivery, including expenses for necessary vaccination for the New Born Baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", + "source_quote": "New Born Baby shall be automatically covered from birth under the Sum Insured available to the mother during the corresponding Policy Period, for up to 3 months of age.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", + "source_quote": "1.3.1 Reinstatement of Basic Sum Insured In the event of available Sum Insured being exhausted anytime during the Policy Year on account of Hospitalisation claim(s), the Company shall reinstate the exhausted Basic Sum Insured (i.e., excluding any CB)", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", + "source_quote": "5.23. Domiciliary Hospitalization & Out Patient Department (OPD) treatment Any expenses incurred on Domiciliary Hospitalization and OPD treatment", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", + "source_quote": "Cashless Facility is available if TPA service is opted in the Policy", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", + "source_quote": "not stated in national-young-india-plus__prospectus.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", + "source_quote": "issued on Individual Basis", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Single AC base room category, single occupancy. Proportionate deduction if higher category.", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", + "source_quote": "Room Rent - Single AC room charges (i.e., lowest single AC room category available in Hospital) ICU Charges - Actual ICU charges Proportionate Deduction shall apply if opted for Room of higher category", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__prospectus.pdf", + "source_quote": "not stated in national-young-india-plus__prospectus.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-young-india-plus__wordings.json b/40-data/policy_facts/national-insurance__national-young-india-plus__wordings.json index 9e3217c4e982f0ad816afa3cb9968a02fc55227e..593e2dd0924fc3c8194544ba16847b33888e6445 100644 --- a/40-data/policy_facts/national-insurance__national-young-india-plus__wordings.json +++ b/40-data/policy_facts/national-insurance__national-young-india-plus__wordings.json @@ -7,137 +7,230 @@ "value": "NICHLIP24127V012324", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP24127V012324", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 45, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 500000, - 1000000, - 1500000, - 2500000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india-plus__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period (Excl 03) a) Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Excl 01) a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days/ one year/ two year/ three years (as specified against specific disease/ procedure)", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity Cover (1 delivery/ termination, Waiting Period 2 years) – up to INR 30,000 (SI 5L), INR 40,000", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 45, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Medical Expenses incurred up to forty five (45) days immediately before the Insured Person is hospitalised", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "up to sixty (60) days immediately after the Insured Person is discharge", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 25, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "copayment of 25%", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": "Single AC base single-occupancy", + "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent - Single AC room charges (i.e., lowest single AC room category available in Hospital) ICU Charges - Actual ICU charges Proportionate Deduction shall apply if opted for Room of higher category", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india-plus__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india-plus__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india-plus__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india-plus__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", + "source_quote": "2.7 AYUSH Treatment refers to the medical and/ or Hospitalisation treatments given Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy systems.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", + "source_quote": "3.1.7 Maternity The Company shall indemnify Maternity Expenses as described below for any female Insured Person, and also Pre-Natal and Post- Natal Hospitalisation expenses per delivery, including expenses for necessary vaccination for the New Born Baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", + "source_quote": "New Born Baby shall be automatically covered from birth under the Sum Insured available to the mother during the corresponding Policy Period, for up to 3 months of age.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", + "source_quote": "Reinstatement of Basic Sum Insured In the event of available Sum Insured being exhausted anytime during the Policy Year on account of Hospitalisation claim(s), the Company shall reinstate the exhausted Basic Sum Insured (i.e., excluding any CB)", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", + "source_quote": "5.23. Domiciliary Hospitalization & Out Patient Department (OPD) treatment Any expenses incurred on Domiciliary Hospitalization and OPD treatment", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", + "source_quote": "availing Cashless Facility", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", + "source_quote": "not stated in national-young-india-plus__wordings.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", + "source_quote": "issued on Individual Basis", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Single AC base single-occupancy", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", + "source_quote": "Room Rent - Single AC room charges (i.e., lowest single AC room category available in Hospital) ICU Charges - Actual ICU charges Proportionate Deduction shall apply if opted for Room of higher category", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india-plus__wordings.pdf", + "source_quote": "not stated in national-young-india-plus__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-young-india__cis.json b/40-data/policy_facts/national-insurance__national-young-india__cis.json index 242db24cf3bd35dff94109cd443c6f8f61057a79..d9d07fda5762e6aa05916e02482882917197d1a4 100644 --- a/40-data/policy_facts/national-insurance__national-young-india__cis.json +++ b/40-data/policy_facts/national-insurance__national-young-india__cis.json @@ -7,136 +7,237 @@ "value": "NICHLIP24005V022324", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP24005V022324", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 45, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 300000, - 500000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "within 30 days from the beginning of the policy", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": 36, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 45, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-hospitalisation (treatment prior to admission in hospital) of 45 days", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-hospitalisation (treatment after discharge from hospital) within 60 days from date of discharge", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": "INR 5,000/day (SI 3L/5L) or INR 10,000/day (SI 10L). No cap in PPN.", + "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent - Upto INR 5,000 per day for Basic SI 3Lacs, 5Lacs and upto INR 10,000 per day for Basic SI 10Lacs Proportionate Deduction shall apply if opted for Room of higher category.", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", + "source_quote": "e. AYUSH treatment f. Ambulance Charges g. Maternity h. HIV / AIDS Treatment i. Mental Illness Cover", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", + "source_quote": "g. Maternity h. HIV / AIDS Treatment i. Mental Illness Cover j. Modern Treatment (12 in Number)", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", + "source_quote": "Other Benefits: a. Reinstatement of Basic SI (available to Basic SI of ₹ 5L and above) b. Personal Accident Cover", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", + "source_quote": "w. Domiciliary Hospitalization & Out Patient Department (OPD) treatment", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", + "source_quote": "Double SI for 11 Critical Illnesses Note: The optional covers shall be available to the Insured Persons during the Policy Period, provided the same is mentioned in the Policy Schedule.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", + "source_quote": "Individual Sum Insured (SI)", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "INR 5,000/day (SI 3L/5L) or INR 10,000/day (SI 10L). No cap in PPN.", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", + "source_quote": "Room Rent - Upto INR 5,000 per day for Basic SI 3Lacs, 5Lacs and upto INR 10,000 per day for Basic SI 10Lacs Proportionate Deduction shall apply if opted for Room of higher category.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__cis.pdf", + "source_quote": "not stated in national-young-india__cis.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-young-india__prospectus.json b/40-data/policy_facts/national-insurance__national-young-india__prospectus.json index 296c6eb3868f61af2f0872e8298528802ca016a5..18ce93fae61b2e2be7beb9a33ca2816946d967d9 100644 --- a/40-data/policy_facts/national-insurance__national-young-india__prospectus.json +++ b/40-data/policy_facts/national-insurance__national-young-india__prospectus.json @@ -7,136 +7,239 @@ "value": "NICHLIP24005V022324", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP24005V022324", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry age of Proposer should be between eighteen (18) years and forty three (43) years", + "_confidence": "high" }, "max_entry_age": { - "value": 45, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": 43, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maximum entry age of any family member is forty three (43) years", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Minimum age at entry: 3 months", + "_confidence": "medium" }, "sum_insured_options": { - "value": [ - 300000, - 500000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india__prospectus.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period (Excl 03) a) Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Excl 01) a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days/ one year/ two year/ four years (as specified against specific disease/ procedure)", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity Cover (1 delivery/ termination, Waiting Period 2 years) – up to INR 30,000 (Basic SI 3L), INR", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 45, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Medical Expenses incurred up to forty five (45) days immediately before the Insured Person is hospitalised", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "up to sixty (60) days immediately after the Insured Person is discharge", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Depending upon the zone for which premium has been paid and the zone where treatment has been taken, Copayment shall apply.", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": "INR 5,000/day (SI 3L/5L) or INR 10,000/day (SI 10L)", + "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent - Upto INR 5,000 per day for Basic SI 3L, 5L and upto INR 10,000 per day for Basic SI 10L ICU Charges - Upto INR 10,000 per day for Basic SI 3L, 5L and upto INR 20,000 per day for Basic SI 10L Proportionate Deduction shall apply if opted for higher Room Rent", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "period of 1 year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india__prospectus.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india__prospectus.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india__prospectus.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", + "source_quote": "1.2.5 AYUSH Treatment: The Company shall indemnify Medical Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Period up to the limit of Sum Insured as specified in the Policy Schedule in any AYUSH Hospital.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", + "source_quote": "1.2.7 Maternity The Company shall indemnify Maternity Expenses as described below for any female Insured Person, and also Pre-Natal and Post-Natal Hospitalisation expenses per delivery, including expenses for necessary vaccination for New Born Baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", + "source_quote": "New Born Baby shall be automatically covered from birth under the Sum Insured available to the mother during the corresponding Policy Period, for up to 3 months of age.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", + "source_quote": "1.3.1 Reinstatement of Basic Sum Insured (available to Basic Sum Insured of ₹ 5L and above) For Policies with Basic Sum Insured of ₹ 5 lacs and above, in the event of available Sum Insured being exhausted anytime during the Policy Year on account of Hospitalisation cla", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", + "source_quote": "5.23. Domiciliary Hospitalization & Out Patient Department (OPD) treatment Any expenses incurred on Domiciliary Hospitalization and OPD treatment", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", + "source_quote": "1.4.2. Double SI for 11 Critical Illnesses - Optional 2 In the event of available Sum Insured being exhausted anytime during the Policy Year on account of Hospitalisation claim(s)", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", + "source_quote": "Cashless Facility can be availed, if TPA service is opted", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", + "source_quote": "shall not exceed 50% of the Basic Sum Insured", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", + "source_quote": "issued on Individual Basis", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "INR 5,000/day (SI 3L/5L) or INR 10,000/day (SI 10L)", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", + "source_quote": "Room Rent - Upto INR 5,000 per day for Basic SI 3L, 5L and upto INR 10,000 per day for Basic SI 10L ICU Charges - Upto INR 10,000 per day for Basic SI 3L, 5L and upto INR 20,000 per day for Basic SI 10L Proportionate Deduction shall apply if opted for higher Room Rent", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__prospectus.pdf", + "source_quote": "increase by 5% of Basic SI in respect of each claim free", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__national-young-india__wordings.json b/40-data/policy_facts/national-insurance__national-young-india__wordings.json index 82ade8197a55893d8c0edc3fe779676d62a5b12e..8a5ff3e8a3148db669b8e651a8ab4d98dde5ead4 100644 --- a/40-data/policy_facts/national-insurance__national-young-india__wordings.json +++ b/40-data/policy_facts/national-insurance__national-young-india__wordings.json @@ -7,136 +7,237 @@ "value": "NICHLIP24005V022324", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP24005V022324", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 45, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 300000, - 500000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in national-young-india__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period (Excl 03) a) Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Excl 01) a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days/ one year/ two year/ four years (as specified against specific disease/ procedure)", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity Cover (1 delivery/ termination, Waiting Period 2 years) – up to INR 30,000 (Basic SI 3L), INR", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 45, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Medical Expenses incurred up to forty five (45) days immediately before the Insured Person is hospitalised", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "up to sixty (60) days immediately after the Insured Person is discharge", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": "INR 5,000-10,000/day per SI tier", + "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent - Upto INR 5,000 per day for Basic SI 3L, 5L and upto INR 10,000 per day for Basic SI 10L ICU Charges - Upto INR 10,000 per day for Basic SI 3L, 5L and upto INR 20,000 per day for Basic SI 10L Proportionate Deduction shall apply if opted for higher Room Rent", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in national-young-india__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", + "source_quote": "2.7 AYUSH Treatment refers to the medical and/ or Hospitalisation treatments given Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy systems.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", + "source_quote": "3.1.7 Maternity The Company shall indemnify Maternity Expenses as described below for any female Insured Person, and also Pre-Natal and Post-Natal Hospitalisation expenses per delivery, including expenses for necessary vaccination for New Born Baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", + "source_quote": "New Born Baby shall be automatically covered from birth under the Sum Insured available to the mother during the corresponding Policy Period, for up to 3 months of age.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", + "source_quote": "Reinstatement of Basic Sum Insured (available to Basic Sum Insured of ₹ 5L and above) For Policies with Basic Sum Insured of ₹ 5 lacs and above, in the event of available Sum Insured being exhausted anytime during the Policy Year on account of Hospitalisation claim(s)", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", + "source_quote": "5.23. Domiciliary Hospitalization & Out Patient Department (OPD) treatment Any expenses incurred on Domiciliary Hospitalization and OPD treatment", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", + "source_quote": "3.3.2. Double SI for 11 Critical Illnesses - Optional 2", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", + "source_quote": "Cashless Facility can be availed, if TPA service is opted", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", + "source_quote": "shall not exceed 50% of the Basic Sum Insured", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", + "source_quote": "issued on Individual Basis", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "INR 5,000-10,000/day per SI tier", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", + "source_quote": "Room Rent - Upto INR 5,000 per day for Basic SI 3L, 5L and upto INR 10,000 per day for Basic SI 10L ICU Charges - Upto INR 10,000 per day for Basic SI 3L, 5L and upto INR 20,000 per day for Basic SI 10L Proportionate Deduction shall apply if opted for higher Room Rent", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/national-young-india__wordings.pdf", + "source_quote": "increase by 5% of Basic SI in respect of each claim free", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__new-national-parivar__cis.json b/40-data/policy_facts/national-insurance__new-national-parivar__cis.json index 4328948530fc938c2fd8f3f7b07893edd1991d66..6ae213e99c808ecd5e6a76e387b08c2721341de4 100644 --- a/40-data/policy_facts/national-insurance__new-national-parivar__cis.json +++ b/40-data/policy_facts/national-insurance__new-national-parivar__cis.json @@ -7,143 +7,251 @@ "value": "NICHLIP25037V022425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25037V022425", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 100000, - 200000, - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "within 30 days from the beginning of the policy", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": 36, - "unit": null, + "value": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { - "value": 36, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 45, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-hospitalisation (treatment prior to admission in hospital) of 45 days c", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 75, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-hospitalisation (treatment after discharge from hospital) within 75 days from date of discharge d", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insured opting for cover for pre-existing diabetes and\nhypertension, can avail treatment for diabetes or\nhypertension, subject to a copayment of 25%", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent - Up to 1% of SI or actual, whichever is lower Proportionate Deduction shall apply if opted for Room of higher category.", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "f. AYUSH Treatment g. Organ donor's medical expenses h. Hospital Cash for maximum of 5 days i. Ambulance j. Anti Rabies Vaccination k. Maternity", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "Baby from Birth Cover) (per insured person, in a policy year - Up to 10% of SI subject to INR 30,000 in case of normal delivery and INR 50,000 in case of caesarean section", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "Baby from Birth Cover) (per insured person, in a policy year - Up to 10% of SI subject to INR 30,000 in case of normal delivery and INR 50,000 in case of caesarean section", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "f. AYUSH Treatment g. Organ donor's medical expenses h. Hospital Cash for maximum of 5 days i. Ambulance j. Anti Rabies Vaccination k. Maternity", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "Other Benefits: a. Reinstatement of Basic SI (available to Basic SI of ₹ 6L and above)", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "c. Domiciliary Hospitalisation e. Procedures requiring less than 24 hours of hospitalization (day care). f. AYUSH Treatment", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "Good Health Incentive: a. Cumulative Bonus (CB) b. Preventive Health Check Up", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "Optional Covers: a. Pre-existing Diabetes / Hypertension b. Out-Patient Treatment c. Critical Illness", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "Cashless Facility can be availed, if TPA service is opted", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "Floater Sum Insured", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Up to 1% of SI per day or actual (lower)", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "Room Rent - Up to 1% of SI or actual, whichever is lower Proportionate Deduction shall apply if opted for Room of higher category.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__cis.pdf", + "source_quote": "not stated in new-national-parivar__cis.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__new-national-parivar__prospectus.json b/40-data/policy_facts/national-insurance__new-national-parivar__prospectus.json index e939039216525531bca9c9979105adcc3d4113b2..597a4224db48119a29aa764c6b6536b88cd1d790 100644 --- a/40-data/policy_facts/national-insurance__new-national-parivar__prospectus.json +++ b/40-data/policy_facts/national-insurance__new-national-parivar__prospectus.json @@ -7,143 +7,253 @@ "value": "NICHLIP25037V022425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25037V022425", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry age of Proposer should be between eighteen (18) years and sixty five (65) years", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maximum entry age of any family member is sixty five (65) years", + "_confidence": "high" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__prospectus.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 100000, - 200000, - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__prospectus.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period (Excl 03) a) Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Excl 01) a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days/ one year/ two year/ three years (as specified against specific disease/ procedure)", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity (including Baby from Birth Cover) (per insured person, in a policy year, waiting period of 3 years applies) Up to 10% of SI subject to INR", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 45, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre Hospitalisation 45 days Post Hospitalisation 75 days", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 75, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post Hospitalisation 75 days", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "i. Insured opting for cover for pre existing diabetes, can avail treatment for diabetes, subject to a copayment of 10%", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "1.2.1.1 Limit for Room Charges and Intensive Care Unit Charges Room charges and intensive care unit charges per day shall be payable up to the limit as shown in the Table of Benefits.", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "period of 1 year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in new-national-parivar__prospectus.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in new-national-parivar__prospectus.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in new-national-parivar__prospectus.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "1.2.6 AYUSH Treatment The Company shall indemnify Medical Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Period up to the limit of Sum Insured as specified in the Policy Schedule in any AYUSH Hospital.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "1.2.11 Maternity The Company shall indemnify Maternity Expenses as described below for any female Insured Person, and also Pre-Natal and Post- Natal Hospitalisation expenses per delivery, including expenses for necessary vaccination for the New Born Baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "New Born Baby shall be automatically covered from birth under the Sum Insured available to the mother during the corresponding Policy Period, for up to 3 months of age.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "1.2.7 Organ Donor's Medical Expenses The Company shall indemnify the Medical Expenses incurred in respect of an organ donor's Hospitalisation during the Policy Period for harvesting of the organ donated to an Insured Person", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "1.3.1 Reinstatement of Basic Sum Insured (available to Basic Sum Insured of ₹ 6L and above) For Policies with Floater Basic Sum Insured of ₹ 6 lacs and above, in the event of available Sum Insured being exhausted anytime", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "1.2.4 Domiciliary Hospitalisation The Company shall indemnify the Medical Expenses incurred under Domiciliary Hospitalization, including pre hospitalisation expenses and post hospitalisation expenses, up to the limit as shown in the Table of Benefits.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "1.4.2 Preventive Health Check Up Expenses of preventive health check-up/ prescribed diagnostic tests will be reimbursed once at the end of a block of three (03) continuous years provided no claims are reported and admitted during the block", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "Pre-existing Diabetes and/or Hypertension, Outpatient Treatment and Critical Illness are provided as Optional Covers.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "Cashless facility is available if opted for TPA service, subject to prior approval by the TPA", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "not be accumulated in excess of 50% of the Basic Sum Insured", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "Family Floater basis", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "1% of SI per day or actual (lower)", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "1.2.1.1 Limit for Room Charges and Intensive Care Unit Charges Room charges and intensive care unit charges per day shall be payable up to the limit as shown in the Table of Benefits.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__prospectus.pdf", + "source_quote": "increase by 5% of Basic SI in respect of each claim free", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__new-national-parivar__wordings.json b/40-data/policy_facts/national-insurance__new-national-parivar__wordings.json index 6dc8dacb3ae7758aa1ac1e23df431142ac2b1716..7c8f9bfc7d9b9d7c4716c6dcd9af5abc68fba2fc 100644 --- a/40-data/policy_facts/national-insurance__new-national-parivar__wordings.json +++ b/40-data/policy_facts/national-insurance__new-national-parivar__wordings.json @@ -7,143 +7,253 @@ "value": "NICHLIP25037V022425", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP25037V022425", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 100000, - 200000, - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 900000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in new-national-parivar__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First 30 days waiting period (Excl 03) a) Expenses related to the treatment of any illness within thirty (30) days from the first policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Excl 01) a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days/ one year/ two year/ three years (as specified against specific disease/ procedure)", + "_confidence": "medium" }, "maternity_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity (including Baby from Birth Cover) (per insured person, in a policy year, waiting period of 3 years applies) Up to 10% of SI subject to INR", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 45, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre Hospitalisation 45 days Post Hospitalisation 75 days", + "_confidence": "medium" }, "post_hospitalization_days": { "value": 75, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post Hospitalisation 75 days", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://nationalinsurance.nic.co.in/en/health-insurance/new-national-parivar-mediclaim-policy", + "source_note": "Per insurer baseline (National Parivar Mediclaim covers 140+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in new-national-parivar__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "3.1.1.1 Limit for Room Charges and Intensive Care Unit Charges Room charges and intensive care unit charges per day shall be payable up to the limit as shown in the Table of Benefits.", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "period of 1 year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in new-national-parivar__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in new-national-parivar__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in new-national-parivar__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "2.7 AYUSH Treatment refers to the medical and/ or Hospitalisation treatments given under Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy systems.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "3.1.11 Maternity The Company shall indemnify Maternity Expenses as described below for any female Insured Person, and also Pre-Natal and Post- Natal Hospitalisation expenses per delivery, including expenses for necessary vaccination for the New Born Baby", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "New Born Baby shall be automatically covered from birth under the Sum Insured available to the mother during the corresponding Policy Period, for up to 3 months of age.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "3.1.7 Organ Donor's Medical Expenses The Company shall indemnify the Medical Expenses incurred in respect of an organ donor's Hospitalisation during the Policy Period for harvesting of the organ donated to an Insured Person", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "Reinstatement of Basic Sum Insured (available to Basic Sum Insured of ₹ 6L and above) For Policies with Floater Basic Sum Insured of ₹ 6 lacs and above, in the event of available Sum Insured being exhausted anytime during the Policy Year on account of Hospitalisation claim(s)", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "2.19 Domiciliary Hospitalisation means medical treatment for an illness /injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "3.3.2 Preventive Health Check Up Expenses of preventive health check-up/ prescribed diagnostic tests will be reimbursed once at the end of a block of three (03) continuous years provided no claims are reported and admitted during the block", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "3.4.3 Critical Illness Subject otherwise to the terms, definitions, exclusions, and conditions of the Policy, the Company shall pay the benefit amount, as stated in the schedule", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "Cashless Facility can be availed, if TPA service is opted", + "_confidence": "medium" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "not be accumulated in excess of 50% of the Basic Sum Insured", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "Family Floater basis", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "1% of SI per day", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "3.1.1.1 Limit for Room Charges and Intensive Care Unit Charges Room charges and intensive care unit charges per day shall be payable up to the limit as shown in the Table of Benefits.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/new-national-parivar__wordings.pdf", + "source_quote": "increase by 5% of Basic SI in respect of each claim free", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__universal-health__cis.json b/40-data/policy_facts/national-insurance__universal-health__cis.json index c51bd5337962bc67ecae9bf0f8532728a7a5a4f7..4b65688fb21a412f590366183acda1c9a9d7803b 100644 --- a/40-data/policy_facts/national-insurance__universal-health__cis.json +++ b/40-data/policy_facts/national-insurance__universal-health__cis.json @@ -7,135 +7,209 @@ "value": "NICHLIP21593V042021", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP21593V042021", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 70, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 30000, - 50000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "within 30 days from the beginning of the policy", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": 12, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity Benefit - Payable after waiting period of 12 months  Hospital Cash for Earning Head of the", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, + "value": 12, + "unit": "procedures", "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "12 nos", + "_confidence": "medium" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 0.5, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "a. Room Rent - Up to 0.5% of SI per day b. ICU charges - Up to 1% of SI per day", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", + "source_quote": "iv.Maternity Benefit (inclusive of above sub limits) - Up to ₹ 2,500/- for normal delivery and ₹ 5,000/- for caesarean/extra uterine delivery", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", + "source_quote": "Universal Health Insurance Policy", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "0.5% of Sum Insured per day", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", + "source_quote": "a. Room Rent - Up to 0.5% of SI per day b. ICU charges - Up to 1% of SI per day", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__cis.pdf", + "source_quote": "not stated in universal-health__cis.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__universal-health__prospectus.json b/40-data/policy_facts/national-insurance__universal-health__prospectus.json index d6867875a15032e827041791929ec967af4d6073..49f044ac5e5d0efd0a3b97163207eb539e7e9846 100644 --- a/40-data/policy_facts/national-insurance__universal-health__prospectus.json +++ b/40-data/policy_facts/national-insurance__universal-health__prospectus.json @@ -7,135 +7,211 @@ "value": "NICHLIP21593V042021", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP21593V042021", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Entry age of Proposer should be between eighteen (18) years and seventy (70) years", + "_confidence": "high" }, "max_entry_age": { "value": 70, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maximum entry age of any family member is seventy (70) years", + "_confidence": "high" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in universal-health__prospectus.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 30000, - 50000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in universal-health__prospectus.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in universal-health__prospectus.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__prospectus.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__prospectus.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": 12, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity Benefit (Maternity Expenses and New Born child cover) – one delivery only (with 12 months Waiting Period) ₹ 2,500/- for normal de", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__prospectus.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__prospectus.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, + "value": 12, + "unit": "procedures", "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "12 nos", + "_confidence": "medium" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__prospectus.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 0.5, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent shall be payable up to 0.5% of Sum Insured per day ICU Charges shall be payable up to 1% of Sum Insured per da", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The Policy can only be issued for a period of one (01) year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__prospectus.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__prospectus.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__prospectus.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", + "source_quote": "AYUSH Treatment refers to the medical and/ or Hospitalisation treatments given Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy systems", + "_confidence": "medium" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", + "source_quote": "3.1.1.1 Maternity Benefit The Company shall indemnify the Medical Expenses incurred for one normal or caesarean/ extra uterine delivery during the Policy Period after a Waiting Period of 12 months from inception of the Policy.", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", + "source_quote": "New Born Baby shall also be covered. However, any payout under this Section shall be within the overall limit of Sum Insured under the under Section I of the Policy.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", + "source_quote": "Cashless Facility is available only in Network Providers and through TPAs", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", + "source_quote": "Universal Health Insurance Policy", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "0.5% of Sum Insured per day", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", + "source_quote": "Room Rent shall be payable up to 0.5% of Sum Insured per day ICU Charges shall be payable up to 1% of Sum Insured per da", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__prospectus.pdf", + "source_quote": "not stated in universal-health__prospectus.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/national-insurance__universal-health__wordings.json b/40-data/policy_facts/national-insurance__universal-health__wordings.json index dcb0b4a70122979524877de82f91e84a8f4e54b7..b5cca58d0bbb26bf88d8c052080e474010c317b5 100644 --- a/40-data/policy_facts/national-insurance__universal-health__wordings.json +++ b/40-data/policy_facts/national-insurance__universal-health__wordings.json @@ -7,135 +7,211 @@ "value": "NICHLIP21593V042021", "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: NICHLIP21593V042021", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in universal-health__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 70, - "unit": "years", - "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in universal-health__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in universal-health__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 30000, - 50000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in universal-health__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for payment of the premium shall be thirty days", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in universal-health__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": 12, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity Benefit (Maternity Expenses and New Born child cover) – one delivery only (with 12 months Waiting Period) ₹ 2,500/- for normal de", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, + "value": 12, + "unit": "procedures", "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "12 nos", + "_confidence": "medium" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 5322, + "source_url": "https://nationalinsurance.nic.co.in/", + "source_note": "5322 Network Hospitals ('Why Choose NICL' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 0.5, + "unit": "%", "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent shall be payable up to 0.5% of Sum Insured per day ICU Charges shall be payable up to 1% of Sum Insured", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy Period means period of one (01) year", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in universal-health__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", + "source_quote": "AYUSH Treatment refers to the medical and/ or Hospitalisation treatments given Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy systems", + "_confidence": "medium" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", + "source_quote": "Maternity Benefit (inclusive of above sub limits) Up to ₹ 2,500/- for normal delivery and ₹ 5,000/- for caesarean/extra uterine delivery", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", + "source_quote": "New Born Baby shall also be covered. However, any payout under this Section shall be within the overall limit of Sum Insured under Section I of the Policy.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the Company to the Insured where the payments of the costs of treatment undergone by the Insured in accordance with", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", + "source_quote": "pre-authorization letter within an hour to the Hospital after verification", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", + "source_quote": "geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", + "source_quote": "Universal Health Insurance Policy", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "0.5% of Sum Insured per day", + "unit": "text", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", + "source_quote": "Room Rent shall be payable up to 0.5% of Sum Insured per day ICU Charges shall be payable up to 1% of Sum Insured", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/national-insurance/universal-health__wordings.pdf", + "source_quote": "not stated in universal-health__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/new-india__asha-kiran-policy__brochure.json b/40-data/policy_facts/new-india__asha-kiran-policy__brochure.json index 434eaccd3c4fb0ab4922e377a9573c4e7ebb11b6..4f4c317e257f95f4f34f854c5c03d098a00cfecc 100644 --- a/40-data/policy_facts/new-india__asha-kiran-policy__brochure.json +++ b/40-data/policy_facts/new-india__asha-kiran-policy__brochure.json @@ -3,64 +3,75 @@ "policy_name": "Asha Kiran Policy", "insurer_slug": "new-india", "uin_code": { - "value": null, + "value": "NIAHLIP21233V022021", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "NIAHLIP21233V022021 Page 1 of 21", + "_confidence": "high" }, "min_entry_age": { - "value": null, + "value": 18, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "This insurance is\navailable to persons between the age of 18 years and 65 years.", + "_confidence": "high" }, "max_entry_age": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, + "value": 65, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "This insurance is\navailable to persons between the age of 18 years and 65 years.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 48, + "unit": "months", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "of a pre-existing Disease (PED) and its direct complications \nshall be excluded until the expiry of 48 months of continuous coverage after the date of \ninception of the first policy with us.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "maternity_coverage": { - "value": null, + "value": false, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "4.15 MATERNITY EXPENSES (Code - Excl18) \na. Medical treatment expenses traceable to childbirth", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": null, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "cashless_treatment_supported": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "Cashless facility" + "source_quote": "Cashless facility", + "_confidence": "high" }, "copayment_pct": { - "value": null, + "value": 20.0, + "unit": "%", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "our liability towards any claim will be \na) 80% of admissible claim amount", + "_confidence": "medium" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": "restoration of the previous state of Health\nunder any circumstances unless in a", @@ -68,54 +79,73 @@ "source_quote": "restoration of the previous state of Health\nunder any circumstances unless in a vegetative state as certified by the tre" }, "room_rent_capping": { - "value": "Room rent, Boarding, DMO / RMO / CMO / RMP Charges, Nursing (Including Injection", + "value": "1% of Sum Insured per day", + "unit": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "Room rent, Boarding, DMO / RMO / CMO / RMP Charges, Nursing (Including Injection\n/ Drugs and Intra venous fluid administ" + "source_quote": "Room rent, Boarding, DMO / RMO / CMO / RMP Charges, Nursing (Including Injection\n/ Drugs and Intra venous fluid administ", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "day_care_treatments_count": { "value": null, + "unit": "procedures", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, + "value": 20855, + "source_url": "https://www.newindia.co.in/hospitals-list", + "source_note": "New India Assurance: 20,855 empanelled hospitals as of 11.02.2025 (direct quote from insurer Hospitals List page, scraped 2026-05-15). Counts all GIPSA PPN-empaneled hospitals so larger than aggregator counts that filter for active cashless.", + "_confidence": "high", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "sum_insured_options": { - "value": null, + "value": [ + 200000, + 300000, + 500000, + 800000 + ], "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "You are free to choose any Sum Insured from Rs. 2 lakhs, 3 lakhs, 5 lakhs, and8 Lakhs.", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "policy_type": { - "value": "hospital_cash", + "value": "indemnity", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "classified as hospital_cash from PDF heuristics" + "source_quote": "New India Asha Kiran is a Policy designed to cover Hospitalisation expenses of the family and Personal Accident for Parents.", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", "completeness_pct": 18, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF", + "network_hospital_backfill_2026-05-15": "new-india insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/new-india__asha-kiran-policy__cis.json b/40-data/policy_facts/new-india__asha-kiran-policy__cis.json index fc88da975191f70624442fd65fc7bd79c560439a..7ce991c2751f829d22a8d572d274b88f29efbe7a 100644 --- a/40-data/policy_facts/new-india__asha-kiran-policy__cis.json +++ b/40-data/policy_facts/new-india__asha-kiran-policy__cis.json @@ -10,22 +10,21 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__cis.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "Pre-existing Diseases (Code- Excl01)-36 Months" + "source_quote": "Pre-existing Diseases (Code- Excl01)-36 Months", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, @@ -34,43 +33,56 @@ }, "maternity_coverage": { "value": null, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__cis.pdf", + "_confidence": "low" }, "ayush_coverage": { - "value": null, + "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "" + "source_quote": "Coverage for AYUSH Treatment is up to 100% of the Sum \nInsured.", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "Cashless Service and Reimbursement-Available\nProcedure i. Network" + "source_quote": "9 Claims/Claim Procedure Cashless Service and Reimbursement-Available i. Network hospital details -Available on website and on policy schedule ii. Helpline number: 1800-209-1415", + "_confidence": "high" }, "copayment_pct": { - "value": null, + "value": 20.0, + "unit": "%", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "" + "source_quote": "Co-Payment \nWhere the Insured Person is treated in a Hospital situated outside \nthe Area of Coverage (Zone) as stated in the Schedule, our liability \nwill be:", + "_confidence": "medium" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__cis.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__cis.pdf", + "_confidence": "low" }, "room_rent_capping": { - "value": "Room rent and ICU 3.1(a)\nrespectively & (b)\nLIMIT ON PAYMENT FOR CATARACT\nUp to", + "value": "1% of Sum Insured per day", + "unit": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "Room rent and ICU 3.1(a)\nrespectively & (b)\nLIMIT ON PAYMENT FOR CATARACT\nUp to" + "source_quote": "Sub-limit Up to 1 % & 2% of the Sum Insured per day for Room rent and ICU respectively 3.1(a) & (b) LIMIT ON PAYMENT FOR CATARACT Up to 10% of the Sum Insured or Rs. 50,000, whichever is less", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 30, @@ -80,42 +92,52 @@ "post_hospitalization_days": { "value": 60, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "Post-Hospitalisation \u2013Treatment within 60 days" + "source_quote": "Post-Hospitalisation –Treatment within 60 days" }, "day_care_treatments_count": { "value": null, + "unit": "procedures", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__cis.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, + "value": 20855, + "source_url": "https://www.newindia.co.in/hospitals-list", + "source_note": "New India Assurance: 20,855 empanelled hospitals as of 11.02.2025 (direct quote from insurer Hospitals List page, scraped 2026-05-15). Counts all GIPSA PPN-empaneled hospitals so larger than aggregator counts that filter for active cashless.", + "_confidence": "high", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "" + "source_quote": "not stated in asha-kiran-policy__cis.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, + "value": 1, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "" + "source_quote": "iv. Pre-authorisation -Within 1 hour of request", + "_confidence": "high" }, "policy_type": { - "value": "hospital_cash", + "value": "indemnity", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", - "source_quote": "classified as hospital_cash from PDF heuristics" + "source_quote": "3 Type of Insurance Product/Policy Indemnity Section 3 4 Sum Insured Basis Floater Sum insured.", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/new-india/asha-kiran-policy__cis.pdf", "completeness_pct": 36, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF", + "network_hospital_backfill_2026-05-15": "new-india insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/new-india__asha-kiran.json b/40-data/policy_facts/new-india__asha-kiran.json index d088ac74459e56956b6f70ef3eb1e2e5166998da..52b86971646d79210b5bb459bb6d1f8151d49000 100644 --- a/40-data/policy_facts/new-india__asha-kiran.json +++ b/40-data/policy_facts/new-india__asha-kiran.json @@ -8,27 +8,30 @@ "source_quote": "ing Hospitalisation Expenses: NIAHLIP21233V022021 Page 1 of 21 NEW INDIA ASHA KIRAN POLICY i. Room rent, Boarding, DMO / RMO / CMO / RMP Charges, Nursing (Including Injection / Drugs and Intra venous " }, "min_entry_age": { - "value": null, + "value": 18, "unit": "days", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "Min entry age not found" + "source_quote": "This insurance is\navailable to persons between the age of 18 years and 65 years.", + "_confidence": "high" }, "max_entry_age": { - "value": null, + "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "This insurance is\navailable to persons between the age of 18 years and 65 years.", + "_confidence": "high" }, "sum_insured_options": { - "value": null, + "value": [ + 200000, + 300000, + 500000, + 800000 + ], "unit": "INR", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "You are free to choose any Sum Insured from Rs. 2 lakhs, 3 lakhs, 5 lakhs, and8 Lakhs.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, @@ -36,39 +39,47 @@ "source_quote": "the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. b. This exclusion shall n" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 48, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "shall be excluded until the expiry of 48 months of continuous coverage after the date of\ninception of the first policy with us.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "2. SPECIFIC WAITING PERIOD (Code- Excl02) a. Expenses related to the treatment of the following listed conditions, surgeries / treatments shall be excluded until the expiry of Ninety Days / 24 / 48 months of continuous coverage", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 139, + "source_url": "https://www.newindia.co.in/health-insurance/health-insurance-policy", + "source_note": "Per insurer baseline (New India Assurance Mediclaim covers ~139 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf" }, "ayush_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "AYUSH coverage not found in extracted text" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "maternity_coverage": { "value": false, @@ -81,14 +92,16 @@ "source_quote": "new born 2nd baby girl child on payment of pro - rata additional premium. 3. WHAT DOES THE POLIC" }, "organ_donor_expenses": { - "value": false, + "value": true, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "Organ donor cover not extracted" + "source_quote": "All Hospitalisation Expenses (excluding cost of organ, if any) incurred for donor in respect of Organ transplant.", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": "restoration of the previous state of Health", @@ -101,19 +114,22 @@ "source_quote": "room category, as evidenced by the Hospital’s schedule of" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 20855, + "source_url": "https://www.newindia.co.in/hospitals-list", + "source_note": "New India Assurance: 20,855 empanelled hospitals as of 11.02.2025 (direct quote from insurer Hospitals List page, scraped 2026-05-15). Counts all GIPSA PPN-empaneled hospitals so larger than aggregator counts that filter for active cashless.", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -123,23 +139,28 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", + "source_quote": "not stated in asha-kiran-policy__brochure.pdf", + "_confidence": "low" }, "policy_type": { - "value": "hospital-cash", + "value": "indemnity", "source_pdf_path": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "New India Asha Kiran is a Policy designed to cover Hospitalisation expenses of the family and Personal Accident for Parents.", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/new-india/asha-kiran-policy__brochure.pdf", "supporting_source_pdfs": [], "completeness_pct": 60, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill.", + "network_hospital_backfill_2026-05-15": "new-india insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/new-india__floater-mediclaim.json b/40-data/policy_facts/new-india__floater-mediclaim.json index 96ffe81151c2db8e3385ae7dc7de037ef45ace7a..a70681f619685a0efd3e83d8292ef13076a43419 100644 --- a/40-data/policy_facts/new-india__floater-mediclaim.json +++ b/40-data/policy_facts/new-india__floater-mediclaim.json @@ -19,21 +19,18 @@ "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", "source_quote": "Enhancement of Sum Insured will not be considered for: 1) Insured Persons over 65 years of age. (Max entry age commonly 65 years for retail floater)" }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "Lifelong renewability per IRDAI norms" - }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "Sum Insured options per Policy Schedule (New India floater grid: 3L, 5L, 8L, 10L, 15L; example referenced at 10,00,000 for long-term policy table)" + "source_quote": "not stated in new-india-floater-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "30-day waiting period for any illness (standard IRDAI Excl03)" + "source_quote": "4.3 FIRST THIRTY DAYS WAITING PERIOD (Code- Excl03) a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, @@ -43,12 +40,14 @@ "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "SPECIFIC WAITING PERIOD (Code- Excl02) ... excluded until the expiry of Ninety Days / 24 / 36 months of continuous coverage ... ii. 24 Months waiting period" + "source_quote": "4.2 SPECIFIC WAITING PERIOD (Code- Excl02) a. Expenses related to the treatment of the following listed conditions, surgeries / treatments shall be excluded until the expiry of Ninety Days / 24 / 36 months of continuous coverage,", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "Maternity Expenses defined; not a base benefit of Floater Mediclaim (delivery expenses excluded except for newborn illness)" + "source_quote": "not stated in new-india-floater-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, @@ -61,9 +60,11 @@ "source_quote": "3.1 (f) Post-Hospitalization Medical Expenses, not exceeding sixty days" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "DAY CARE TREATMENT defined per IRDAI Standard Definition (no fixed count in wording)" + "value": 139, + "source_url": "https://www.newindia.co.in/health-insurance/health-insurance-policy", + "source_note": "Per insurer baseline (New India Assurance Mediclaim covers ~139 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -73,7 +74,8 @@ "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "Maternity expenses not covered as base benefit (delivery/maternity-related expenses excluded; only newborn illness coverage available with 24-month continuous coverage)" + "source_quote": "4.4.15 MATERNITY EXPENSES (Code - Excl18) a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy;", + "_confidence": "high" }, "newborn_coverage": { "value": true, @@ -93,7 +95,8 @@ "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "No automatic Sum Insured restoration in base floater policy (optional Auto TOP-UP referenced)" + "source_quote": "not stated in new-india-floater-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": "Proportionate Deduction applies if higher Room than eligible category opted (per SI eligibility grid)", @@ -103,42 +106,51 @@ "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "co-payment does not reduce the Sum Insured (defined; applicability per Policy Schedule, typically zone/age-based)" + "source_quote": "not stated in new-india-floater-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible in standard floater plan" + "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", + "source_quote": "not stated in new-india-floater-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; New India advertises 3,000+ network hospitals nationally" + "value": 20855, + "source_url": "https://www.newindia.co.in/hospitals-list", + "source_note": "New India Assurance: 20,855 empanelled hospitals as of 11.02.2025 (direct quote from insurer Hospitals List page, scraped 2026-05-15). Counts all GIPSA PPN-empaneled hospitals so larger than aggregator counts that filter for active cashless.", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "Cashless facility through Network Provider (standard IRDAI definition adopted)" + "source_quote": "2.6 CASHLESS FACILITY means a facility extended by Us to You where the payments, of the costs of treatment undergone by You in accordance with the policy terms and conditions, are directly made to the Network provider by Us", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); New India PSU CSR available in IRDAI Annual Report" + "source_quote": "not stated in new-india-floater-mediclaim-policy__wordings.pdf", + "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", + "source_quote": "not stated in new-india-floater-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "Sum Insured ... indemnify the Insured Person (indemnity-based PSU floater mediclaim)" + "source_quote": "You or any Insured Person incurs Hospitalisation Expenses and/or services which are Reasonable and Customary and Medically Necessary for treatment of any Illness or Injury sustained in Accident, we will reimburse such expense incurred by You, in the manner stated herein.", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", "completeness_pct": 85, - "notes": "New India Floater Mediclaim (PSU insurer). Pre 30 days / Post 60 days (vs private insurers 60/180). NCB 25% per year, max 50%. No base maternity." + "notes": "New India Floater Mediclaim (PSU insurer). Pre 30 days / Post 60 days (vs private insurers 60/180). NCB 25% per year, max 50%. No base maternity.", + "network_hospital_backfill_2026-05-15": "new-india insurer-wide count backfilled in targeted scrape pass" } } diff --git a/40-data/policy_facts/new-india__janata-mediclaim-policy__wordings.json b/40-data/policy_facts/new-india__janata-mediclaim-policy__wordings.json index 006c90462d7936f8f56cc9929a53a22cb8d57ff3..50ad1dd22e06b3b3cc5391c8aa5d4e5421680a41 100644 --- a/40-data/policy_facts/new-india__janata-mediclaim-policy__wordings.json +++ b/40-data/policy_facts/new-india__janata-mediclaim-policy__wordings.json @@ -10,52 +10,60 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "of a pre-existing Disease (PED) and its direct \ncomplications shall be excluded until the expiry of 36 months of continuous coverage \nafter the date of inception of the first policy with us.", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "a. Expenses related to the treatment of any illness within 30 days from the first policy\ncommencement date shall be excluded except claims arising due to an accident", + "_confidence": "high" }, "maternity_coverage": { - "value": null, + "value": false, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "4.4.15 MATERNITY EXPENSES (Code - Excl18) \na. \nMedical treatment expenses traceable to childbirth", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "AYUSH TREATMENT\nExpenses incurred for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy\nsystem of medicines i" + "source_quote": "AYUSH TREATMENT\nExpenses incurred for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy\nsystem of medicines i", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "CASHLESS FACILITY" + "source_quote": "CASHLESS FACILITY", + "_confidence": "high" }, "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 5, @@ -68,9 +76,11 @@ "source_quote": "restoration of the previous state of Health\nunder any circumstances unless in a vegetative state as certified by the tre" }, "room_rent_capping": { - "value": null, + "value": "Room Rent (inclusive of nursing/treatment charges) Rs 450 per day", + "unit": null, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "PER DAY CHARGES \nRoom Rent (inclusive of nursing / treatment charges) \n450/-", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 30, @@ -83,39 +93,49 @@ "source_quote": "Post-Hospitalisation medical Expenses up to 60 days" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "" + "value": 139, + "source_url": "https://www.newindia.co.in/health-insurance/health-insurance-policy", + "source_note": "Per insurer baseline (New India Assurance Mediclaim covers ~139 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf" }, "network_hospital_count": { - "value": null, + "value": 20855, + "source_url": "https://www.newindia.co.in/hospitals-list", + "source_note": "New India Assurance: 20,855 empanelled hospitals as of 11.02.2025 (direct quote from insurer Hospitals List page, scraped 2026-05-15). Counts all GIPSA PPN-empaneled hospitals so larger than aggregator counts that filter for active cashless.", + "_confidence": "high", "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "policy_type": { - "value": "group", + "value": "indemnity", "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "the Company will pay to the Hospital / Day Care Centre or reimburse the Insured Person the following expenses that are Medically Necessary incurred for the treatment of such Illness or Injury.", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", "completeness_pct": 36, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF", + "network_hospital_backfill_2026-05-15": "new-india insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/new-india__janata-mediclaim.json b/40-data/policy_facts/new-india__janata-mediclaim.json index d09bd8de9940e7eca41e963ae6f8947e02d4931a..994b6e3d3935ac0affef1541d2d44a420f258367 100644 --- a/40-data/policy_facts/new-india__janata-mediclaim.json +++ b/40-data/policy_facts/new-india__janata-mediclaim.json @@ -11,24 +11,22 @@ "value": null, "unit": "days", "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -36,19 +34,22 @@ "source_quote": "the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. b. This exclusion shall n" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "complications shall be excluded until the expiry of 36 months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "4.2 SPECIFIC WAITING PERIOD (Code- Excl02) a. Expenses related to the treatment of the following listed conditions, surgeries / treatments shall be excluded until the expiry of Ninety Days / 24 / 36 months of continuous coverage, as may be", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, @@ -61,9 +62,11 @@ "source_quote": "l Expenses up to 30 days. 3.6 Post-Hospitalisation medical Expenses up to 60 days, subject to maximum of 10% of hospital bill. 3.7 COVERAGE FOR AYUSH TREATMENT Expenses incurred for Ayurveda, Yoga and" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 139, + "source_url": "https://www.newindia.co.in/health-insurance/health-insurance-policy", + "source_note": "Per insurer baseline (New India Assurance Mediclaim covers ~139 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -76,14 +79,16 @@ "source_quote": "15 MATERNITY EXPENSES (Code - Excl18) a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "organ_donor_expenses": { - "value": false, + "value": true, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "Organ donor cover not extracted" + "source_quote": "3.9 Hospitalisation expenses (excluding cost of organ) incurred on the donor during the course of organ transplant to the Insured person. The Company’s liability towards expenses incurred on the donor and the Insured recipient shall not exceed the Sum Insured", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": 5, @@ -96,24 +101,28 @@ "source_quote": "restoration of the previous state of Health" }, "room_rent_capping": { - "value": null, + "value": "3.1 Cost of treatment taken in General Ward of the Hospital / Day-Care Centre per day maximum\ncharges Rs. 450/-.", "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "3.1 Cost of treatment taken in General Ward of the Hospital / Day-Care Centre per day maximum\ncharges Rs. 450/-.", + "_confidence": "high" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 20855, + "source_url": "https://www.newindia.co.in/hospitals-list", + "source_note": "New India Assurance: 20,855 empanelled hospitals as of 11.02.2025 (direct quote from insurer Hospitals List page, scraped 2026-05-15). Counts all GIPSA PPN-empaneled hospitals so larger than aggregator counts that filter for active cashless.", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -123,12 +132,15 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", + "source_quote": "not stated in janata-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", @@ -140,6 +152,7 @@ "primary_source_pdf": "rag/corpus/new-india/janata-mediclaim-policy__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 70, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill.", + "network_hospital_backfill_2026-05-15": "new-india insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/new-india__mediclaim-policy.json b/40-data/policy_facts/new-india__mediclaim-policy.json index 8e37b923e1d2d2a195c1d8d52ccf48c881b7c3f7..e0bf98a881644b238dba4f1f60144e7e702bd882 100644 --- a/40-data/policy_facts/new-india__mediclaim-policy.json +++ b/40-data/policy_facts/new-india__mediclaim-policy.json @@ -11,24 +11,22 @@ "value": null, "unit": "days", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -36,24 +34,28 @@ "source_quote": "not renewed before or within 30 days from the date of expiry. In case sum insured under the policy is reduced at the time of renewal, the applicable Cumulative Bonus percentage shall be applied on the" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 48, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "complications shall be excluded until the expiry of 48 months of continuous coverage after\nthe date of inception of the first policy with us.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "4.2 SPECIFIC WAITING PERIOD (Code- Excl02) a. Expenses related to the treatment of the following listed conditions, surgeries / treatments shall be excluded until the expiry of Ninety Days / 24 / 36/ 48 months of continuous coverage, as may", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": 15, @@ -61,9 +63,11 @@ "source_quote": "ring the claim. d. In case of Post-Hospitalisation treatment, submit all claim documents within 15 days after completion of such treatment. e. Provide TPA with authorization to obtain medical and othe" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 139, + "source_url": "https://www.newindia.co.in/health-insurance/health-insurance-policy", + "source_note": "Per insurer baseline (New India Assurance Mediclaim covers ~139 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -81,14 +85,16 @@ "source_quote": "New Born Baby is covered for any Illness or Injury from the date of birth till the expiry of this Policy, within the terms of this Policy. Any expe" }, "organ_donor_expenses": { - "value": false, + "value": true, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "Organ donor cover not extracted" + "source_quote": "3.9 MEDICAL EXPENSES FOR ORGAN TRANSPLANT: If treatment involves Organ Transplant to Insured Person, then We will also pay Hospitalisation Expenses (excluding cost of organ) incurred on the donor", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": "restoration of normal state of Health under any circumstances", @@ -101,19 +107,22 @@ "source_quote": "room category, as evidenced by the Hospital’s schedule of charges / tariff" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 20855, + "source_url": "https://www.newindia.co.in/hospitals-list", + "source_note": "New India Assurance: 20,855 empanelled hospitals as of 11.02.2025 (direct quote from insurer Hospitals List page, scraped 2026-05-15). Counts all GIPSA PPN-empaneled hospitals so larger than aggregator counts that filter for active cashless.", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -123,23 +132,28 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "policy_type": { - "value": "hospital-cash", + "value": "indemnity", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "We will reimburse such expense incurred by You, through the Third Party Administrator, in the manner stated herein.", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 65, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill.", + "network_hospital_backfill_2026-05-15": "new-india insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/new-india__new-india-floater-mediclaim-policy__wordings.json b/40-data/policy_facts/new-india__new-india-floater-mediclaim-policy__wordings.json index 003aedf286a07af3fa51cc045fbad6d09f2fd5d7..0e08a65963eec6245fdbae76f310d369e80b6b40 100644 --- a/40-data/policy_facts/new-india__new-india-floater-mediclaim-policy__wordings.json +++ b/40-data/policy_facts/new-india__new-india-floater-mediclaim-policy__wordings.json @@ -10,52 +10,61 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-floater-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-floater-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "of a pre-existing Disease (PED) and its direct \ncomplications shall be excluded until the expiry of 36 months of continuous coverage \nafter the date of inception of the first policy with us", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "a. Expenses related to the treatment of any illness within 30 days from the first policy\ncommencement date shall be excluded except claims arising due to an accident", + "_confidence": "high" }, "maternity_coverage": { - "value": null, + "value": false, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "4.4.15 MATERNITY EXPENSES (Code - Excl18) \na. \nMedical treatment expenses traceable to childbirth", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-floater-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "AYUSH TREATMENT\nExpenses incurred for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy\nsystem of medicines i" + "source_quote": "AYUSH TREATMENT\nExpenses incurred for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy\nsystem of medicines i", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "CASHLESS FACILITY" + "source_quote": "CASHLESS FACILITY", + "_confidence": "high" }, "copayment_pct": { - "value": 20, + "value": null, + "unit": "%", "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "Co-payment of 20%" + "source_quote": "Co-payment of 20% will be applicable only, if the insured opts the lower zone and gets treated in the higher zone.", + "_confidence": "medium" }, "no_claim_bonus_pct": { "value": 25, @@ -68,9 +77,11 @@ "source_quote": "restoration of normal state of Health under any circumstances.\nWe cover the expenses up to 10%" }, "room_rent_capping": { - "value": "Room rent, Boarding, DMO / RMO / CMO / RMP Charges, Nursing (Including\nInjection", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "Room rent, Boarding, DMO / RMO / CMO / RMP Charges, Nursing (Including\nInjection / Drugs and Intra venous fluid administ" + "source_quote": "Room rent, Boarding, DMO / RMO / CMO / RMP Charges, Nursing (Including\nInjection / Drugs and Intra venous fluid administ", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 30, @@ -84,38 +95,48 @@ }, "day_care_treatments_count": { "value": null, + "unit": "procedures", "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-floater-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, + "value": 20855, + "source_url": "https://www.newindia.co.in/hospitals-list", + "source_note": "New India Assurance: 20,855 empanelled hospitals as of 11.02.2025 (direct quote from insurer Hospitals List page, scraped 2026-05-15). Counts all GIPSA PPN-empaneled hospitals so larger than aggregator counts that filter for active cashless.", + "_confidence": "high", "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-floater-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-floater-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-floater-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "policy_type": { - "value": "group", + "value": "indemnity", "source_pdf_path": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "You or any Insured Person incurs Hospitalisation Expenses and/or services which are Reasonable and Customary and Medically Necessary for treatment of any Illness or Injury sustained in Accident, we will reimburse such expense incurred by You, in the manner stated herein.", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/new-india/new-india-floater-mediclaim-policy__wordings.pdf", "completeness_pct": 45, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF", + "network_hospital_backfill_2026-05-15": "new-india insurer-wide count backfilled in targeted scrape pass" } } \ No newline at end of file diff --git a/40-data/policy_facts/new-india__new-india-mediclaim-policy__brochure.json b/40-data/policy_facts/new-india__new-india-mediclaim-policy__brochure.json index d14a056c637c8a62756c624ba1f613e696ff923b..60caa57486cbf10899def62eb2b4a01d50e9816b 100644 --- a/40-data/policy_facts/new-india__new-india-mediclaim-policy__brochure.json +++ b/40-data/policy_facts/new-india__new-india-mediclaim-policy__brochure.json @@ -8,54 +8,63 @@ "source_quote": "UIN: NIAHLIP25040V082425" }, "min_entry_age": { - "value": null, + "value": 18, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "" + "source_quote": "All the persons proposed for this Insurance should be between the age of 18 years and 65 years.", + "_confidence": "high" }, "max_entry_age": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, + "value": 65, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "" + "source_quote": "All the persons proposed for this Insurance should be between the age of 18 years and 65 years.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "" + "source_quote": "of a pre-existing Disease (PED) and its direct \ncomplications shall be excluded until the expiry of 36 months of continuous coverage \nafter the date of inception of the first policy with us.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-mediclaim-policy__brochure.pdf", + "_confidence": "low" }, "maternity_coverage": { - "value": null, + "value": false, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "" + "source_quote": "MATERNITY EXPENSES (Code - Excl18) \na. \nMedical treatment expenses traceable to childbirth", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-mediclaim-policy__brochure.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "AYUSH TREATMENT\nExpenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy,\nUnani, Siddha and H" + "source_quote": "AYUSH TREATMENT\nExpenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy,\nUnani, Siddha and H", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "Cashless facility" + "source_quote": "Cashless facility", + "_confidence": "high" }, "copayment_pct": { - "value": 20, + "value": 20.0, + "unit": "%", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "CO-PAY\nIf the Insured person opts for voluntary co-pay of 20%" + "source_quote": "CO-PAY\nIf the Insured person opts for voluntary co-pay of 20%", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": 25, @@ -68,9 +77,11 @@ "source_quote": "restoration of normal state of Health under any\ncircumstances. We cover the expenses up to 10%" }, "room_rent_capping": { - "value": "Room rent, Boarding, DMO / RMO / CMO / RMP Charges, Nursing (Including Injection", + "value": 2.0, + "unit": "%", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "Room rent, Boarding, DMO / RMO / CMO / RMP Charges, Nursing (Including Injection / Drugs\nand Intra venous fluid administ" + "source_quote": "Room rent, Boarding, DMO / RMO / CMO / RMP Charges, Nursing (Including Injection / Drugs\nand Intra venous fluid administ", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 30, @@ -84,38 +95,48 @@ }, "day_care_treatments_count": { "value": null, + "unit": "procedures", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-mediclaim-policy__brochure.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, + "value": 20855, + "source_url": "https://www.newindia.co.in/hospitals-list", + "source_note": "New India Assurance: 20,855 empanelled hospitals as of 11.02.2025 (direct quote from insurer Hospitals List page, scraped 2026-05-15). Counts all GIPSA PPN-empaneled hospitals so larger than aggregator counts that filter for active cashless.", + "_confidence": "high", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "" + "source_quote": "You are free to choose any Sum Insured ranging from Rs. One Lakh to Fifteen Lakhs.", + "_confidence": "medium" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-mediclaim-policy__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-mediclaim-policy__brochure.pdf", + "_confidence": "low" }, "policy_type": { - "value": "group", + "value": "indemnity", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "NEW INDIA MEDICLAIM POLICY is a Policy designed to cover Hospitalisation expenses and/or services incurred in India.", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/new-india/new-india-mediclaim-policy__brochure.pdf", "completeness_pct": 45, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF", + "network_hospital_backfill_2026-05-15": "new-india insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/new-india__new-india-mediclaim-policy__wordings.json b/40-data/policy_facts/new-india__new-india-mediclaim-policy__wordings.json index 5c1ba499647f2d3c9c1593d9220b948695a20c54..9b33788546b457b077e4f17a76cdc152c899cd48 100644 --- a/40-data/policy_facts/new-india__new-india-mediclaim-policy__wordings.json +++ b/40-data/policy_facts/new-india__new-india-mediclaim-policy__wordings.json @@ -10,52 +10,61 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 48, + "unit": "months", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "of a pre-existing Disease (PED) and its direct \ncomplications shall be excluded until the expiry of 48 months of continuous coverage after \nthe date of inception of the first policy with us.", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "a. Expenses related to the treatment of any illness within 30 days from the first policy\ncommencement date shall be excluded except claims arising due to an accident", + "_confidence": "high" }, "maternity_coverage": { - "value": null, + "value": false, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "4.4.15 MATERNITY EXPENSES (Code - Excl18) \na. Medical treatment expenses traceable to childbirth", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "AYUSH TREATMENT\nExpenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani,\nSiddha and H" + "source_quote": "AYUSH TREATMENT\nExpenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani,\nSiddha and H", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "CASHLESS FACILITY" + "source_quote": "CASHLESS FACILITY", + "_confidence": "high" }, "copayment_pct": { - "value": 20, + "value": 20.0, + "unit": "%", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "CO-PAY\nIf the Insured person opts for voluntary co-pay of 20%" + "source_quote": "CO-PAY\nIf the Insured person opts for voluntary co-pay of 20%", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": 25, @@ -68,9 +77,11 @@ "source_quote": "restoration of normal state of Health under any circumstances. We cover\nthe expenses up to 10%" }, "room_rent_capping": { - "value": "Room rent, Boarding, DMO / RMO / CMO / RMP Charges, Nursing (Including Injection", + "value": 1.0, + "unit": "%", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "Room rent, Boarding, DMO / RMO / CMO / RMP Charges, Nursing (Including Injection /\n3.1 (a) Drugs and Intra venous fluid " + "source_quote": "3.1 (a) Room rent, Boarding, DMO / RMO / CMO / RMP Charges, Nursing (Including Injection / Drugs and Intra venous fluid administration expenses), not exceeding 1% of the Sum Insured per day", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 30, @@ -84,38 +95,48 @@ }, "day_care_treatments_count": { "value": null, + "unit": "procedures", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, + "value": 20855, + "source_url": "https://www.newindia.co.in/hospitals-list", + "source_note": "New India Assurance: 20,855 empanelled hospitals as of 11.02.2025 (direct quote from insurer Hospitals List page, scraped 2026-05-15). Counts all GIPSA PPN-empaneled hospitals so larger than aggregator counts that filter for active cashless.", + "_confidence": "high", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in new-india-mediclaim-policy__wordings.pdf", + "_confidence": "low" }, "policy_type": { - "value": "group", + "value": "indemnity", "source_pdf_path": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "We will reimburse such expense incurred by You, through the Third Party Administrator, in the manner stated herein.", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/new-india/new-india-mediclaim-policy__wordings.pdf", "completeness_pct": 45, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF", + "network_hospital_backfill_2026-05-15": "new-india insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/new-india__universal-health-insurance__wordings.json b/40-data/policy_facts/new-india__universal-health-insurance__wordings.json index dc8a8f02d1560ed3bcfdf2d370ac8780eebb5a53..5b590c9f373266216276f54004f1919938a94908 100644 --- a/40-data/policy_facts/new-india__universal-health-insurance__wordings.json +++ b/40-data/policy_facts/new-india__universal-health-insurance__wordings.json @@ -10,112 +10,137 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "of a pre-existing Disease (PED) and its direct \ncomplications shall be excluded until the expiry of 36 months of continuous coverage after \nthe date of inception of the first policy with us.", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "a. Expenses related to the treatment of any illness within 30 days from the first policy\ncommencement date shall be excluded except claims arising due to an accident", + "_confidence": "high" }, "maternity_coverage": { - "value": null, + "value": false, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "4.18 MATERNITY EXPENSES (Code - Excl18) \na. Medical treatment expenses traceable to childbirth", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "AYUSH TREATMENT\nExpenses incurred for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy system\nof medicines i" + "source_quote": "AYUSH TREATMENT\nExpenses incurred for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy system\nof medicines i", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "CASHLESS FACILITY" + "source_quote": "CASHLESS FACILITY", + "_confidence": "high" }, "copayment_pct": { "value": null, + "unit": "%", "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "room_rent_capping": { - "value": null, + "value": "0.5% of Sum Insured per day", + "unit": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "Room, Boarding expenses as provided by the \nHospital / Nursing Home \n(ii) If admitted in IC Unit \n(i) Upto to 0.5% of Sum \nInsured per day", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "value": 139, + "source_url": "https://www.newindia.co.in/health-insurance/health-insurance-policy", + "source_note": "Per insurer baseline (New India Assurance Mediclaim covers ~139 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf" }, "network_hospital_count": { - "value": null, + "value": 20855, + "source_url": "https://www.newindia.co.in/hospitals-list", + "source_note": "New India Assurance: 20,855 empanelled hospitals as of 11.02.2025 (direct quote from insurer Hospitals List page, scraped 2026-05-15). Counts all GIPSA PPN-empaneled hospitals so larger than aggregator counts that filter for active cashless.", + "_confidence": "high", "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "policy_type": { - "value": "group", + "value": "indemnity", "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "the Company will pay through TPA to the Hospital or Insured person the amount of such expenses subject to limits as are Reasonably and Customarily and Medically necessarily incurred in respect thereof by or on behalf of such Insured Person", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", "completeness_pct": 18, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF", + "network_hospital_backfill_2026-05-15": "new-india insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/new-india__universal-health.json b/40-data/policy_facts/new-india__universal-health.json index b68a217d93e910fd395c45dd07ff0ab22a66c5f0..bab912e61e2080f59be0f83a0118396f09f64988 100644 --- a/40-data/policy_facts/new-india__universal-health.json +++ b/40-data/policy_facts/new-india__universal-health.json @@ -11,24 +11,22 @@ "value": null, "unit": "days", "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -36,34 +34,41 @@ "source_quote": "the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. b. This exclusion shall n" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "complications shall be excluded until the expiry of 36 months of continuous coverage after", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": 12, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "4.2 SPECIFIC WAITING PERIOD (Code- Excl02) a. Expenses related to the treatment of Cataract, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital Internal Disease, Fistula in anus, Piles, Sinusitis and related disorders shall be excluded until the expiry of 12 months of continuous coverage", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 139, + "source_url": "https://www.newindia.co.in/health-insurance/health-insurance-policy", + "source_note": "Per insurer baseline (New India Assurance Mediclaim covers ~139 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -76,19 +81,22 @@ "source_quote": "18 MATERNITY EXPENSES (Code - Excl18) a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "organ_donor_expenses": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "Organ donor cover not extracted" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": "restoration of the previous state of Health under any circumstances", @@ -98,22 +106,26 @@ "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 20855, + "source_url": "https://www.newindia.co.in/hospitals-list", + "source_note": "New India Assurance: 20,855 empanelled hospitals as of 11.02.2025 (direct quote from insurer Hospitals List page, scraped 2026-05-15). Counts all GIPSA PPN-empaneled hospitals so larger than aggregator counts that filter for active cashless.", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -123,12 +135,15 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", + "source_quote": "not stated in universal-health-insurance__wordings.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", @@ -140,6 +155,7 @@ "primary_source_pdf": "rag/corpus/new-india/universal-health-insurance__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 55, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill.", + "network_hospital_backfill_2026-05-15": "new-india insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/new-india__yuva-bharat-health-policy__wordings.json b/40-data/policy_facts/new-india__yuva-bharat-health-policy__wordings.json index 20e65fb202dfd6a8a13e0a89707534a2e73eca66..98ad15891b3e37e60258d592b589d6592cd70aa9 100644 --- a/40-data/policy_facts/new-india__yuva-bharat-health-policy__wordings.json +++ b/40-data/policy_facts/new-india__yuva-bharat-health-policy__wordings.json @@ -10,57 +10,67 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 24, + "unit": "months", "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "" + "source_quote": "of a pre-existing Disease (PED) and its direct \ncomplications shall be excluded until the expiry of 24 months of continuous coverage \nafter the date of inception of the first policy", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "" + "source_quote": "a. Expenses related to the treatment of any illness within 30 days from the first policy\ncommencement date shall be excluded except claims arising due to an accident", + "_confidence": "high" }, "maternity_coverage": { - "value": false, + "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "Maternity Coverage\n4.3 FIRST THIRTY DAYS WAITING PERIOD (Code- Excl03)\na. Expenses related to the treatment of any illne" + "source_quote": "Maternity Coverage\n4.3 FIRST THIRTY DAYS WAITING PERIOD (Code- Excl03)\na. Expenses related to the treatment of any illne", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "AYUSH TREATMENT\nExpenses incurred for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy\nsystem of medicines i" + "source_quote": "AYUSH TREATMENT\nExpenses incurred for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy\nsystem of medicines i", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "CASHLESS FACILITY" + "source_quote": "CASHLESS FACILITY", + "_confidence": "high" }, "copayment_pct": { - "value": null, + "value": 0.0, + "unit": "%", "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "" + "source_quote": "Insured Person opting for Zone I can avail treatment anywhere in India and No Co-pay \nshall be applicable.", + "_confidence": "medium" }, "no_claim_bonus_pct": { - "value": null, + "value": 10, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "" + "source_quote": "Insured Person will be entitled for cumulative bonus of 10% at each claim free year Renewal,", + "_confidence": "high" }, "restoration_benefit": { "value": "restoration of normal state of Health under any\ncircumstances. We cover the expe", @@ -68,9 +78,11 @@ "source_quote": "restoration of normal state of Health under any\ncircumstances. We cover the expenses up to 25%" }, "room_rent_capping": { - "value": null, + "value": "Single AC room (Sum Insured Rs 5/10/15 lakh); Deluxe AC room (Sum Insured Rs 25/50 lakh)", + "unit": null, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "" + "source_quote": "Room Rent including Boarding, DMO / RMO / CMO / RMP Charges, Nursing \n(Including Injection / Drugs and Intra venous fluid administration expenses) as \nprovided by the hospital \nSum insured of Rs. 5,00,000 /10,00,000/15,00,000 \nSingle AC room", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 60, @@ -84,38 +96,48 @@ }, "day_care_treatments_count": { "value": null, + "unit": "procedures", "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, + "value": 20855, + "source_url": "https://www.newindia.co.in/hospitals-list", + "source_note": "New India Assurance: 20,855 empanelled hospitals as of 11.02.2025 (direct quote from insurer Hospitals List page, scraped 2026-05-15). Counts all GIPSA PPN-empaneled hospitals so larger than aggregator counts that filter for active cashless.", + "_confidence": "high", "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "policy_type": { - "value": "group", + "value": "indemnity", "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "we will reimburse such expense through the Third-Party Administrator incurred by You in the manner stated herein.", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", "completeness_pct": 36, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF", + "network_hospital_backfill_2026-05-15": "new-india insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/new-india__yuva-bharat.json b/40-data/policy_facts/new-india__yuva-bharat.json index 575966e9c6909b4a070252fd397e22fcfd498286..12d953c6f1005f762672a32003b89b7f3255b333 100644 --- a/40-data/policy_facts/new-india__yuva-bharat.json +++ b/40-data/policy_facts/new-india__yuva-bharat.json @@ -11,24 +11,22 @@ "value": null, "unit": "days", "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -36,19 +34,22 @@ "source_quote": "the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. b. This exclusion shall n" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 24, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "complications shall be excluded until the expiry of 24 months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "4.2 SPECIFIC WAITING PERIOD (Code- Excl02) a. Expenses related to the treatment of the following listed conditions, surgeries / treatments shall be excluded until the expiry of Ninety Days / 12 / 24 months of continuous coverage,", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, @@ -58,12 +59,15 @@ "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 139, + "source_url": "https://www.newindia.co.in/health-insurance/health-insurance-policy", + "source_note": "Per insurer baseline (New India Assurance Mediclaim covers ~139 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -81,14 +85,16 @@ "source_quote": "New Born Baby Coverage 2. Gold Plan covers the following in addition to" }, "organ_donor_expenses": { - "value": false, + "value": true, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "Organ donor cover not extracted" + "source_quote": "3.4 MEDICAL EXPENSES FOR ORGAN TRANSPLANT: If treatment involves Organ Transplant to Insured Person, then We will also pay Hospitalisation Expenses (excluding cost of organ and Pre and Post Hospitalisation Expenses) incurred on the donor", + "_confidence": "high" }, "no_claim_bonus_pct": { - "value": null, + "value": 10, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "Insured Person will be entitled for cumulative bonus of 10% at each claim free year Renewal,", + "_confidence": "high" }, "restoration_benefit": { "value": "restoration of normal state of Health under any", @@ -101,19 +107,22 @@ "source_quote": "room category, as evidenced by the Hospital’s schedule of charges / tariff" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 20855, + "source_url": "https://www.newindia.co.in/hospitals-list", + "source_note": "New India Assurance: 20,855 empanelled hospitals as of 11.02.2025 (direct quote from insurer Hospitals List page, scraped 2026-05-15). Counts all GIPSA PPN-empaneled hospitals so larger than aggregator counts that filter for active cashless.", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -123,23 +132,28 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", + "source_quote": "not stated in yuva-bharat-health-policy__wordings.pdf", + "_confidence": "low" }, "policy_type": { - "value": "hospital-cash", + "value": "indemnity", "source_pdf_path": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "we will reimburse such expense through the Third-Party Administrator incurred by You in the manner stated herein.", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/new-india/yuva-bharat-health-policy__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 65, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill.", + "network_hospital_backfill_2026-05-15": "new-india insurer-wide count backfilled in targeted scrape pass" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/niva-bupa__aspire.json b/40-data/policy_facts/niva-bupa__aspire.json index 3d8728602c263a31aab02ead4dabb11cd17d256c..ce09d924921f295c3d8e89c67880283be441a4a7 100644 --- a/40-data/policy_facts/niva-bupa__aspire.json +++ b/40-data/policy_facts/niva-bupa__aspire.json @@ -11,27 +11,22 @@ "value": null, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in niva-bupa__aspire.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in niva-bupa__aspire.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 500000, - 1000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "10 Lakhs ReAssureX from Base Sum Insured (this 10 Lakh ReAssureX ReAssureX and 5 Lakhs will trigger from ReAs- unlimited sureX times) Either ReAssure+ or ReAssureX can be offered in a single policy. 4" + "source_quote": "not stated in niva-bupa__aspire.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -39,9 +34,10 @@ "source_quote": "the treatment of any Illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered. b. This exclusion shall n" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "Pre-existing Diseases (Code–Excl01): a. Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 12months/24 months/ 36 months (as per Variant selected) of continuous coverage", + "_confidence": "medium" }, "specific_disease_waiting_months": { "value": 24, @@ -51,12 +47,14 @@ "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in niva-bupa__aspire.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "We will pay expenses incurred on consultations, medicines, physiotherapy, diagnostic tests for 60 days before the date of admission and 180 days after date of discharge IF these are related to the condition for which hospitalization claim is paid.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, @@ -64,9 +62,11 @@ "source_quote": "ore the date of admission and 180 days after date of discharge IF these are related to the condition for which hospitalization claim is paid. 4.1.4. Home Care / Domiciliary Treatment Home Care Treatme" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -74,9 +74,10 @@ "source_quote": "tments anywhere in the world. AYUSH treatments are covered in India only. After all, the world comes to us for the best of AYUSH. 2. Definitions It is IMPORTANT You should go through the definition of" }, "maternity_coverage": { - "value": false, + "value": true, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "4.1.10. M-iracle Celebrating Parenthood! A baby adds new meaning to life, new meaning to family. All that goes in to planning for, welcoming and bringing up the little ones are the most beautiful times in life.", + "_confidence": "high" }, "newborn_coverage": { "value": true, @@ -91,12 +92,14 @@ "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in niva-bupa__aspire.pdf", + "_confidence": "low" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "Restoration benefit not found in extracted text" + "source_quote": "ReAssure “Forever”: Enjoy unlimited Sum Insured. The first paid claim in the life of the policy triggers ReAssure “Forever”. Once Triggered it stays for life, provided that the policy is renewed without break.", + "_confidence": "high" }, "room_rent_capping": { "value": "room category we are offering, and opt for what suits you best!", @@ -111,12 +114,14 @@ "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "Aggregate Deductible" + "source_quote": "not stated in niva-bupa__aspire.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -126,23 +131,50 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in niva-bupa__aspire.pdf", + "_confidence": "low", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "not stated in niva-bupa__aspire.pdf", + "_confidence": "low" }, "policy_type": { - "value": "hospital-cash", + "value": "indemnity", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "4.1.2. Expenses during Hospitalization a. We will pay the expenses incurred by you on treatment (Naturally this excludes expenses not linked to treatment like food, beverage, toiletries and cosmetics).", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/niva-bupa/aspire__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 65, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "Road Ambulance: We will pay you up to Base Sum Insured b", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an Illness/disease/Injury which in the normal course would requi", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "Annual Health Checkup", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } } \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__aspire__wordings.json b/40-data/policy_facts/niva-bupa__aspire__wordings.json index 722092b85bc4dd9cb8d3a6a10eaeca0bae17d813..e84b57d12e7e9629c637657c7661a895957111fe 100644 --- a/40-data/policy_facts/niva-bupa__aspire__wordings.json +++ b/40-data/policy_facts/niva-bupa__aspire__wordings.json @@ -7,132 +7,260 @@ "value": "NBHHLIP26049V022526", "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Product Name: Aspire | Product UIN: NBHHLIP26049V022526 Aspire Policy Wordings 1. Preamble You are a global citizen and the w", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__aspire__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__aspire__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": 90, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "New Born Baby means baby born during the policy period and is aged up to 90 days", + "_confidence": "high" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__aspire__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "d for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases. Provided the insurers shall offer coverage during the grace period, if", + "_confidence": "medium" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "sured person shall be allowed free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "nses related to the treatment of any Illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-existing Diseases (Code-Excl01): a. Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 12months/24 months/ 36 months (as per Variant selected)", + "_confidence": "medium" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the treatment of the listed conditions, surgeries/treatments shall be excluded until the expiry of 24 months/12 months (as per Variant Selected) of continuous", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__aspire__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "incurred on consultations, medicines, physiotherapy, diagnostic tests for 60 days before the date of admission and 180 days after date of discharge IF t", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "for 60 days before the date of admission and 180 days after date of discharge IF these are related to the condition for wh", + "_confidence": "high" }, "day_care_treatments_count": { "value": null, - "unit": null, + "unit": "procedures", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__aspire__wordings.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 0, + "unit": "%", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "treatments anywhere in the world. Choose from a range of co-payments options 0%, 20%, 30%, 40% & 50% Note", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": "No cap", + "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "choose to change the room category we are offering, and opt for what suits you best! You can choose between a Standard Single Room and a Shared Room up to Sum Insured", + "_confidence": "medium" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy Year means the period of one year from the date of commencement of the policy", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__aspire__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__aspire__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__aspire__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "This Policy covers Allopathic treatments anywhere in the world. AYUSH treatments are covered in India only. After all, the world comes to us for the best of AYUSH.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "4.1.10. M-iracle Celebrating Parenthood! A baby adds new meaning to life, new meaning to family. All that goes in to planning for, welcoming and bringing up the little ones are the most beautiful times in life.", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "The New Born will be covered from Day 1 in the policy. (Excl 5.2.3 will not apply for New Born Babies added)", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "4.1.5. Organ donor If you ever undergo an organ transplant, we will pay the hospitalization expenses of the donor for harvesting the organ, ONLY when your Hospitalization claim is paid.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "ReAssure “Forever”: Enjoy unlimited Sum Insured. The first paid claim in the life of the policy triggers ReAssure “Forever”. Once Triggered it stays for life, provided that the policy is renewed without break.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "4.1.4. Home Care / Domiciliary Treatment Home Care Treatment means treatment availed by the insured person at home which in normal course would require care and treatment at a hospital but is actually taken at home", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "consumer can be diagnosed anywhere in the world and can go for treatments anywhere in the world. This benefit is also available under cashless and reimbursement.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "Annual Health Checkup Available once every Policy Year, from day 1 of the policy. You can choose any test(s) from the list specified below.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "not stated in niva-bupa__aspire.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "not stated in niva-bupa__aspire__wordings.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "not stated in niva-bupa__aspire__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "worldwide", + "unit": "enum", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "This Policy covers Allopathic treatments anywhere in the world. AYUSH treatments are covered in India only. After all, th", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "In a floater policy, if a claim is paid for anyone in the plan then we will unlock the age for the entire policy", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "No cap", + "unit": "text", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "choose to change the room category we are offering, and opt for what suits you best! You can choose between a Standard Single Room and a Shared Room up to Sum Insured", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/niva-bupa/aspire__wordings.pdf", + "source_quote": "not stated in niva-bupa__aspire__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__health-companion-v2022__brochure.json b/40-data/policy_facts/niva-bupa__health-companion-v2022__brochure.json index 92788e63268cf8ce27f6fe4c76f22231ba66a68c..bfff503a2a1e5c208859e56bef253ab7bff073bb 100644 --- a/40-data/policy_facts/niva-bupa__health-companion-v2022__brochure.json +++ b/40-data/policy_facts/niva-bupa__health-companion-v2022__brochure.json @@ -10,67 +10,80 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__health-companion-v2022__brochure.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__health-companion-v2022__brochure.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": 24, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "pre-existing diseases | 24 months" + "source_quote": "pre-existing diseases | 24 months", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "" + "source_quote": "Investigation & Evaluation | OPD Treatment | 30-day initial waiting period | 36 months waiting period on pre-existing diseases | 24 months waiting period on specific diseases.", + "_confidence": "high" }, "maternity_coverage": { "value": null, + "unit": "boolean", "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__health-companion-v2022__brochure.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__health-companion-v2022__brochure.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "AYUSH Treatment(2) Covered" + "source_quote": "AYUSH Treatment(2) Covered", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "CASHLESS HASSLE FREE\nhospital" + "source_quote": "Avail 30 minutes$ cashless claims processing at 10,000 + Network Hospitals$$ across India", + "_confidence": "high" }, "copayment_pct": { "value": null, + "unit": "%", "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__health-companion-v2022__brochure.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 100, "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "No Claim Bonus Year; maximum up to 100%" + "source_quote": "every claim free year. Maximum 100% of Base Sum Insured.", + "_confidence": "high" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "" + "source_quote": "Refill Benefit – Reinstatement of an amount equal to base sum insured.", + "_confidence": "high" }, "room_rent_capping": { - "value": "Room Rent)\nalcoholism, drug or substance abuse or any addictive\ncondition and co", + "value": "No cap", + "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "Room Rent)\nalcoholism, drug or substance abuse or any addictive\ncondition and consequences thereof. Refer to the\nDay Car" + "source_quote": "Room Rent)\nalcoholism, drug or substance abuse or any addictive\ncondition and consequences thereof. Refer to the\nDay Car", + "_confidence": "medium" }, "pre_hospitalization_days": { "value": 60, @@ -83,39 +96,60 @@ "source_quote": "Post Hospitalisation 180 Days" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf" }, "network_hospital_count": { "value": null, + "unit": "hospitals", "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__health-companion-v2022__brochure.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "" + "value": [ + 300000, + 400000, + 500000, + 750000, + 1000000, + 1250000, + 1500000, + 2000000, + 3000000, + 5000000, + 10000000 + ], + "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", + "source_quote": "Floater Base Sum Insured (INR) 3 Lakhs 4 Lakhs 5 Lakhs 7.5 Lakhs 10 Lakhs 12.5 Lakhs 15 Lakhs 20 Lakhs 30 Lakhs 50 Lakhs 1 Crore", + "_confidence": "high", + "unit": "INR" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__health-companion-v2022__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { - "value": null, + "value": 0.5, "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "" + "source_quote": "Niva Bupa pre-authorisation requests within 30 minutes for all active policies, subject to receiving all documents and information(s) up to Niva Bupa’s satisfaction.", + "_confidence": "high" }, "policy_type": { - "value": "hospital_cash", + "value": "indemnity", "source_pdf_path": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", - "source_quote": "classified as hospital_cash from PDF heuristics" + "source_quote": "Benefits Inpatient Care Covered up to Sum Insured (No Capping on Room Rent) Day Care Treatment All procedures Covered up to Sum Insured", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/niva-bupa/health-companion-v2022__brochure.pdf", "completeness_pct": 41, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } } \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__health-companion.json b/40-data/policy_facts/niva-bupa__health-companion.json index 37a83c7f6d34c6e2253dbf82bbc32680c2f5206f..116ea3351d5fcb197683d277427941b31cbc9ea2 100644 --- a/40-data/policy_facts/niva-bupa__health-companion.json +++ b/40-data/policy_facts/niva-bupa__health-companion.json @@ -8,32 +8,31 @@ "source_quote": "Product Name: Health Companion | Product UIN: MAXHLIP21509V042021" }, "min_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "Dependent child entry standard 91 days (per Policy Schedule)" + "source_quote": "not stated in niva-bupa__health-companion.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "Adult entry per Policy Schedule (Health Companion: 18+ years, no max entry cap per IRDAI revised norms)" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "Lifelong renewability" + "source_quote": "not stated in niva-bupa__health-companion.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "Sum Insured options per Policy Schedule (Variant 1/2/3 + Family First; SI grid typically 3L/5L/7.5L/10L/15L/20L/25L/50L)" + "source_quote": "not stated in niva-bupa__health-companion.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "30-day waiting period applies to illness (standard IRDAI Excl03)" + "source_quote": "within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, @@ -43,12 +42,14 @@ "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "Specified disease/procedure Waiting Period (Code- Excl02): ... excluded until the expiry of 24 months of continuous coverage" + "source_quote": "expiry of 24 months of continuous coverage after the date of inception of the first Policy with Us. This exclusion shall not be applicable for claims arising due to an Accident (covered from day 1) or Cancer (covered after 30-day w", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "Maternity Expense defined; not a base benefit of Health Companion (optional via maternity rider)" + "source_quote": "not stated in niva-bupa__health-companion.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, @@ -61,79 +62,96 @@ "source_quote": "We will not be liable to pay Post-hospitalization Medical Expenses for more than 60 days immediately" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "Day Care Treatment defined per IRDAI Standard Definition" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "AYUSH treatment covered up to Sum Insured (standard Niva Bupa inclusion)" + "source_quote": "Any form of AYUSH Treatments, except as mentioned under Section 3.4.", + "_confidence": "medium" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "Maternity Expense defined; excluded in base (optional add-on)" + "source_quote": "Maternity (Code-Excl18) a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during Hospitalization) except ectopic pregnancy;", + "_confidence": "high" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "Maternity excluded in base; newborn linked to maternity" + "source_quote": "not stated in niva-bupa__health-companion.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "Organ donor expenses covered (standard Niva Bupa inclusion)" + "source_quote": "Living Organ Donor Transplant We will indemnify the Medical Expenses incurred for a living organ donor's Inpatient treatment for the harvesting of the organ donated provided that: a. The donation conforms to The Transplantation of Human Organs Act 1994", + "_confidence": "high" }, "no_claim_bonus_pct": { - "value": null, + "value": 20, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "No Claim Bonus means an increase to the Base Sum Insured in accordance with the provisions of Section 3.11 (rate per claim-free year per Policy Schedule, typically 20%; max accumulated 100%)" + "source_quote": "each Policy Year We will increase the Sum Insured applicable under the Policy by 20% of the Base Sum Insured of the immediately preceding Policy Year; subject up to maximum of 100% of the expiring Base Sum Insured.", + "_confidence": "high" }, "restoration_benefit": { "value": "Re-fill of Sum Insured (per Section 3.12)", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "Sum Insured means the total of the Base Sum Insured, re-fill amount as per Section 3.12 and No Claim Bonus as per Section 3.11" + "source_quote": "re-fill amountas per Section 3.12 and No Claim Bonus as per Section 3.11 which is Our maximum, total and cumulative liability for any and all claims during the Policy Year in respect of the Insured Person.", + "_confidence": "medium" }, "room_rent_capping": { - "value": "Per Policy Schedule (Variant-dependent: Single Private AC Room or higher)", + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "Room Rent means the amount charged (per Policy Schedule)" + "source_quote": "not stated in niva-bupa__health-companion.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "No mandatory base copay (voluntary copay options per Policy Schedule)" + "source_quote": "not stated in niva-bupa__health-companion.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible" + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-companion.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric (Niva Bupa 10,000+); not extracted" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "Cashless facility through Network Provider" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric; not extracted" + "source_quote": "not stated in niva-bupa__health-companion.pdf", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-companion.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "Indemnity-based mid-tier health plan" + "source_quote": "Inpatient Care We will indemnify the Medical Expenses incurred on the Insured Person's Hospitalization during the Policy Period following an Illness or Injury that occurs during the Policy Period", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-13", @@ -141,4 +159,4 @@ "completeness_pct": 78, "notes": "Niva Bupa Health Companion: 30/60 pre/post hospitalization (shorter than ReAssure 2.0's 60/180). 3 Variants with PED varying 36/48 months." } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__health-companion__wordings.json b/40-data/policy_facts/niva-bupa__health-companion__wordings.json index 52c7022d44de551b08ad4ba309fa6d6103b54f3e..469606db9357aae25e511694de88d9b5974d048a 100644 --- a/40-data/policy_facts/niva-bupa__health-companion__wordings.json +++ b/40-data/policy_facts/niva-bupa__health-companion__wordings.json @@ -7,141 +7,237 @@ "value": "MAXHLIP21509V042021", "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "lth Companion | Product UIN: MAXHLIP21509V042021", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 300000, - 500000, - 750000, - 1000000, - 1500000, - 2500000, - 5000000, - 10000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" }, "free_look_period": { - "value": 30, + "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Insured Person shall be allowed free look period of fifteen days (thirty days for policies with a term of 3 years, if sold through distance marketing) from date of receipt of the Policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 48, - "unit": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-existing Diseases (Code-Excl01): a. Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months (under Variant 2, Variant 3 Plans and Family First Policy)/ 48 months", + "_confidence": "medium" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the treatment of the listed conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 180, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "Any form of AYUSH Treatments, except as mentioned under Section 3.4.", + "_confidence": "medium" + }, + "maternity_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "Living Organ Donor Transplant We will indemnify the Medical Expenses incurred for a living organ donor's Inpatient treatment for the harvesting of the organ donated provided that: a. The donation conforms to The Transplantation of Human Organs Act 1994", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "re-fill amountas per Section 3.12 and No Claim Bonus as per Section 3.11 which is Our maximum, total and cumulative liability for any and all claims during the Policy Year in respect of the Insured Person.", + "_confidence": "medium" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "Domiciliary Hospitalization We will indemnify on a Reimbursement basis the Medical Expenses incurred for Domiciliary Hospitalization during the Policy Period following an Illness or Injury that occurs during the Policy Period", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "X. Health Checkup If the Policy is Renewed with Us without a break or if the Policy continues to be in force for the 2ndPolicy Year in the 2 year Policy Period (if applicable), then the Insured Person may avail a health check-up a", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "All benefits are available in India only and all claims shall be payable in India in Indian Rupees only", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "As per Product Benefits Table; proportionate deduction for higher room category", + "unit": "text", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "e Insured Person is admitted in the Hospital in a room category higher than the eligibility as specified in the Product Benefits Table, then We shall be liable to pay only a pro-rated proportion of the total Associated Medical Expenses", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/niva-bupa/health-companion__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-companion__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__health-plus-top-up.json b/40-data/policy_facts/niva-bupa__health-plus-top-up.json index 1790a53fb3c6d5ca01887a0fd59d127ad104dc38..a03ebe04e7c4b59e7e3e0d561f642337414826ba 100644 --- a/40-data/policy_facts/niva-bupa__health-plus-top-up.json +++ b/40-data/policy_facts/niva-bupa__health-plus-top-up.json @@ -11,24 +11,22 @@ "value": null, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in niva-bupa__health-plus-top-up.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in niva-bupa__health-plus-top-up.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in niva-bupa__health-plus-top-up.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -36,19 +34,22 @@ "source_quote": "eatment of any Illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered. b. This exclusion shall not, ho" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "Pre-existing Diseases (Code–Excl01): a. Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first Policy.", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "not stated in niva-bupa__health-plus-top-up.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in niva-bupa__health-plus-top-up.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, @@ -61,9 +62,11 @@ "source_quote": "ore the date of admission and 60 days after date of discharge IF these are related to the condition for which in-patient claim is paid. Conditions: a. We have accepted a claim under Section 3.1 (Inpat" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -76,9 +79,10 @@ "source_quote": ".17. Maternity Expenses (Code-Excl18) a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during Hospitalization) except ectopic" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in niva-bupa__health-plus-top-up.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, @@ -88,12 +92,14 @@ "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in niva-bupa__health-plus-top-up.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "Restoration benefit not found in extracted text" + "source_quote": "not stated in niva-bupa__health-plus-top-up.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": "room category opted or Room Rent incurred is higher", @@ -101,19 +107,22 @@ "source_quote": "room category opted or Room Rent incurred is higher" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in niva-bupa__health-plus-top-up.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in niva-bupa__health-plus-top-up.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -123,17 +132,21 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in niva-bupa__health-plus-top-up.pdf", + "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-plus-top-up.pdf", + "_confidence": "low" }, "policy_type": { - "value": "top-up", + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "Top-up / super top-up policy (per product name)" + "source_quote": "not stated in niva-bupa__health-plus-top-up.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", diff --git a/40-data/policy_facts/niva-bupa__health-plus-top-up__wordings.json b/40-data/policy_facts/niva-bupa__health-plus-top-up__wordings.json index 10805ecd1d7358d7e8e83dc6e596cd783b386ba2..0ca46d19b8591e99839f02df076ed4ef9013769c 100644 --- a/40-data/policy_facts/niva-bupa__health-plus-top-up__wordings.json +++ b/40-data/policy_facts/niva-bupa__health-plus-top-up__wordings.json @@ -7,132 +7,223 @@ "value": "NBHHLIP24135V012324", "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "me: Health+, Product UIN: NBHHLIP24135V012324", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "d for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases. Provided the insurers shall offer coverage during the grace period, if", + "_confidence": "medium" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "sured person shall be allowed free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "treatment of any Illness within 30 days from the first Policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-existing Diseases (Code-Excl01): a. Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 36, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "on consultations, medicines, physiotherapy, diagnostic tests for 30 days before the date of admission and 60 days after date of discharge IF t", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "for 30 days before the date of admission and 60 days after date of discharge IF these are related to the condition for wh", + "_confidence": "high" }, "day_care_treatments_count": { "value": null, - "unit": null, + "unit": "procedures", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_quote": "This Policy covers Allopathic and AYUSH treatments taken in India ONLY.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_quote": "3.7. Organ Transplant What is covered: We will indemnify the Medical Expenses incurred for a living organ donor’s Inpatient treatment for the harvesting of the organ donated during the Policy Period.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_quote": "3.6. Home Care / Domiciliary Treatment Home Care Treatment means treatment availed by the insured person at home which in normal course would require care and treatment at a hospital but is actually taken at home", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_quote": "Allopathic and AYUSH treatments taken in India ONLY", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" + }, + "deductible_amount": { + "value": null, + "unit": "INR", + "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "Per Policy Schedule eligibility; proportionate deduction for higher room category", + "unit": "text", + "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_quote": "room where the room category opted or Room Rent incurred is higher than the eligibility as specified in the Policy Schedule, then We shall be liable to pay only a pro-rated portion", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/niva-bupa/health-plus-top-up__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-plus-top-up__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__health-premia.json b/40-data/policy_facts/niva-bupa__health-premia.json index 725c9390dc3020a2a5a61cb0196c46bbb61bba48..04106eb19ad14b5a26132ca9a9a68d2a38472c89 100644 --- a/40-data/policy_facts/niva-bupa__health-premia.json +++ b/40-data/policy_facts/niva-bupa__health-premia.json @@ -11,59 +11,65 @@ "value": null, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in niva-bupa__health-premia.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in niva-bupa__health-premia.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in niva-bupa__health-premia.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "Default IRDAI 30-day waiting period applies (not explicitly quoted in extracted snippet)" + "source_quote": "within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered. b. This exclusion shall not, however, apply if the Insured Perso", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 24, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "excluded until the expiry of 24 months of continuous coverage after the date of inception of the first", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "expiry of 24 months of continuous coverage after the date of inception of the first Policy.. b. In case of enhancement of Sum Insured the exclusion sh", + "_confidence": "high" }, "maternity_waiting_months": { - "value": null, + "value": 24, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "Person for a period of 24 months of continuous coverage since the inception of the First Policy, with maternity as a benefit, with", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": null, + "value": 90, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "a. We will pay above mentioned Pre-hospitalization Medical Expenses only for period up to 90 days immediately preceding the", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 180, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "a. We will pay Post-hospitalization Medical Expenses only for up to 180 days immediately following the Insured Person’s discharge", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -71,9 +77,10 @@ "source_quote": "age as on last birthday. 2.38 AYUSH Treatment refers to the medical and / or hospitalization treatments given under Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy systems. Product Name: H" }, "maternity_coverage": { - "value": false, + "value": true, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "We will indemnify the Maternity Expenses incurred during the Policy Period.", + "_confidence": "high" }, "newborn_coverage": { "value": true, @@ -108,12 +115,14 @@ "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in niva-bupa__health-premia.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -123,23 +132,50 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in niva-bupa__health-premia.pdf", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-premia.pdf", + "_confidence": "low" }, "policy_type": { - "value": "hospital-cash", + "value": "indemnity", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "Inpatient Care What is covered: We will indemnify the Medical Expenses incurred for one or more of the following due to the Insured Person’s Hospitalization during the Policy Period following an Illness or Injury:", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/niva-bupa/health-premia__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 65, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "Emergency Ambulance What is covered: We will indemnify the costs incurred, on transportation of the Insured Person by road Ambulance to a Hospital for", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an Illness/disease/Injury which in the normal course would requi", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "Health check-up on", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } } \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__health-premia__wordings.json b/40-data/policy_facts/niva-bupa__health-premia__wordings.json index 7f1dfdf83f723c472fcab8e5143382bbdf781934..91a34f499bc0640ce9b45b235ea3abc5b0382b2f 100644 --- a/40-data/policy_facts/niva-bupa__health-premia__wordings.json +++ b/40-data/policy_facts/niva-bupa__health-premia__wordings.json @@ -7,142 +7,258 @@ "value": "MAXHLIP21176V022021", "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Health Premia, Product UIN: MAXHLIP21176V022021", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-premia__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__health-premia__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": 90, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "New Born Baby means baby born during the Policy Period and is aged between 1 day and 90 days", + "_confidence": "high" }, "sum_insured_options": { - "value": [ - 500000, - 1000000, - 1500000, - 2000000, - 3000000, - 5000000, - 10000000, - 20000000, - 30000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__health-premia__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "d for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases. Provided the insurers shall offer coverage during the grace period, if", + "_confidence": "medium" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "sured person shall be allowed free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "treatment of any Illness within 30 days from the first Policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-existing Diseases (Code-Excl01) a. Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": 12, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Specified disease/procedure waiting period- Code- Excl02 a. Expenses related to the treatment of the listed conditions, surgeries/treatments shall be excluded until the expiry of 12 months of continuous", + "_confidence": "high" }, "maternity_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__health-premia__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__health-premia__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 180, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__health-premia__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-premia__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-premia__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-premia__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-premia__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-premia__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__health-premia__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "AYUSH Treatment Any form of AYUSH Treatments, except as mentioned under Section 3.6", + "_confidence": "medium" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "We will indemnify the Maternity Expenses incurred during the Policy Period.", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "3.11 New Born Baby What is covered: We will cover the Medical Expenses incurred towards the medical treatment of the Insured Person’s New Born Baby from the date of delivery until the expiry of the Policy Year", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "Living Organ Donor Transplant What is covered: We will indemnify the Medical Expenses incurred for a living organ donor's treatment as an Inpatient for the harvesting of the organ donated", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "Re-fill Benefit What is covered: If the Base Sum Insured and increased Sum Insured under Loyalty Additions (Section 3.16)/ Enhanced Loyalty Additions (Section 4.3) (if any) has been partially or compl", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "Domiciliary Hospitalization What is covered: We will indemnify on Reimbursement basis only, the Medical Expenses incurred for the Insured Person’s Domiciliary Hospitalization during the Policy Period following an Illness or Injury", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "Enhanced Geographical Scope for International Coverage’ can ", + "_confidence": "medium" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "Health Check-up What is covered: The Insured Person may avai", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "Critical Illness Cover What is covered: ", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "Cumulative Bonus by increasing the Sum Insured applicable under the Policy by 10% of the Base Sum Insured of the immediately preceding Policy Year subject to a maximum of 100% of the Base Sum Insured", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-premia__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "worldwide", + "unit": "enum", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "Enhanced Geographical Scope for International Coverage’ can ", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "not stated in niva-bupa__health-premia__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "Per Policy Schedule eligibility; proportionate deduction for higher room category", + "unit": "text", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "room where the room category opted or Room Rent incurred is higher than the eligibility as specified in the Policy Schedule, then We shall be liable to pay only a pro-rated portion", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 10, + "unit": "%", + "source_pdf_path": "rag/corpus/niva-bupa/health-premia__wordings.pdf", + "source_quote": "Cumulative Bonus by increasing the Sum Insured applicable under the Policy by 10% of the Base Sum Insured of the immediately preceding Policy Year subject to a maximum of 100% of the Base Sum Insured", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__reassure-2-0__wordings.json b/40-data/policy_facts/niva-bupa__reassure-2-0__wordings.json index 59aa8f47eadb1c075824d0955e728babe08495ab..a02a75cf5189f24c3a49430fd7ac52d6d711c107 100644 --- a/40-data/policy_facts/niva-bupa__reassure-2-0__wordings.json +++ b/40-data/policy_facts/niva-bupa__reassure-2-0__wordings.json @@ -10,72 +10,86 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-2-0__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-2-0__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "Pre-existing Diseases (Code-Excl01): a. Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "a. Expenses related to the treatment of any Illness within 30 days from the first Policy commencement date shall be", + "_confidence": "high" }, "maternity_coverage": { "value": null, + "unit": "boolean", "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-2-0__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-2-0__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { - "value": null, + "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "This Policy covers Allopathic and AYUSH treatments taken in India ONLY", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "Cashless Facility" + "source_quote": "Cashless Facility", + "_confidence": "high" }, "copayment_pct": { "value": null, + "unit": "%", "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-2-0__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-2-0__wordings.pdf", + "_confidence": "low" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "4.7.1. ReAssure “Forever”: Enjoy unlimited Sum Insured. The first paid claim in the life of the policy triggers ReAssure “Forever”.", + "_confidence": "high" }, "room_rent_capping": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-2-0__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "We will pay expenses incurred on consultations, medicines, physiotherapy, diagnostic tests for 60 days before the date of admission", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, @@ -83,39 +97,46 @@ "source_quote": "Post hospitalization)\nWe will pay expenses incurred on consultations, medicines, physiotherapy, diagnostic tests for 60 " }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-2-0__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-2-0__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-2-0__wordings.pdf", + "_confidence": "low" }, "policy_type": { - "value": "hospital_cash", + "value": "indemnity", "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "classified as hospital_cash from PDF heuristics" + "source_quote": "We will pay the expenses incurred by you on treatment (Naturally this excludes expenses not linked to treatment like food, beverage, toiletries and cosmetics).", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", "completeness_pct": 18, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } } \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__reassure-2.json b/40-data/policy_facts/niva-bupa__reassure-2.json index 74d80ce478583e08b4af89c748a7e1b1708618e0..2f2f762be356cbfb9d0da02f6975a4af7133a7da 100644 --- a/40-data/policy_facts/niva-bupa__reassure-2.json +++ b/40-data/policy_facts/niva-bupa__reassure-2.json @@ -8,27 +8,25 @@ "source_quote": "Product Name: ReAssure 2.0: Product UIN: NBHHLIP26042V022526" }, "min_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "Child entry standard 91 days (per Policy Schedule / Niva Bupa norms)" + "source_quote": "not stated in niva-bupa__reassure-2.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "Adult entry per Policy Schedule (ReAssure 2.0: 18+ years, no upper cap on entry)" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "Lifelong renewability" + "source_quote": "not stated in niva-bupa__reassure-2.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "Sum Insured options per Policy Schedule (ReAssure 2.0 base SI: 3L/5L/7L/10L/15L/25L/50L/1Cr; Booster+ up to 3x/5x/10x base SI)" + "source_quote": "not stated in niva-bupa__reassure-2.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -48,7 +46,8 @@ "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "5.1.16. Maternity Expenses (Code-Excl18) — base policy excludes Medical treatment expenses traceable to childbirth (maternity optional via separate plan/rider)" + "source_quote": "not stated in niva-bupa__reassure-2.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, @@ -61,9 +60,11 @@ "source_quote": "60 days before the date of admission and 180 days after date of discharge" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "Day Care Treatment defined per IRDAI Standard Definition (covered; no fixed count enumerated)" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -73,12 +74,14 @@ "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "5.1.16. Maternity Expenses (Code-Excl18) — excluded as standard in base ReAssure 2.0" + "source_quote": "Maternity Expenses (Code-Excl18) a. Medical treatment expens", + "_confidence": "high" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "Maternity excluded; newborn baby cover tied to maternity option" + "source_quote": "not stated in niva-bupa__reassure-2.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, @@ -88,12 +91,14 @@ "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "ReAssure 2.0 uses 'Booster+' (instead of fixed-% NCB): unused Sum Insured can be banked as Booster+ up to 3x/5x/10x of Base SI (plan-dependent)" + "source_quote": "not stated in niva-bupa__reassure-2.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": "ReAssure 'Forever': unlimited Sum Insured triggered by first paid claim (lifetime trigger). ReAssureX restores SI for any subsequent unrelated illness.", "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "4.7.1. ReAssure 'Forever': Enjoy unlimited Sum Insured. The first paid claim in the life of the policy triggers ReAssure 'Forever'. Once Triggered it stays for life" + "source_quote": "ReAssure “Forever”: ", + "_confidence": "medium" }, "room_rent_capping": { "value": "No room rent cap — 'Choose the room you like'", @@ -101,44 +106,75 @@ "source_quote": "We don't limit your choice. Choose the room you like, but choose judiciously to protect your Sum Insured." }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "Co-payment ... will bear a specified percentage of the admissible claim amount (defined; no mandatory base copay in ReAssure 2.0)" + "source_quote": "not stated in niva-bupa__reassure-2.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible (optional deductible/voluntary copay add-ons available)" + "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", + "source_quote": "not stated in niva-bupa__reassure-2.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; Niva Bupa advertises 10,000+ network hospitals on its website" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "Annual Health Checkup ... ONLY on cashless and no re-imbursement is allowed (cashless network in operation)" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric; not extracted" + "source_quote": "not stated in niva-bupa__reassure-2.pdf", + "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", + "source_quote": "not stated in niva-bupa__reassure-2.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", - "source_quote": "Indemnity-based health insurance (Hospitalization Expenses indemnified up to Sum Insured)" + "source_quote": "We will pay the expenses incurred by you on treatment (Naturally this excludes expenses not linked to treatment like food, beverage, toiletries and cosmetics).", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", "completeness_pct": 85, - "notes": "ReAssure 2.0 uses Booster+ (Sum Insured banking) instead of fixed NCB. ReAssure 'Forever' provides unlimited SI after first claim. Maternity excluded in base." + "notes": "ReAssure 2.0 uses Booster+ (Sum Insured banking) instead of fixed NCB. ReAssure 'Forever' provides unlimited SI after first claim. Maternity excluded in base. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", + "source_quote": "Road Ambulance: We will pay you up to Sum Insured", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an Illness/disease/Injury which in the normal course would requi", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/reassure-2-0__wordings.pdf", + "source_quote": "Annual Health Checkup", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__reassure-3-0__wordings.json b/40-data/policy_facts/niva-bupa__reassure-3-0__wordings.json index d1180fdb45f63f9e264c069453ba4bff9f749085..41c0aa9bd5add0e96f0a26cb1a5335fd6842d02d 100644 --- a/40-data/policy_facts/niva-bupa__reassure-3-0__wordings.json +++ b/40-data/policy_facts/niva-bupa__reassure-3-0__wordings.json @@ -10,72 +10,86 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-3-0__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-3-0__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, + "unit": "months", "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "source_quote": "Pre-existing Diseases (Code-Excl01): a. Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "source_quote": "a. Expenses related to the treatment of any Illness within 30 days from the first Policy", + "_confidence": "high" }, "maternity_coverage": { "value": null, + "unit": "boolean", "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-3-0__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-3-0__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { - "value": null, + "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "source_quote": "This Policy covers Allopathic and AYUSH treatments taken in India ONLY", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "Cashless Facility" + "source_quote": "Cashless Facility", + "_confidence": "high" }, "copayment_pct": { - "value": 0, + "value": 0.0, + "unit": "%", "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "co-payments\noptions 0%" + "source_quote": "co-payments\noptions 0%", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-3-0__wordings.pdf", + "_confidence": "low" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "source_quote": "The first paid claim in the life of the policy triggers ReAssure “Forever”. Once Triggered it stays for life,", + "_confidence": "high" }, "room_rent_capping": { "value": null, + "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-3-0__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "source_quote": "We will pay expenses incurred on consultations, medicines, physiotherapy, diagnostic tests for 60 days", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, @@ -83,39 +97,46 @@ "source_quote": "Post hospitalization)\nWe will pay expenses incurred on consultations, medicines, physiotherapy, diagnostic tests for 60 " }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "Sum Insured\u201d option " + "source_quote": "not stated in niva-bupa__reassure-3-0__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-3-0__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__reassure-3-0__wordings.pdf", + "_confidence": "low" }, "policy_type": { - "value": "hospital_cash", + "value": "indemnity", "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "classified as hospital_cash from PDF heuristics" + "source_quote": "We will pay the expenses incurred by you on treatment (Naturally this excludes expenses not linked to treatment like food, beverage, toiletries and cosmetics).", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", "completeness_pct": 23, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } } \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__reassure-3.json b/40-data/policy_facts/niva-bupa__reassure-3.json index 5eb6e5c8b3b86ecf591441993c3a1fc840265159..76d3822691f6c0fd948c448b240c8b82b24006a4 100644 --- a/40-data/policy_facts/niva-bupa__reassure-3.json +++ b/40-data/policy_facts/niva-bupa__reassure-3.json @@ -11,18 +11,15 @@ "value": null, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in niva-bupa__reassure-3.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in niva-bupa__reassure-3.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -37,22 +34,26 @@ "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "Default IRDAI 30-day waiting period applies (not explicitly quoted in extracted snippet)" + "source_quote": "treatment of any Ill", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "be excluded until the expiry of 36 months of continuous coverage after the date of inception of the", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "expiry of 24 months of continuous coverage after the date of", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in niva-bupa__reassure-3.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, @@ -65,9 +66,11 @@ "source_quote": "ore the date of admission and 180 days after date of discharge IF these are related to the condition for which hospitalization claim is paid. 4.4. Home Care / Domiciliary Treatment Home Care Treatment" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -77,7 +80,8 @@ "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "Maternity Expenses (Code-Excl18) a. Medi", + "_confidence": "high" }, "newborn_coverage": { "value": true, @@ -92,12 +96,14 @@ "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in niva-bupa__reassure-3.pdf", + "_confidence": "low" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "Restoration benefit not found in extracted text" + "source_quote": "The first paid claim in the life of the policy triggers ReAssure “Forever”. Once Triggered it stays for life,", + "_confidence": "high" }, "room_rent_capping": { "value": "single private room, general ward, twin sharing) you are eligible for will get fixed", @@ -112,12 +118,14 @@ "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "Aggregate Deductible" + "source_quote": "not stated in niva-bupa__reassure-3.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -127,23 +135,50 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in niva-bupa__reassure-3.pdf", + "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", + "source_quote": "not stated in niva-bupa__reassure-3.pdf", + "_confidence": "low" }, "policy_type": { - "value": "hospital-cash", + "value": "indemnity", "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "We will pay the expenses incurred by you on treatment (Naturally this excludes expenses not linked to treatment like food, beverage, toiletries and cosmetics).", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", "supporting_source_pdfs": [], "completeness_pct": 70, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", + "source_quote": "Road Ambulance: We will pay you up to the mentioned limit in your policy", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an Illness/disease/Injury which in the normal course would requi", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/reassure-3-0__wordings.pdf", + "source_quote": "Annual Health Check-up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } } \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__rise.json b/40-data/policy_facts/niva-bupa__rise.json index 176c70d99d9d0c1dc0036023dcf2be2490490b9a..4542c660eb1dcf04eb10886037c002fc71ca1abb 100644 --- a/40-data/policy_facts/niva-bupa__rise.json +++ b/40-data/policy_facts/niva-bupa__rise.json @@ -11,24 +11,22 @@ "value": null, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in niva-bupa__rise.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in niva-bupa__rise.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in niva-bupa__rise.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -36,9 +34,10 @@ "source_quote": "the treatment of any Illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered. b. This exclusion shall n" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "expiry of 36 months of continuous coverage after the date of inception of the first Policy.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, @@ -48,12 +47,14 @@ "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in niva-bupa__rise.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "We will pay expenses incurred on consultations, medicines, physiotherapy, diagnostic tests for 60 days before the date of", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, @@ -61,9 +62,11 @@ "source_quote": "ore the date of admission and 180 days after date of discharge IF these are related to the condition for which hospitalization claim is paid. 4.1.4. Home Care / Domiciliary Treatment Home Care Treatme" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -76,9 +79,10 @@ "source_quote": ".16. Maternity Expenses (Code-Excl18) a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during Hospitalization) except ectopic" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in niva-bupa__rise.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, @@ -88,12 +92,14 @@ "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in niva-bupa__rise.pdf", + "_confidence": "low" }, "restoration_benefit": { - "value": null, + "value": true, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "Restoration benefit not found in extracted text" + "source_quote": "4.1.7. Re-fill\nOnce in a policy year, we will add an amount equal to the base sum insured. This amount will be added at complete or partial", + "_confidence": "high" }, "room_rent_capping": { "value": "Single Private Room or All Room Category", @@ -108,12 +114,14 @@ "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "Aggregate Deductible cannot be opted together" + "source_quote": "not stated in niva-bupa__rise.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -123,17 +131,21 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in niva-bupa__rise.pdf", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_quote": "not stated in niva-bupa__rise.pdf", + "_confidence": "low" }, "policy_type": { - "value": "hospital-cash", + "value": "indemnity", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "We will pay the expenses incurred by you on treatment (Naturally this excludes expenses not linked to treatment like food, beverage, toiletries and cosmetics).", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", diff --git a/40-data/policy_facts/niva-bupa__rise__wordings.json b/40-data/policy_facts/niva-bupa__rise__wordings.json index c436d316af998fe2e52f71a721c7e485157d3312..12a6b99585dce083c290d1103997dfebad756c4e 100644 --- a/40-data/policy_facts/niva-bupa__rise__wordings.json +++ b/40-data/policy_facts/niva-bupa__rise__wordings.json @@ -7,132 +7,237 @@ "value": "NBHHLIP25041V012425", "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": ": RISE | PRODUCT UIN: NBHHLIP25041V012425", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 90, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "d for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases. Provided the insurers shall offer coverage during the grace period, if", + "_confidence": "medium" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "sured person shall be allowed free look period of thirty days from date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "treatment of any Illness within 30 days from the first Policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-existing Diseases (Code-Excl01): a. Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 36, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Specified disease/procedure waiting period (Code- Excl02) a. Expenses related to the treatment of the listed conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "incurred on consultations, medicines, physiotherapy, diagnostic tests for 60 days before the date of admission and 180 days after date of discharge IF t", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "for 60 days before the date of admission and 180 days after date of discharge IF these are related to the condition for wh", + "_confidence": "high" }, "day_care_treatments_count": { "value": null, - "unit": null, + "unit": "procedures", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 20, + "unit": "%", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "reatment is taken outside this network, then a flat 20% co-payment will be applicable to the admissible claim amount. This co-payment you would have to bear for every claim", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_quote": "covers Allopathic and AYUSH treatments taken in India ONLY.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_quote": "ReAssure Forever Enj", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_quote": "Home Care / Domiciliary Treatm", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_quote": "Health Checkup (Only", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_quote": "Allopathic and AYUSH treatments taken in India ONLY", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "No cap; choose any room category up to Sum Insured", + "unit": "text", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_quote": "choose to change the room category we are offering, and opt for what suits you best! PRODUCT NAME: RISE | PRODUCT UIN: NBHHLIP25041V012425 You can choose between a General Ward (any room with 4 beds and m", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/niva-bupa/rise__wordings.pdf", + "source_quote": "not stated in niva-bupa__rise__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__saral-suraksha-bima__wordings.json b/40-data/policy_facts/niva-bupa__saral-suraksha-bima__wordings.json index 3a31d99e94885d089d40f1222855f7afab9b38f2..d178bfbdbf983863a2eb6c825458c4781440116b 100644 --- a/40-data/policy_facts/niva-bupa__saral-suraksha-bima__wordings.json +++ b/40-data/policy_facts/niva-bupa__saral-suraksha-bima__wordings.json @@ -10,52 +10,59 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "maternity_coverage": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "AYUSH (as defined in IRDAI\n(Health Insurance) Regulations, 2016) systems of medicine shall be covered" + "source_quote": "AYUSH (as defined in IRDAI\n(Health Insurance) Regulations, 2016) systems of medicine shall be covered", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Cashless Facility" + "source_quote": "Cashless Facility", + "_confidence": "high" }, "copayment_pct": { "value": null, + "unit": "%", "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 5, @@ -65,57 +72,68 @@ "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in niva-bupa__saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "policy_type": { - "value": "group", + "value": "personal-accident", "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "a) Death: The Compan", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", "completeness_pct": 23, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } } \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__saral-suraksha.json b/40-data/policy_facts/niva-bupa__saral-suraksha.json index 9661244f5b8ec857043ab67cdc9655ef145c2153..6e7b01555a7cc1257fb936831f5820d3d6260d10 100644 --- a/40-data/policy_facts/niva-bupa__saral-suraksha.json +++ b/40-data/policy_facts/niva-bupa__saral-suraksha.json @@ -8,27 +8,25 @@ "source_quote": "surance Co. Ltd, Product UIN: NBHPAIP22153V012122. authorized personnel. 2.9. Hospitalisation means admission in a hospital for a minimum period of twenty-four (24) consecutive 'In-patient care' hours" }, "min_entry_age": { - "value": null, + "value": 90, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "(vi) dependent Children (i.e. natural or legally adopted) between the age 3 months to 25 years. If", + "_confidence": "medium" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, @@ -38,32 +36,39 @@ "pre_existing_disease_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf" }, "ayush_coverage": { "value": true, @@ -71,19 +76,22 @@ "source_quote": "zation due to accident, under AYUSH (as defined in IRDAI (Health Insurance) Regulations, 2016) systems of medicine shall be covered without any sub- Product Name: Saral Suraksha Bima, Niva Bupa Health" }, "maternity_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "organ_donor_expenses": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Organ donor cover not extracted" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 5, @@ -93,27 +101,32 @@ "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Restoration benefit not found in extracted text" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -123,12 +136,15 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/niva-bupa/saral-suraksha-bima__wordings.pdf", + "source_quote": "not stated in niva-bupa__saral-suraksha.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", diff --git a/40-data/policy_facts/niva-bupa__senior-first.json b/40-data/policy_facts/niva-bupa__senior-first.json index f7b89bd6a3b8157658167853ec5121d191bbc1c3..864003bb06331f6d3845dc081515cb6ed1aa5086 100644 --- a/40-data/policy_facts/niva-bupa__senior-first.json +++ b/40-data/policy_facts/niva-bupa__senior-first.json @@ -8,32 +8,31 @@ "source_quote": "Product Name: Senior First | Product UIN: MAXHLIP21575V012021" }, "min_entry_age": { - "value": 60, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "Senior First (senior-citizens-only product; typical entry: 60+ years per Policy Schedule)" + "source_quote": "not stated in niva-bupa__senior-first.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "No max entry age cap stated explicitly in wording (senior-citizens product positioned for unlimited entry age)" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "Lifelong renewability" + "source_quote": "not stated in niva-bupa__senior-first.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "SI options per Policy Schedule (Senior First base: 5L/7.5L/10L/15L/25L; example references 10 Lac base SI)" + "source_quote": "not stated in niva-bupa__senior-first.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "30-day waiting period (Code- Excl03) applies (standard IRDAI clause; consistent across Niva Bupa products)" + "source_quote": "30-day waiting period (Code- E", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, @@ -43,12 +42,14 @@ "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "Specified disease/procedure waiting period (Code-Excl02): standard 24 months continuous coverage (per IRDAI standard)" + "source_quote": "expiry of 24 months of continuous coverage after the date of", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "XVIII. Maternity Expenses (Code-Excl18) — excluded; senior-citizens product, no maternity benefit" + "source_quote": "not stated in niva-bupa__senior-first.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, @@ -61,24 +62,29 @@ "source_quote": "60 days before date of admission and 180 days after date of discharge" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "Day Care Treatment defined per IRDAI Standard Definition (covered)" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "AYUSH hospitalization covered (standard inclusion across Niva Bupa products)" + "source_quote": "This Policy covers Allopathic and AYUSH treatments taken in India ONLY.", + "_confidence": "high" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "XVIII. Maternity Expenses (Code-Excl18) excluded; senior-citizens product" + "source_quote": "Maternity Expenses (Code-Excl18) a. Medi", + "_confidence": "high" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "Maternity excluded; no newborn benefit (senior-citizens product)" + "source_quote": "not stated in niva-bupa__senior-first.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, @@ -103,7 +109,8 @@ "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "4.1. Co-payment ... Co-payment once chosen CAN NOT be changed. It's the percentage of admissible claim amount You would have to bear (chosen at inception; typical seniors product: 10-30% co-pay options)" + "source_quote": "not stated in niva-bupa__senior-first.pdf", + "_confidence": "low" }, "deductible_amount": { "value": "Annual Aggregate Deductible (optional benefit)", @@ -111,34 +118,64 @@ "source_quote": "4.2. Annual Aggregate Deductible (optional benefit) This is an aggregate amount in a year that is incurred by you on Hospital admission, which we will NOT pay." }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; Niva Bupa 10,000+ network hospitals" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "Cashless facility through Network Provider (standard)" + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric; not extracted" + "source_quote": "not stated in niva-bupa__senior-first.pdf", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "not stated in niva-bupa__senior-first.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "Indemnity-based senior-citizens health policy" + "source_quote": "3.2. Expenses during hospitalization (Hospital admission) a. We will pay the expenses incurred by you on treatment (Naturally this excludes expenses not linked to treatment like food, beverage, toiletries and cosmetics)", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/niva-bupa/senior-first__wordings.pdf", "completeness_pct": 85, - "notes": "Niva Bupa Senior First: 24-month PED (shorter than standard 36-month), ReAssure unlimited SI trigger, optional copay/deductible at inception." + "notes": "Niva Bupa Senior First: 24-month PED (shorter than standard 36-month), ReAssure unlimited SI trigger, optional copay/deductible at inception. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "each hospital (Ambul", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "Domiciliary Hospitalization means medical treatment for an Illness/disease/Injury which in the normal course would requi", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "Health Check-up benefit", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/niva-bupa__senior-first__wordings.json b/40-data/policy_facts/niva-bupa__senior-first__wordings.json index b82690e31eb6991e6bf1ec09cb108726c88e10c8..f158026f34c966f9b3262f7cdf4cb57a9b3e835f 100644 --- a/40-data/policy_facts/niva-bupa__senior-first__wordings.json +++ b/40-data/policy_facts/niva-bupa__senior-first__wordings.json @@ -7,132 +7,238 @@ "value": "MAXHLIP21575V012021", "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "or First | Product UIN: MAXHLIP21575V012021", + "_confidence": "high" }, "min_entry_age": { - "value": 61, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "hall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy", + "_confidence": "high" }, "free_look_period": { "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "sured person shall be allowed free look period of fifteen days (thirty days for policies with a term of 3 years", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "treatment of any Illness within 30 days from the first Policy commencement date shall be excluded", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-existing Diseases (Code-Excl01): a. Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Specified disease/procedure waiting period (Code- Excl02) a. Expenses related to the treatment of the listed conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "tic tests 60 days before date of admission and 180 days after date of discharge IF t", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ests 60 days before date of admission and 180 days after date of discharge IF these are related to the condition for wh", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 586, + "source_url": "https://www.nivabupa.com/family-health-insurance-plans/reassurev2-insurance.html", + "source_note": "Per insurer baseline (Niva Bupa ReAssure 2.0 covers ~586 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 10400, + "source_url": "https://www.nivabupa.com/health-insurance-plans.html", + "source_note": "10,400+ cashless hospitals spanning 450+ cities across India (health-insurance-plans page, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "This Policy covers Allopathic and AYUSH treatments taken in India ONLY.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "3.5. Organ", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "3.7. ReAssure The first paid claim triggers ReAssure, a bene", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "3.4. Treatment at home (Domici", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "This Policy covers Allopathic and AYUSH treatments taken in India ONLY.", + "_confidence": "medium" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "3.8. Health Checkup Available ", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "Allopathic and AYUSH treatments taken in India ONLY. Expense incurred outside the policy period will NOT be covered", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" + }, + "maternity_coverage": null, + "room_rent_capping": { + "value": "Eligible room category as per Policy Schedule; additional co-payment for higher room category", + "unit": "text", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "0% co-payment IF treatment is taken in a higher room category than the eligible room category as specified in Your Policy Schedule", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/niva-bupa/senior-first__wordings.pdf", + "source_quote": "not stated in niva-bupa__senior-first__wordings.pdf", + "_confidence": "low" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/oriental-insurance__arogya-sanjeevani__brochure.json b/40-data/policy_facts/oriental-insurance__arogya-sanjeevani__brochure.json index ff664daf57281e4d5b9dbd2824b09f15f72a48cb..1955665f4384a648f2634b71919ed0ffa27da02d 100644 --- a/40-data/policy_facts/oriental-insurance__arogya-sanjeevani__brochure.json +++ b/40-data/policy_facts/oriental-insurance__arogya-sanjeevani__brochure.json @@ -7,31 +7,29 @@ "value": "OICHLIP21557V022021", "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Oriental Insurance Company Ltd AROGYA SANJEEVANI POLICY-ORIENTAL UIN: OICHLIP21557V022021", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Policy term is one year and is available to any proposer between the age of 18 to 65 years for treatment taken in India.", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maximum Entry age for any member, is 65 years.", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "mid-term inclusion is permitted for a newly married spouse and /or a child attaining the age of 3 months during the currency of the policy, on payment of pro-rata premium.", + "_confidence": "medium" }, "sum_insured_options": { "value": [ @@ -52,102 +50,189 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Minimum sum insured is Rs 100,000 and in multiples of Rs 50,000 upto Rs 5,00,000 and thereafter, sum insured is available for Rs. 6,8,10,15, and 20 lacs.", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace period facility for payment of renewal premium available. • 30 days grace for annual premium. • 15 days for half yearly, quarterly and monthly modes of premium payment.", + "_confidence": "high" }, "free_look_period": { "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Free Look Period- A period of 15 days from the date of receipt of the policy to review the terms and conditions of the policy and return the same, if not acceptable.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First Thirty Days Waiting Period (Code- Exc103) i. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, - "unit": null, + "unit": "months", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "All pre-existing diseases covered after 48 months of continuous coverage, subject to the same being declared at the time of application and accepted by insurer.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "f) 24 Months waiting period: 1. Benign ENT disorders 2. Tonsillectomy 3. Adenoidectomy 4. Mastoidectomy", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__arogya-sanjeevani__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The company shall indemnify pre-hospitalization medical expenses incurred, related to an admissible hospitalization requiring inpatient care, for a fixed period of 30 days prior to the date of admissible hospitalization covered under the policy.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "POST-HOSPITALISATION The company shall indemnify post hospitalization medical expenses incurred, related to", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://orientalinsurance.org.in/", + "source_note": "Per insurer baseline (Oriental Insurance health plans cover 140+ day care treatments)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 4300, + "source_url": "https://www.coverfox.com/health-insurance/oriental-health-insurance/network-hospitals/", + "source_note": "Oriental Insurance: 4,300+ network hospitals via GIPSA PPN (Coverfox aggregator; insurer site timed out). Alternate aggregator counts range 4,000-5,116 across the four PSU general insurers (GIPSA shared network). Scraped 2026-05-15.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 5, + "unit": "%", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "8. CO-PAYMENT Each and every claim under the Policy shall be subject to a Co-payment of 5% applicable to claim amount admissible and payable as per the terms and conditions of the Policy.", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 2.0, + "unit": "%", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent, Boarding, Nursing Expenses as provided by the Hospital /Nursing Home: Upto SI INR 5 Lacs: Up to 2% of the sum insured subject to maximum of Rs. 5000/- per day.", + "_confidence": "medium" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The Policy term is one year and is available to any proposer between the age of 18 to 65 years for treatment taken in India.", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__arogya-sanjeevani__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__arogya-sanjeevani__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__arogya-sanjeevani__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", + "source_quote": "AYUSH TREATMENT The Company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the limit of sum insured as specified in th", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", + "source_quote": "Any expenses incurred on Domiciliary Hospitalization and OPD treatment. Treatment taken outside the geographical limits of India", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", + "source_quote": "The Policy term is one year and is available to any proposer between the age of 18 to 65 years for treatment taken in India.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured person in accordance with the Policy ter", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", + "source_quote": "Cumulative Bonus of 5% of sum insured for each claim free year maximum up to 50% of sum insured, provided the policy is renewed without any break.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", + "source_quote": "Treatment taken outside the geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", + "source_quote": "Policy can be issued, as per the option of the Proposer, on • Individual Basis (i.e., Sum Insured and Cumulative Bonus shall apply separately on each Insured Person) • Floater Basis (i.e., Sum Insured and Cumulative Bonus shall apply cumulatively to c", + "_confidence": "medium" + }, + "maternity_coverage": null, + "room_rent_capping": { + "value": "Upto SI INR 5 Lacs: Up to 2% of the sum insured subject to maximum of Rs. 5000/- per day. SI INR 6, 8, 10 Lacs: Up to 2% of the sum insured subject to maximum of Rs. 10,000/- per day. SI INR 15 & 20 Lacs: Up to 2% of the sum insured subject to maximum of Rs. 20,000/- per day.", + "unit": "text", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", + "source_quote": "Upto SI INR 5 Lacs: Up to 2% of the sum insured subject to maximum of Rs. 5000/- per day. SI INR 6, 8, 10 Lacs: Up to 2% of the sum insured subject to maximum of Rs. 10,000/- per day. SI INR 15 & 20 Lacs: Up to 2% of the sum insured subject to maximum of Rs. 20,000/- per day.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__brochure.pdf", + "source_quote": "Cumulative Bonus of 5% of sum insured for each claim free year maximum up to 50% of sum insured, provided the policy is renewed without any break.", + "_confidence": "high" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "oriental-insurance insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/oriental-insurance__arogya-sanjeevani__wordings.json b/40-data/policy_facts/oriental-insurance__arogya-sanjeevani__wordings.json index a11f4027f300d9238dee7563f305b626486fc16d..b0c2dd96df12ca88455bd68edd0c627f67350420 100644 --- a/40-data/policy_facts/oriental-insurance__arogya-sanjeevani__wordings.json +++ b/40-data/policy_facts/oriental-insurance__arogya-sanjeevani__wordings.json @@ -7,147 +7,216 @@ "value": "OICHLIP21557V022021", "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "AROGYA SANJEEVANI POLICY- ORIENTAL UIN: OICHLIP21557V022021 Page 1", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in oriental-insurance__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in oriental-insurance__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Dependent Children (i.e. natural or legally adopted) between the ages 3 months to 25 years.", + "_confidence": "medium" }, "sum_insured_options": { - "value": [ - 100000, - 150000, - 200000, - 250000, - 300000, - 350000, - 400000, - 450000, - 500000, - 600000, - 800000, - 1000000, - 1500000, - 2000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in oriental-insurance__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in oriental-insurance__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "free_look_period": { "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured shall be allowed a period of fifteen days from date of receipt of the Policy to review the terms and conditions of the Policy, and to return the same if not acceptable.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "First Thirty Days Waiting Period (Code- Excl03) i. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Existing Diseases (Code- Excl01) a) Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 48 months Of continuous coverage after the date of inception of the first policy with us.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Specific Waiting Period: (Code- Excl02) a) Expenses related to the treatment of the following listed conditions, surgeries/treatments shall be excluded until the expiry of 24/48 months of continuous coverage, as may be the case after the date of inception of the first policy with the insurer.", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre Hospitalization The company shall indemnify pre-hospitalization medical expenses incurred, related to an admissible hospitalization requiring inpatient care, for a fixed period of 30 days prior to the date of admissible hospitalization covered under the policy.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post Hospitalization The company shall indemnify post hospitalization medical expenses incurred, related to", + "_confidence": "medium" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://orientalinsurance.org.in/", + "source_note": "Per insurer baseline (Oriental Insurance health plans cover 140+ day care treatments)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 4300, + "source_url": "https://www.coverfox.com/health-insurance/oriental-health-insurance/network-hospitals/", + "source_note": "Oriental Insurance: 4,300+ network hospitals via GIPSA PPN (Coverfox aggregator; insurer site timed out). Alternate aggregator counts range 4,000-5,116 across the four PSU general insurers (GIPSA shared network). Scraped 2026-05-15.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 5, + "unit": "%", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Co-payment Each and every claim under the Policy shall be subject to a Copayment of 5% applicable to claim amount admissible and payable as per the terms and conditions of the Policy.", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 2, + "unit": "%", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Up to SI INR 5 Lakhs: Up to 2% of the sum insured subject to maximum of Rs. 5000/- per day. SI INR 6, 8, 10 Lakhs: Up to 2% of the sum insured subject to maximum of Rs. 10,000/- per day. SI INR 15 & 20 Lakhs: Up to 2% of the sum insured subject to maximum of Rs. 20,000/- per day.", + "_confidence": "medium" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The Free Look Period shall be applicable at the inception of the Policy and not on renewals or at the time of porting the policy.", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "AYUSH Treatment The Company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the limit of sum insured as speci", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Any expenses incurred on Domiciliary Hospitalization and OPD treatment Treatment taken outside the geographical limits of India", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Territorial Limit All medical treatment for the purpose of this insurance will have to be taken in India only.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured person in accordance with the Policy terms an", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cumulative Bonus will be increased by 5% in respect of each claim free policy year (where no claims are reported), provided the policy is renewed with the company without a break subject to maximum of 50% of the sum insured under the current policy year.", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Treatment taken outside the geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Sum Insured and Cumulative Bonus represents the maximum, total and cumulative liability for any and all claims made under the Policy, in respect of that Insured Person (on Individual basis) or all Insured Persons (on Floater basis) during the Policy Year.", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Up to SI INR 5 Lakhs: Up to 2% of the sum insured subject to maximum of Rs. 5000/- per day. SI INR 6, 8, 10 Lakhs: Up to 2% of the sum insured subject to maximum of Rs. 10,000/- per day. SI INR 15 & 20 Lakhs: Up to 2% of the sum insured subject to maximum of Rs. 20,000/- per day.", + "unit": "text", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Up to SI INR 5 Lakhs: Up to 2% of the sum insured subject to maximum of Rs. 5000/- per day. SI INR 6, 8, 10 Lakhs: Up to 2% of the sum insured subject to maximum of Rs. 10,000/- per day. SI INR 15 & 20 Lakhs: Up to 2% of the sum insured subject to maximum of Rs. 20,000/- per day.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/oriental-insurance/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cumulative Bonus will be increased by 5% in respect of each claim free policy year (where no claims are reported), provided the policy is renewed with the company without a break subject to maximum of 50% of the sum insured under the current policy year.", + "_confidence": "high" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "oriental-insurance insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/oriental-insurance__happy-family-floater__brochure.json b/40-data/policy_facts/oriental-insurance__happy-family-floater__brochure.json index 602f8d2a1aa49a2de319b787a07cef47fa624d89..faf61cff5be5d5ba432d7df09ef225a043497b58 100644 --- a/40-data/policy_facts/oriental-insurance__happy-family-floater__brochure.json +++ b/40-data/policy_facts/oriental-insurance__happy-family-floater__brochure.json @@ -7,31 +7,29 @@ "value": "OICHLIP22010V042223", "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "OICL HAPPY FAMILY FLOATER POLICY-2021 UIN: OICHLIP22010V042223 Page1", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "1. ELIGIBILITY Any person of 18 years or more can take this Policy covering self and /or anyone or more of the family members as mentioned below:", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maximum Entry Age is 65 years for all members. However, this can be extended to 70 years subject to certain conditions.", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Dependent Children (i.e. natural or legally adopted) between the ages 91daysto 18 years. However male child can be covered up to the age of 25 years if he is a bonafide re", + "_confidence": "high" }, "sum_insured_options": { "value": [ @@ -40,9 +38,14 @@ 300000, 400000, 500000, - 750000, + 600000, + 700000, + 800000, + 900000, 1000000, + 1200000, 1500000, + 1800000, 2000000, 2500000, 3000000, @@ -51,102 +54,181 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "i. Sum Insured Available Rs.1, 2,3,4 & 5 lakh Rs.6,7,8,9 & 10 lakh Rs.12, 15, 18 and 20 lacs Rs.,25,30, 40 and 50 lacs", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.", + "_confidence": "high" }, "free_look_period": { "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the insured person shall be allowed free look period of 15 days from the date of receipt of the Policy document to review the terms and conditions of the Policy, and to return the same if not acceptable.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "5.3 30 day waiting period- code – ExcI03 a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "existing Diseases - code -ExcI0 1 A. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 48 months of continuous coverage after the date of inception of the first policy with the insurer.", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in oriental-insurance__happy-family-floater__brochure.pdf", + "_confidence": "low" }, "maternity_waiting_months": { - "value": null, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "i. Diamond / Platinum Plan has been continuously in force for a period of minimum 24 months in respect", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "PRE-HOSPITALISATION MEDICALEXPENSES means medical expenses incurred during the period up to 30 days prior to the date of admission in the Hospital, provided that:", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "POST-HOSPITALISATION EXPENSES means medical expenses incurred for a period up to 60 days from the date of discharge from the Hospital, provided that:", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://orientalinsurance.org.in/", + "source_note": "Per insurer baseline (Oriental Insurance health plans cover 140+ day care treatments)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 4300, + "source_url": "https://www.coverfox.com/health-insurance/oriental-health-insurance/network-hospitals/", + "source_note": "Oriental Insurance: 4,300+ network hospitals via GIPSA PPN (Coverfox aggregator; insurer site timed out). Alternate aggregator counts range 4,000-5,116 across the four PSU general insurers (GIPSA shared network). Scraped 2026-05-15.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { - "value": null, + "value": 10, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "5.39 Compulsory Co-Payment: Under the SILVER plan the insured has to bear 10% of admissible claim", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 1, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "ii. Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. 1 % of the Sum Insured per day 1 % of the Sum Insured per day 1% of the Sum Insured per day 1% of the Sum Insured per day", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "vi. Term of the Policy is one year and is renewable lifelong.", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__happy-family-floater__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__happy-family-floater__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__happy-family-floater__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", + "source_quote": "The Company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the limit of sum insured as specified in the policy schedul", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", + "source_quote": "A. MATERNITY EXPENSES: The Company shall pay the Medical Expenses incurred as an In-patient for a delivery (including caesarean section) or lawful medical termination of pregnancy during the Policy Period limited to two deliveries", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", + "source_quote": "B. NEW BORN BABY COVER: New born Baby shall be covered from day one up to the age of 90 days and expenses incurred for treatment taken in Hospital as in patient shall only be payable, provided that:", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", + "source_quote": "The Policy covers reasonable and customary charges in respect of Hospitalization and / or Domiciliary Hospitalization for medically necessary treatment only for Illnesses / diseases contracted / suffered or Injury sustained by the Insured Person(s) during the", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", + "source_quote": "CASHLESS FACILITY Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are di", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", + "source_quote": "Treatment taken outside the geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", + "source_quote": "iii. A floater policy covering the proposer and his / her family under single Sum insured under one Policy.", + "_confidence": "high" + }, + "room_rent_capping": { + "value": "ii. Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. 1 % of the Sum Insured per day 1 % of the Sum Insured per day 1% of the Sum Insured per day 1% of the Sum Insured per day", + "unit": "text", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__brochure.pdf", + "source_quote": "ii. Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. 1 % of the Sum Insured per day 1 % of the Sum Insured per day 1% of the Sum Insured per day 1% of the Sum Insured per day", + "_confidence": "high" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "oriental-insurance insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/oriental-insurance__happy-family-floater__wordings.json b/40-data/policy_facts/oriental-insurance__happy-family-floater__wordings.json index b588ba47e4e67d677d2ecaa2c026621e4fc5dd01..c5440469284ef751b0aa0bb8b7164d3ea73afbd4 100644 --- a/40-data/policy_facts/oriental-insurance__happy-family-floater__wordings.json +++ b/40-data/policy_facts/oriental-insurance__happy-family-floater__wordings.json @@ -7,31 +7,29 @@ "value": "OICHLIP22010V042223", "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "OICL HAPPY FAMILY FLOATER POLICY-2021 UIN: OICHLIP22010V042223 Page1", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in oriental-insurance__happy-family-floater__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "5.31 ENTRY AGE: Maximum Entry Age under the Policy is 65years for all members.", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Dependent Children (i.e. natural or legally adopted) between the ages 91daysto 18 years. However male child can be covered up to the age of 25 years if he is a bonafide re", + "_confidence": "high" }, "sum_insured_options": { "value": [ @@ -40,9 +38,14 @@ 300000, 400000, 500000, - 750000, + 600000, + 700000, + 800000, + 900000, 1000000, + 1200000, 1500000, + 1800000, 2000000, 2500000, 3000000, @@ -51,102 +54,179 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "i. Sum Insured Available Rs.1, 2,3,4 & 5 lakh Rs.6,7,8,9 & 10 lakh Rs.12, 15, 18 and 20 lacs Rs.,25,30, 40 and 50 lacs", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.", + "_confidence": "high" }, "free_look_period": { "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the insured person shall be allowed free look period of 15 days from the date of receipt of the Policy document to review the terms and conditions of the Policy, and to return the same if not acceptable.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "5.1 30 day waiting period- code – ExcI03 a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "existing Diseases - code -ExcI0 1 A. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 48 months of continuous coverage after the date of inception of the first policy with the insurer.", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in oriental-insurance__happy-family-floater__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { - "value": null, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "i. Diamond / Platinum Plan has been continuously in force for a period of minimum 24 months in", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "PRE-HOSPITALISATION MEDICALEXPENSES means medical expenses incurred during the period up to 30 days prior to the date of admission in the Hospital, provided that:", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "POST-HOSPITALISATION EXPENSES means medical expenses incurred for a period up to 60 days from the date of discharge from the Hospital, provided that:", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://orientalinsurance.org.in/", + "source_note": "Per insurer baseline (Oriental Insurance health plans cover 140+ day care treatments)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 4300, + "source_url": "https://www.coverfox.com/health-insurance/oriental-health-insurance/network-hospitals/", + "source_note": "Oriental Insurance: 4,300+ network hospitals via GIPSA PPN (Coverfox aggregator; insurer site timed out). Alternate aggregator counts range 4,000-5,116 across the four PSU general insurers (GIPSA shared network). Scraped 2026-05-15.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { - "value": null, + "value": 10, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "4.40 Compulsory Co-Payment: Under the SILVER plan the insured has to bear 10% of admissible", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 1, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "ii. Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. 1 % of the Sum Insured per day 1 % of the Sum Insured per day 1% of the Sum Insured per day. 1% of the Sum Insured per day.", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__happy-family-floater__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__happy-family-floater__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__happy-family-floater__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__happy-family-floater__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", + "source_quote": "The Company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the limit of sum insured as specified in the policy schedul", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", + "source_quote": "A. MATERNITY EXPENSES: The Company shall pay the Medical Expenses incurred as an In-patient for a delivery (including caesarean section) or lawful medical termination of pregnancy during the Policy Period limited to two deliveries or terminations or either dur", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", + "source_quote": "B. NEW BORN BABY COVER: New born Baby shall be covered from day one up to the age of 90 days and expenses incurred for treatment taken in Hospital as in patient shall only be payable, provided that:", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", + "source_quote": "covers reasonable and customary charges in respect of Hospitalization and / or Domiciliary Hospitalization for medically necessary treatment only for Illnesses / diseases contracted / suffered or Injury sustained by the Insured Person(s) during the Policy Peri", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", + "source_quote": "CASHLESS FACILITY Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are di", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", + "source_quote": "Treatment taken outside the geographical limits of India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", + "source_quote": "HAPPY FAMILY FLOATER POLICY 2021 WE VALUE YOUR HEALTH & YOUR WEALTH. BUILD A PRODUCTIVE NATION WHEREAS the insured named in the Schedule hereto has by a proposal and declaration", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "ii. Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. 1 % of the Sum Insured per day 1 % of the Sum Insured per day 1% of the Sum Insured per day. 1% of the Sum Insured per day.", + "unit": "text", + "source_pdf_path": "rag/corpus/oriental-insurance/happy-family-floater__wordings.pdf", + "source_quote": "ii. Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. 1 % of the Sum Insured per day 1 % of the Sum Insured per day 1% of the Sum Insured per day. 1% of the Sum Insured per day.", + "_confidence": "high" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "oriental-insurance insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/oriental-insurance__oriental-mediclaim-individual__cis.json b/40-data/policy_facts/oriental-insurance__oriental-mediclaim-individual__cis.json index 6a7a109f1f655bae5ad6f642bdcfd7ec36f8ed32..17524c8a40d1421637a35414495924b938fff091 100644 --- a/40-data/policy_facts/oriental-insurance__oriental-mediclaim-individual__cis.json +++ b/40-data/policy_facts/oriental-insurance__oriental-mediclaim-individual__cis.json @@ -7,144 +7,207 @@ "value": "OICHLIP23084V042223", "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ORIENTAL MEDICLAIM INSURANCE POLICY (INDIVIDUAL) UIN: OICHLIP23084V042223 Page1", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__cis.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 100000, - 200000, - 300000, - 500000, - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 4000000, - 5000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__cis.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace period of 30 days", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 15, "unit": "days", - "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", + "source_quote": "y. The insured person shall be allowed free look period of 15 days from the date of receipt of the Policy document to review t", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Initial waiting period: 30 days for all illnesses (not applicable on renewal or for accidents)", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-existing diseases: Covered after 48 months", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Specific waiting periods: 1. 90 days for named diseases 2. 12 months for named diseases(clauses 4.3 (i & ii)) 3. 24 months for disease at (clauses 4.3 (iii to xxii)) 4. 48 months for diseases (clauses 4.3 (xxiii & xxiv)", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Related medical expenses incurred 30 days prior to hospitalization & 60 days from date of discharge.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Related medical expenses incurred 30 days prior to hospitalization & 60 days from date of discharge.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://orientalinsurance.org.in/", + "source_note": "Per insurer baseline (Oriental Insurance health plans cover 140+ day care treatments)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 4300, + "source_url": "https://www.coverfox.com/health-insurance/oriental-health-insurance/network-hospitals/", + "source_note": "Oriental Insurance: 4,300+ network hospitals via GIPSA PPN (Coverfox aggregator; insurer site timed out). Alternate aggregator counts range 4,000-5,116 across the four PSU general insurers (GIPSA shared network). Scraped 2026-05-15.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Option of voluntary co-payment of 10% and 20% with corresponding premium discount of 10% and 20% respectively on SI of Rs. 2.0 lacs and above.", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", + "source_quote": "Ayurveda, Yoga,Siddha, Unani and Homeopathic treatment.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", + "source_quote": "Donor Expenses", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", + "source_quote": "Treatment outside India", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", + "source_quote": "Health check up benefit for every block of 3 claim free policy years for the insured persons up to 1% of average sum insured subject to maximum Rs. 5000/- per insured person", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", + "source_quote": "Cover for 22 critical illnesses.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", + "source_quote": "Cashless services for covered expenses in Network hospitals", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", + "source_quote": "Treatment outside India", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", + "source_quote": "1 Product Name Oriental Mediclaim Insurance Policy (Individual)", + "_confidence": "high" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "oriental-insurance insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/oriental-insurance__oriental-mediclaim-individual__wordings.json b/40-data/policy_facts/oriental-insurance__oriental-mediclaim-individual__wordings.json index 0e4dfb7d1d018bd199ea8e05b8365335cdd3b04e..fe5571f2e747988c7f400f8c9965dd1901b28d19 100644 --- a/40-data/policy_facts/oriental-insurance__oriental-mediclaim-individual__wordings.json +++ b/40-data/policy_facts/oriental-insurance__oriental-mediclaim-individual__wordings.json @@ -7,144 +7,214 @@ "value": "OICHLIP23084V042223", "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ORIENTAL MEDICLAIM INSURANCE POLICY (INDIVIDUAL) UIN: OICHLIP23084V042223 Page1", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": null, + "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "(a) MAXIMUM ENTRY AGE: Maximum Entry age for any member, is 65years.", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Dependent Children (i.e. natural or legally adopted) between the ages 91daysto 18 years. However male child can be covered up to the age of 25 years if he is a bonafide regular student and financially depen", + "_confidence": "high" }, "sum_insured_options": { - "value": [ - 100000, - 200000, - 300000, - 500000, - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 4000000, - 5000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.", + "_confidence": "high" }, "free_look_period": { "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of 15 days from the date of receipt of the Policy document to review the terms and conditions of the Policy, and to return the same if not a", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "4.3 30 day waiting period- code – ExcI03 a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 48, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "D) and its direct complications shall be excluded until the expiry of 48 months of continuous coverage after the date of inception of the first policy with the insurer.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, - "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__cis.pdf", + "source_quote": "Specific waiting periods: 1. 90 days for named diseases 2. 12 months for named diseases(clauses 4.3 (i & ii)) 3. 24 months for disease at (clauses 4.3 (iii to xxii)) 4. 48 months for diseases (clauses 4.3 (xxiii & xxiv)", + "_confidence": "medium" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "PRE-HOSPITALISATION MEDICALEXPENSES means medical expenses incurred during the period up to 30 days prior to the date of admission in the Hospital, provided that:", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "POST-HOSPITALISATION EXPENSES means medical expenses incurred for a period up to 60 days from the date of discharge from the Hospital, provided that:", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 140, + "source_url": "https://orientalinsurance.org.in/", + "source_note": "Per insurer baseline (Oriental Insurance health plans cover 140+ day care treatments)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, + "value": 4300, + "source_url": "https://www.coverfox.com/health-insurance/oriental-health-insurance/network-hospitals/", + "source_note": "Oriental Insurance: 4,300+ network hospitals via GIPSA PPN (Coverfox aggregator; insurer site timed out). Alternate aggregator counts range 4,000-5,116 across the four PSU general insurers (GIPSA shared network). Scraped 2026-05-15.", + "_confidence": "medium", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insurer-level metric backfilled from public-web source — see source_url" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "VOLUNTARY CO-PAYMENT: (OPTIONAL) i. If the insured opts for a Co-payment of 10% or 20%, he is eligible for a corresponding premium discount of 10% and 20% respectively.", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 1, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "i. Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. Not exceeding 1 % of the Sum Insured per day ii. Intensive Care Unit (ICU) Expenses as provided by the Hospital /Nursing Home.* Not exceeding 2% of the Sum Insured per day.", + "_confidence": "high" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in oriental-insurance__oriental-mediclaim-individual__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", + "source_quote": "The Company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda,Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the limit of sum insured as", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", + "source_quote": "3.1.2 DONOR EXPENSES: The policy covers in-patient hospitalization Medical expenses in respect of organ donor provided that the donation conforms to the Transplantation of Human Organs Act 1994(amended) and other applicable laws and rules and", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", + "source_quote": "Treatment taken outside the geographical limits of India. 4.39 Treatments such as Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), Hyperbaric Oxygen Therapy.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", + "source_quote": "The Insured shall be entitled for reimbursement of cost of Health checkup undertaken once at the expiry of a block of every THREE continuous underwriting years provided there are no claims reported during the block.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", + "source_quote": "ADDITIONAL SUM INSURED FOR CRITICAL ILLNESS: If an insured person suffers from any critical illness as defined by the IRDAI during the policy period and the selected basic sum insured is exhausted in the treatment of that critical illness, then additional sum insured of", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", + "source_quote": "2.4 CASHLESS FACILITY Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly ma", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", + "source_quote": "4.38 Treatment taken outside the geographical limits of India.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "individual", + "unit": "enum", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", + "source_quote": "ORIENTAL MEDICLAIM INSURANCE POLICY (INDIVIDUAL) UIN: OICHLIP23084V042223 Page1", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. Not exceeding 1 % of the Sum Insured per day", + "unit": "text", + "source_pdf_path": "rag/corpus/oriental-insurance/oriental-mediclaim-individual__wordings.pdf", + "source_quote": "i. Room, Boarding and Nursing Expenses as provided by the Hospital /Nursing Home. Not exceeding 1 % of the Sum Insured per day", + "_confidence": "high" + }, + "_meta": { + "network_hospital_backfill_2026-05-15": "oriental-insurance insurer-wide count backfilled in targeted scrape pass" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/reliance-general__personal-accident__wordings.json b/40-data/policy_facts/reliance-general__personal-accident__wordings.json index a7743ed36ee460cc52e9ca5942909d434e7257c2..aaeebbb43791477332b71a2840c9aaf64ff1feea 100644 --- a/40-data/policy_facts/reliance-general__personal-accident__wordings.json +++ b/40-data/policy_facts/reliance-general__personal-accident__wordings.json @@ -7,132 +7,176 @@ "value": "RELPAGP01001V010001", "unit": null, "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "PERSONAL ACCIDENT POLICY UIN: RELPAGP01001V010001.", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in personal-accident__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in personal-accident__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in personal-accident__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in personal-accident__wordings.pdf", + "_confidence": "low" }, "grace_period": { - "value": null, + "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Grace period means a period of 30 days immediately following the premium due date during which a payment", + "_confidence": "high" }, "free_look_period": { - "value": null, + "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "The Policyholderwould be given a period of 15 days (Free Look Period) from the date of receipt of the Policy to review the", + "_confidence": "high" }, "initial_waiting_period_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in personal-accident__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in personal-accident__wordings.pdf", + "_confidence": "low" }, "specific_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in personal-accident__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in personal-accident__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in personal-accident__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in personal-accident__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 405, + "source_url": "https://www.reliancegeneral.co.in/Downloads/List_of_Day_Care_Procedures.pdf", + "source_note": "Per insurer baseline (Reliance General published List of Day Care Procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 10000, + "source_url": "https://www.indusindinsurance.com/", + "source_note": "10,000+ Network Hospitals (Reliance General rebranded to IndusInd Insurance; homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in reliance-general__personal-accident__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in personal-accident__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "15. LIMITATION PERIOD POLICY TENURE Cancellation date up to (x months) From Policy Period Start Date Refund Upto 1 month 75.0% Upto 3 month 50.0% Upto 6 month 25.0% > 6 months 0% 1 YEAR", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in personal-accident__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in personal-accident__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in personal-accident__wordings.pdf", + "_confidence": "low" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", + "source_quote": "anywhere in the world, (d) directly or indirectly caused by venereal diseases, AIDS or insanity, (e) arising or resulting from the Insured Pe", + "_confidence": "medium" + }, + "cashless_treatment_supported": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", + "source_quote": "to any employment or occupation of any description whatsoever, then a lump sum equal to hundred percent (100%) of the Capital Sum Insured, stated in the Schedule hereto applicable to such Insured Person.", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", + "source_quote": "not stated in reliance-general__personal-accident__wordings.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "personal_accident", + "unit": "enum", + "source_pdf_path": "rag/corpus/reliance-general/personal-accident__wordings.pdf", + "source_quote": "WHEREAS the policyholder designated in the Schedule to this Personal Accident Policy having by a proposal and declaration", + "_confidence": "high" } } diff --git a/40-data/policy_facts/royal-sundaram__advanced-top-up__brochure.json b/40-data/policy_facts/royal-sundaram__advanced-top-up__brochure.json index 50740db13915a9f29435991787c9660b41c94784..fae2376c6f62897225bfac3b48366971efa747c3 100644 --- a/40-data/policy_facts/royal-sundaram__advanced-top-up__brochure.json +++ b/40-data/policy_facts/royal-sundaram__advanced-top-up__brochure.json @@ -7,151 +7,239 @@ "value": "RSAHLIP23029V012223", "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "UIN: RSAHLIP23029V012223 Make yo", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "icy) Adult: 18 years to 65 years Depe", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "icy) Adult: 18 years to 65 years Depe", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ears Dependent Children: 91 days to 25 years (After 25 years, dependent", + "_confidence": "high" }, "sum_insured_options": { - "value": [ - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 3500000, - 4000000, - 4500000, - 5000000, - 5500000, - 6000000, - 6500000, - 7000000, - 7500000, - 8000000, - 8500000, - 9000000, - 9500000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__advanced-top-up__brochure.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__advanced-top-up__brochure.pdf", + "_confidence": "low" }, "free_look_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__advanced-top-up__brochure.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "nitial Waiting Period 36 months 24 months 30 days Opti", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "xcluded until the expiry of 36 months of continuous coverage afte", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "l be excluded until the expiry of 24 months of continuous coverage, as may", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__advanced-top-up__brochure.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "are, for a fixed period of 90 days from the date of discharge from the", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 200, + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_note": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12500, + "source_url": "https://www.royalsundaram.in/", + "source_note": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__brochure.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "covered in the same policy) Entry age Room Rent No room rent capping 6% discount for 2 years policy 9% discount for 3 years pol", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "lan with a deductible on annual aggregate basis which offers wide rang", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", + "source_quote": "Ayush Treatment The company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy system of medicines during each policy year up to sum insured in any AYUSH Hospital.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", + "source_quote": "Maternity Expenses: (Code - Excl18) The above is an indicative list. For the complete list of exclusions, please refer to the detailed policy terms and conditions.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", + "source_quote": "Organ Donor Expenses We will cover inpatient care medical expenses towards the donor for the harvesting of the organ donated provided that: a) the organ donor is any person in accordance with the Transplantation of Human Organs Act, 1994 and other applicable laws.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", + "source_quote": "Life Protect Benefit In the event of life-threatening condition if the sum insured becomes insufficient, we will give additional amount for any claim admissible up to the limits specified in the policy.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", + "source_quote": "Domiciliary Hospitalisation We will cover medical expenses up to sum insured for medical treatment taken at home if this continues for an uninterrupted period of 3 days and the condition for which treatment is taken would otherwise have necessitated hospitalization", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", + "source_quote": "not stated in advanced-top-up__brochure.pdf", + "_confidence": "low" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", + "source_quote": "Second Opinion for 22 Critical Illness We will provide you a second opinion from medical practitioner, if an insured person is diagnosed with the critical illness during the policy period. the expert opinion would be directly sent to the insured person.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", + "source_quote": "not stated in royal-sundaram__advanced-top-up__brochure.pdf", + "_confidence": "low" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", + "source_quote": "not stated in royal-sundaram__advanced-top-up__brochure.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", + "source_quote": "not stated in royal-sundaram__advanced-top-up__brochure.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", + "source_quote": "ce plan with a deductible on annual aggregate basis which offers wide range of deductible and sum insured options. It co", + "_confidence": "medium" + }, + "deductible_amount": { + "value": 500000, + "unit": "INR", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", + "source_quote": "deductible and `45 lakhs sum insure", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "No room rent capping", + "unit": "text", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", + "source_quote": "No room rent capping 6% discount for 2 years policy 9% discount for 3 years policy Room Rent Discount on Multiyear policy", + "_confidence": "high" } } diff --git a/40-data/policy_facts/royal-sundaram__advanced-top-up__cis.json b/40-data/policy_facts/royal-sundaram__advanced-top-up__cis.json index dd3e5267b68b075996fea123166c24a3bd67ccff..63e4d6a92ceade0e11e3e26f8ad6835d6a590a78 100644 --- a/40-data/policy_facts/royal-sundaram__advanced-top-up__cis.json +++ b/40-data/policy_facts/royal-sundaram__advanced-top-up__cis.json @@ -7,151 +7,232 @@ "value": "RSAHLIP23029V012223", "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "tomer Information Sheet 1 UIN- RSAHLIP23029V012223 CUSTOME", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__advanced-top-up__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__advanced-top-up__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__advanced-top-up__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 3500000, - 4000000, - 4500000, - 5000000, - 5500000, - 6000000, - 6500000, - 7000000, - 7500000, - 8000000, - 8500000, - 9000000, - 9500000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__advanced-top-up__cis.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period means a period of 30 days in case of one year immediately following the Policy Period End Date during whi", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the Insured Person will be allowed a period of 30 days from the date of receipt of the policy to review", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "od • Initial waiting Period: 30 days for all illness (not applicable on renewal or for acci", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "s. • Pre-existing diseases: Covered after 36 months E.1.2 E.1.3 E.1", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "nts) Specific Waiting periods: 24 months for 16 diseases specified in", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__advanced-top-up__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ted medical expenses incurred within 90 days from date of discharge. • Day-care", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 200, + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_note": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12500, + "source_url": "https://www.royalsundaram.in/", + "source_note": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__cis.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", - "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__brochure.pdf", + "source_quote": "covered in the same policy) Entry age Room Rent No room rent capping 6% discount for 2 years policy 9% discount for 3 years pol", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired policy period, if the term of policy is up to one year and there is no c", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", + "source_quote": "AYUSH Treatment – Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines is covered up to 100% of Sum Insured, during each policy year as specified in the policy schedule.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", + "source_quote": "Refractive Error, • Unproven Treatments, • Sterility and Infertility, • Maternity • The expenses that are not covered in this policy are placed under List-I of Annexure-A", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", + "source_quote": "Organ Donor Expenses: Medical Expenses for an organ donor’s treatment for harvesting of the organ. Organ donor expenses will be covered up to Sum Insured for the patient who is insured with us i.e. recipient of the Organ (who is undergoing the transplant)", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", + "source_quote": "Life Protect Benefit- In the event of Life Threatening Condition if the Sum Insured becomes insufficient, we will give additional amount for any claim admissible under inpatient Care up to 10% of Sum Insured per policy year.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", + "source_quote": "Domiciliary Hospitalization: Medical Expenses covered up to Sum Insured for medical treatment taken at home if the treatment continues for an uninterrupted period of 3 days and the condition for which treatment is taken would otherwise have necessitated hospitalization.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", + "source_quote": "Second Opinion for Critical Illness – Available once during Policy period for 22 critical illness.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", + "source_quote": "twork Hospital if cashless facility is not availed (Re-imbursement Claims) Notice of claim: Preliminary notice of claim wit", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", + "source_quote": "TAT for preauthorisation of cashless facility is 1 hour ii. TAT", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", + "source_quote": "not stated in royal-sundaram__advanced-top-up__cis.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", + "source_quote": "ble. 2. The Deductible is on Annual aggregate basis during the policy period of this policy. 3. Claims under this plan", + "_confidence": "medium" + }, + "deductible_amount": { + "value": 500000, + "unit": "INR", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", + "source_quote": "5,00,000/- Deductible - Rs.10,00,", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": null, + "unit": "text", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__cis.pdf", + "source_quote": "not stated in advanced-top-up__cis.pdf", + "_confidence": "low" } } diff --git a/40-data/policy_facts/royal-sundaram__advanced-top-up__wordings.json b/40-data/policy_facts/royal-sundaram__advanced-top-up__wordings.json index 41f1e05e5b35a753bd38c1e50c732461d9b8036e..b7dd230f1a27be935ffdad165036432e0684b560 100644 --- a/40-data/policy_facts/royal-sundaram__advanced-top-up__wordings.json +++ b/40-data/policy_facts/royal-sundaram__advanced-top-up__wordings.json @@ -7,31 +7,29 @@ "value": "RSAHLIP23029V012223", "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Road, Chennai - 600 002 1 UIN- RSAHLIP23029V012223 Part II", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "age Adult: 18 years to 65 years Depe", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "age Adult: 18 years to 65 years Depe", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ears Dependent Children: 91 days to 25 yrs (After 25 years, Dependent c", + "_confidence": "high" }, "sum_insured_options": { "value": [ @@ -56,102 +54,204 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "of Benefits 1 Sum Insured 10 Lakhs, 15 Lakhs 20 Lakhs, 25 lakhs, 30 lakhs, 35 Lakhs, 40 Lakhs, 45 Lakhs, 50 lakhs, 55 lakhs, 60 lakhs, 65 Lakhs, 70 Lakhs, 75 lakhs, 80 lakhs, 85 lakhs 90 lakhs, 95 Lakhs 2 De", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period means a period of 30 days in case of one year immediately following the Policy Period End Date during whi", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the Insured Person will be allowed a period of 30 days from the date of receipt of the policy to review", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "s 14 Initial Waiting Period 30 days 15 Pre-Existing Diseases waiting period 36 months 16 S", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "s 15 Pre-Existing Diseases waiting period 36 months 16 Specific wai", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Specific waiting period* 24 months Opti", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__advanced-top-up__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "post hospitalization expenses 60/90 days, Covere", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 200, + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_note": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12500, + "source_url": "https://www.royalsundaram.in/", + "source_note": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "ered as adults in a separate policy) Room Rent No Room Rent capping Entry age Discount on Multiyear policy 6% discount", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired policy period, if the term of policy is up to one year and there is no c", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__advanced-top-up__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", + "source_quote": "AYUSH Treatment Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines is covered up to 100% of Sum Insured, during each policy year as specified in the policy schedule.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", + "source_quote": "Maternity Expenses (Code – Excl18): i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ii. Expenses towards miscarriage", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", + "source_quote": "Organ Donor Expenses We will cover Inpatient Care Medical Expenses towards the donor for the harvesting of the organ donated provided that: (a) the organ donor is any person in accordance with the Transplantation of Human Organs Act, 1994 and other applicable", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", + "source_quote": "Life Protect Benefit In the event of Life Threatening Condition if the Sum Insured becomes insufficient, we will give additional amount for any claim admissible under section D.1 up to the limits specified in Product Benefits Table", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", + "source_quote": "Domiciliary Hospitalization We will cover Medical Expenses upto Sum Insured for medical treatment taken at home if this continues for an uninterrupted period of 3 days and the condition for which treatment is taken would otherwise have necessitated Hospitalization", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", + "source_quote": "Second Opinion for Critical Illness We will provide You a second opinion from Medical Practitioner, if an Insured Person is diagnosed with the Critical Illness during the Policy Period. The expert opinion would be directly sent to the Insured Person.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", + "source_quote": "ace period. C.1.6 Cashless Facility means a facility extended by the insurer to the insured where the payments, of the cost", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", + "source_quote": "not stated in royal-sundaram__advanced-top-up__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", + "source_quote": "we will consider Hospitalizations in India only. C.1.14 Den", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", + "source_quote": "e Product Type Deductible on Annual Aggregate Basis Sr No Product Feature Scope of Benefits 1 Sum Insured 10 Lakhs, 15", + "_confidence": "medium" + }, + "deductible_amount": { + "value": 500000, + "unit": "INR", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", + "source_quote": "Deductible For 10- 95 lakhs Sum Insure", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "No room rent capping", + "unit": "text", + "source_pdf_path": "rag/corpus/royal-sundaram/advanced-top-up__wordings.pdf", + "source_quote": "Room Rent No Room Rent capping Discount on Multiyear policy 6% discount for 2 years policy 9% discount for 3 years policy", + "_confidence": "high" } } diff --git a/40-data/policy_facts/royal-sundaram__arogya-sanjeevani__wordings.json b/40-data/policy_facts/royal-sundaram__arogya-sanjeevani__wordings.json index 7f77046d45e46b0a617f386282fa3a79ffd7635c..6f418250c9cfa9073b09f759ba7726386688e75f 100644 --- a/40-data/policy_facts/royal-sundaram__arogya-sanjeevani__wordings.json +++ b/40-data/policy_facts/royal-sundaram__arogya-sanjeevani__wordings.json @@ -7,34 +7,33 @@ "value": "RSAHLIP25013V022425", "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "l Insurance Co. Limited 1 UIN-RSAHLIP25013V022425 Royal S", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "y age for Adults is 18 years onwards to 65 years and from 3 months to 25y", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "r Adults is 18 years onwards to 65 years and from 3 mont", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "pted) between the age 3 months to 25 years. If t", + "_confidence": "high" }, "sum_insured_options": { "value": [ + 50000, 100000, 150000, 200000, @@ -44,110 +43,203 @@ 400000, 450000, 500000, + 550000, 600000, + 650000, + 700000, + 750000, 800000, - 1000000, - 1500000, - 2000000 + 850000, + 900000, + 950000, + 1000000 ], "unit": "INR", "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "013V022425) Sum Insured (SI) Rupees Rs.50,000, Rs.1 lakh, Rs.1.5 lakhs, Rs.2 lakhs, Rs. 2.5 lakhs, Rs. 3 lakhs, Rs. 3.5 lakhs, Rs.4 lakhs, Rs. 4.5 lakhs, Rs. 5 lakhs, Rs.5.5 lakhs, Rs.6 lakhs, Rs.6.5 lakhs, Rs.7 lakhs, Rs.7.5 lakhs, Rs.8 lakhs, Rs.8.5 lakhs, Rs.9 lakhs, Rs.9.5 lakhs, Rs.10 lakhs", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period of 15 days in monthly and 30 days in case o", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the Insured Person will be allowed a period of 30 days from the date of receipt of the policy to review", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ses - a 30 days Initial waiting period from inception except in case", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "re diagnosed by a physician not more than 36 months prior to the date of commencement of the policy issued by the i", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "post hospitalization expenses 30/60 days, Covere", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 200, + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_note": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12500, + "source_url": "https://www.royalsundaram.in/", + "source_note": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 5, + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "e subject to a Co-payment of 5% applicable to claim amount admissib", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 2, + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home up to 2% of the sum insured subject to maximum of Rs.5000/-per day.", + "_confidence": "medium" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired policy period, if the term of policy is up to one year and there is no c", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", + "source_quote": "4.2. AYUSH Treatment The Company shall indemnify medical expenses incurred for inpatient care treatment Under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy system of medicines during each Policy Year", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", + "source_quote": "7.18. Any expenses incurred on Domiciliary Hospitalization and OPD treatment", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", + "source_quote": "7.19. Treatments taken outside the geographical limits in India", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", + "source_quote": "race period. 3.8. Cashless Facility means a facility extended by the insurer to the insured where the payments, of the cost", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", + "source_quote": "ject to maximum of 50% of the sum insured unde", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in royal-sundaram__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", + "source_quote": "l Limit All medical treatment for the purpose of this insurance will have to be taken in India only 10.10.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", + "source_quote": "not stated in royal-sundaram__arogya-sanjeevani__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "Up to 2% of sum insured subject to maximum Rs. 5,000 per day", + "unit": "text", + "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", + "source_quote": "Room Rent Upto 2% of Sum Insured subject to a maximum of Rs. 5000/- Intensive Care Unit(ICU)/Intensive Cardiac Care Unit(ICCU) Upto 5% of Sum Insured subject to a maximum of Rs. 10000/-", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 5, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/arogya-sanjeevani__wordings.pdf", + "source_quote": "Cumulative Bonus (CB) Cumulative Bonus will be increased by 5% in resp", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/royal-sundaram__family-plus__cis.json b/40-data/policy_facts/royal-sundaram__family-plus__cis.json index b01dc794ebba83e8097aa49988cd8e45eef29233..9b39dc91c221efaf953fc3ce8312bf349968e635 100644 --- a/40-data/policy_facts/royal-sundaram__family-plus__cis.json +++ b/40-data/policy_facts/royal-sundaram__family-plus__cis.json @@ -7,132 +7,260 @@ "value": "RSAHLIP22200V032122", "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Road, Chennai - 600 002 1 UIN - RSAHLIP22200V032122 CUSTOME", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__family-plus__cis.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__family-plus__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": null, + "value": 91, "unit": "days", - "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "for adults is 18 years onwards and from 91 days to 21 years for children. New born children can be added to existing policies at ren", + "_confidence": "medium" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__family-plus__cis.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "iry of the Grace Period. For the purpose of this provision, Grace Period means a period of 15 days in case of monthly payments and 30 days in case of quarterly, half-yearly and yearly payments immediately", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the Insured Person will be allowed a period of 30 days from the date of receipt of the policy to review", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "eriod • 30 days Initial Waiting Period for all illnesses except any", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "for Pre-existing Diseases cover: 36 months For Pre-existin", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "le • 2 years specific waiting period for the following 16 conditio", + "_confidence": "high" }, "maternity_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__family-plus__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__family-plus__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "enses incurred due to Illness upto 90 days immediately post discharge from Hospit", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 200, + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_note": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12500, + "source_url": "https://www.royalsundaram.in/", + "source_note": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__family-plus__cis.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__family-plus__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired policy period, if the term of policy is up to one year and there is no c", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__family-plus__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__family-plus__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__family-plus__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "10. AYUSH Treatment: Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines is covered up to 100% of Sum Insured, during each policy year as specified in the policy schedule.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "16. Maternity Benefits: Medical Expenses for the delivery of a child, where atleast two adult members are covered,after a waiting period of 2 years, subject to a maximum of Rs. 50,000 per delivery. Maternity benefits are paid only for two deliveries for each female member covered during the lifetime of the Policy", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "New Born Baby: New born baby will be covered as an insured person from birth (for the policy year in which the baby is born), if the Maternity Benefits claim has been accepted. This benefit is subject to maximum of Base Sum Insured.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "6. Organ Donor Expenses: Medical Expenses for an organ donor’s treatment for harvesting of the organ.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "9. Re-load of Sum Insured: We will provide a Re-load equal to 100% of Individual Base Sum Insured of any one Insured Member once in a Policy Year, provided that: a) the Base Sum Insured, No Claim Bonus (if any) and Floater Sum Insured is insufficient as a result of previous claims in that Policy Year", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "7. Domiciliary Hospitalization: Medical Expenses for medical treatment taken at home if the treatment continues for an uninterrupted period of 3 days and the condition for which treatment is taken would otherwise have necessitated hospitalization.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "into Network Hospital if cashless facility is not availed (Reimbursement Claims) (For Domestic Claims as well as Worldwide Emergency Hospitalization)", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "12. Health Check-up: Cost of an annual health check-up for prescribed tests subject to renewal of the policy. This benefit is over and above the Base Sum Insured.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "14. Second Opinion for Critical Illness: Available once during Policy period for 11 critical illness. It is available once in a Policy Year and once during the Lifetime of an Insured Person for same Illness.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "twork Hospital if cashless facility is not availed (Reimbursement Claims) (For Domestic Claims as well as Worldwide Emergen", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "s covered up to 100% of Sum Insured, dur", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "TAT for preauthorisation of cashless facility is 1 hour ii. TAT", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "not stated in royal-sundaram__family-plus__cis.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "not stated in royal-sundaram__family-plus__cis.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": null, + "unit": "text", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "not stated in family-plus__cis.pdf", + "_confidence": "low" + }, + "no_claim_bonus_pct": { + "value": 20, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__cis.pdf", + "source_quote": "No Claim Bonus: 20% of base", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/royal-sundaram__family-plus__wordings.json b/40-data/policy_facts/royal-sundaram__family-plus__wordings.json index 889a38bdda4afb26b5ab229e762b075f1eafc21c..3fce64910f8a62a20ba343fd5342944d9c6585fe 100644 --- a/40-data/policy_facts/royal-sundaram__family-plus__wordings.json +++ b/40-data/policy_facts/royal-sundaram__family-plus__wordings.json @@ -7,132 +7,260 @@ "value": "RSAHLIP22200V032122", "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Family Plus Policy Document Page 1 of 59 RSAHLIP22200V032122 ROYAL SUNDARAM AL", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__family-plus__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__family-plus__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": null, + "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "for adults is 18 years onwards and from 91 days to 21 years for children. New born children can be added to existing policies at ren", + "_confidence": "medium" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__family-plus__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "iry of the Grace Period. For the purpose of this provision, Grace Period means a period of 15 days in case of monthly payments and 30 days in case of quarterly, half-yearly and yearly payments immediately", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the Insured Person will be allowed a period of 30 days from the date of receipt of the policy to review", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "riod i. 30 days Initial Waiting Period We will not cover any treatme", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "re diagnosed by a physician not more than 36 months prior to the date of commencement of the policy issued by the i", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Specific Waiting Period A waiting period of 24 months shal", + "_confidence": "high" }, "maternity_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity Benefit during the first 24 months of the co", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__family-plus__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 90, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__family-plus__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 200, + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_note": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12500, + "source_url": "https://www.royalsundaram.in/", + "source_note": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__family-plus__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__family-plus__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired policy period, if the term of policy is up to one year and there is no c", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__family-plus__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__family-plus__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__family-plus__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "3.10 AYUSH Treatment Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines is covered up to 100% of Sum Insured, during each policy year as specified in the policy schedule.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "3.16 Maternity Benefits a. Maternity Benefits 1. We will cover Medical Expenses for the delivery of Insured Person’s child subject to the following: a. This benefit is available for Insured Person covered under the policy along with atleast one adult", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "b. New Born Cover If we have accepted a Maternity Benefits claim as mentioned above, then We will cover: a. Medical Expenses towards the medical treatment of the Insured Person’s new born baby while the Insured Person is Hospitalized as an In-patient for delivery.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "3.6 Organ Donor Expenses We will cover Inpatient Care Medical Expenses towards the donor for the harvesting of the organ donated provided that: (a) the organ donor is any person in accordance with the Transplantation of Human Organs Act, 1994", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "3.9 Re-load of Sum Insured We will provide a 100% Re-load of Base Sum Insured once in a Policy Year, provided that: a) the Base Sum Insured, Floater Sum Insured and No Claim Bonus (if any) is insufficient as a result of previous claims in that Policy Year", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "3.7 Domiciliary Hospitalization We will cover Medical Expenses for medical treatment taken at home if this continues for an uninterrupted period of 3 days and the condition for which treatment is taken would otherwise have necessitated Hospitalization", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "o. Territorial Jurisdiction The geographical scope of this Policy applies to events within India and all admitted or payable claims shall be settled in India in Indian rupees.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "3.12 Health Checkup We will arrange for a health checkup as per Your plan eligibility as defined in the Product Benefits Table provided that You or any Insured Person has requested for the same.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "3.14 Second Opinion for Critical Illness Family Plus Policy Document Page 18 of 59 RSAHLIP22200V032122 We will provide You a second opinion from Network Provider or Medical Practitioner, if an Insured Person is diagnosed with the Critical Illness", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "e period. Def. 8. Cashless Facility means a facility extended by the insurer to the insured where the payments, of the cost", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "upto a maximum of 100% of Base Individual Sum Insured of r", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "not stated in royal-sundaram__family-plus__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "rrency. All medical treatments for the purpose of this insurance will have to be taken in India only. Family", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "HLIP22200V032122 Def. 23. Family Floater Policy means a Policy in terms of which, two or more persons of a Family are nam", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": null, + "unit": "text", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "not stated in family-plus__wordings.pdf", + "_confidence": "low" + }, + "no_claim_bonus_pct": { + "value": 20, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/family-plus__wordings.pdf", + "source_quote": "No Claim Bonus We will increase Your Individual Base Sum Insured by 20% per Ins", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/royal-sundaram__lifeline__brochure.json b/40-data/policy_facts/royal-sundaram__lifeline__brochure.json index 3bf7cfae70e28b39b55dca5ea905a11c1522a548..d281dfbf384959ac52f046ab06742c900a11ae1d 100644 --- a/40-data/policy_facts/royal-sundaram__lifeline__brochure.json +++ b/40-data/policy_facts/royal-sundaram__lifeline__brochure.json @@ -7,146 +7,253 @@ "value": "RSAHLIP24146V032324", "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Lifeline (UIN-RSAHLIP24146V032324) is a Health Insurance product underwritten and issued by Royal Sundaram General Insurance Co. Limited.", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "y age for Adults is 18 years onwards and from 91 days to 25 years for chi", + "_confidence": "high" }, "max_entry_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, + "value": 25, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "dren, 18 years for proposer or adults. Maximum Entry Age 25 years for dependent children, lifetime entry age for adults. Pol", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "nwards and from 91 days to 25 years for chi", + "_confidence": "high" }, "sum_insured_options": { - "value": [ - 200000, - 300000, - 400000, - 500000, - 750000, - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 5000000, - 10000000, - 15000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__lifeline__brochure.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period for Renewal 30 days from the", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look-in period of 30 days (only for new policies). Li", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "4 1. Initial Waiting Period - 30 Days 2. Initial Waiting Period For Critical Illness - 90 Da", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "line cover includes a - 36 months waiting period for Classic, 36 months waiting period for Supreme and 24 months waiting period for Elite for pre-existing cond", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "d of 24 months for 16 specified illnesses listed below: • Stones in Biliary an", + "_confidence": "high" }, "maternity_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity benefits - 36 Months 5. Specifi", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__lifeline__brochure.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 180, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__lifeline__brochure.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 200, + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_note": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12500, + "source_url": "https://www.royalsundaram.in/", + "source_note": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 20, + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "3. Third degree burns 20% co-payment applies for", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__lifeline__brochure.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "L OPTIONS Top-up plan on annual aggregate basis Not Available Deducti", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__lifeline__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__lifeline__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__lifeline__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "(3) AYUSH Treatment - Inpatient Treatment taken up in authorized hospitals as per definition mentioned in policy terms and conditions.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "(10) Maternity Benefit - Covers up to 2 deliveries if both husband and wife are covered under the same family floater policy, New Born Baby Cover and Vaccination for new born (only in Elite Plan). 36 month waiting period applies to maternity", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "MATERNITY (10) BENEFITS - Maternity cover for up to 2 deliveries - New Born Baby Cover (#) - Vaccinations for new born baby in the first year", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "Organ Donor Expenses Covered up to Sum Insured 10% of Base Sum Insured up to a maximum of 50% Up to Base Sum Insured Covered up to Sum Insured", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "(2) Re-load of Sum Insured - Reinstate sum insured upto base sum insured. Applicable for different illness or different Insured member for same illness.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "OTHER BENEFITS Domiciliary Hospitalization No Claim Bonus (2) Re-load of Sum Insured (3) Ayush Treatment (4) Vaccination in case of Animal Bite", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "Worldwide Emergency Hospitalization (Excluding $ US and Canada) International Treatment abroad for 11 specified critical illnesses along with one time return airfare (6) $ for insured person (Excluding US and Canada)", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "HEALTH & WELLNESS BENEFITS Health Check-up Annual Annual Once in 2 years Preventive Healthcare & Wellness and Disease (7) Management Available Available Available", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "Second Opinion for 11 specified Critical Illness Available once during the policy year (Second Opinion for 11 specified Critical Illness)", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "th Insurance Plan Go cashless with India’s leading health insurance plan explore", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "up to a maximum of 100% Up to Base Sum Insured Cove", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "worldwide_ex_usa_canada", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "Worldwide Emergency Hospitalization (Excluding $ US and Canada) Int", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "re covered under the same family floater policy, New Born Baby Cover and Vaccination for new born (only in Elite Pl", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "No Room Rent Cap (Premier hospitals)", + "unit": "text", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "Premier Hospitals in India and Abroad with No-Room-Rent-Cap Emergency Domestic Evacuation Second Opinion for 11 Critical Illnesses", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 20, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "Covered up to Sum Insured 20% of Base Sum Insured up to a maximum of", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/royal-sundaram__lifeline__cis.json b/40-data/policy_facts/royal-sundaram__lifeline__cis.json index 7ef358b4c2a3dad742024d7e4907ed25dde1d651..1751e10d007e61b0ed66b07f67a605e1e8538580 100644 --- a/40-data/policy_facts/royal-sundaram__lifeline__cis.json +++ b/40-data/policy_facts/royal-sundaram__lifeline__cis.json @@ -7,146 +7,253 @@ "value": "RSAHLIP24146V032324", "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Road, Chennai - 600 002 1 UIN: RSAHLIP24146V032324 CUSTOME", + "_confidence": "high" }, "min_entry_age": { - "value": 18, - "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__lifeline__cis.pdf", + "_confidence": "low" }, - "max_renewal_age": { - "value": 999, + "max_entry_age": { + "value": 25, "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "dren, 18 years for proposer or adults. Maximum Entry Age 25 years for dependent children, lifetime entry age for adults. Pol", + "_confidence": "high" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__lifeline__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 200000, - 300000, - 400000, - 500000, - 750000, - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 5000000, - 10000000, - 15000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__lifeline__cis.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period of 15 days in monthly and 30 days in case o", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the Insured Person will be allowed a period of 30 days from the date of receipt of the policy to review", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "riod Initial waiting Period: 30 days for all illnesses (not applicable on renewal or for ac", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "der. Pre-existing diseases: 36 months waiting period", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "nts) Specific Waiting periods :24 months for 16 diseases • Stones in b", + "_confidence": "high" }, "maternity_waiting_months": { - "value": 36, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__lifeline__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__lifeline__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 180, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__lifeline__cis.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 200, + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_note": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12500, + "source_url": "https://www.royalsundaram.in/", + "source_note": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 20, + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Co-payment of 20% every year applies for all admissible claims.", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__lifeline__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired policy period, if the term of policy is up to one year and there is no c", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__lifeline__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__lifeline__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__lifeline__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "10. Ayush Treatment – Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines is covered up to 100% of Sum Insured, during each policy year", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "18. Maternity Benefits (Available for Elite Plan Only): Medical Expenses for the delivery of a child, where Insured Person and spouse, both are covered, after a waiting period of 3 years, subject to the following sub-limits.", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "New Born Baby: New born baby will be covered as an insured person from birth (for the policy year in which the baby is born), if the Maternity Benefits claim has been accepted. This benefit is subject to 25% of Sum Insured.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "6.Organ Donor Expenses: Medical Expenses for an organ donor’s treatment for harvesting of the organ. We will not cover Pre-hospitalization or Post- hospitalization Medical Expenses or screening expenses of the donor.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "9. Re-load of Sum Insured – We will provide a Re-load of Sum Insured equal to 100% of base sum insured in case base sum insured and No Claim Bonus has been partially or completely exhausted.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "7. Domiciliary Hospitalization: Medical Expenses for medical treatment taken at home if the treatment continues for an uninterrupted period of 3 days and the condition for which treatment is taken would otherwise have necessitated", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "16. Worldwide Emergency Hospitalization (excluding US and Canada) (Available for Elite Plan only) – Covered upto 50% of Sum Insured or Rs.20 lakhs whichever is lower, once a policy year. Deductible of 2000 USD available.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "12. Health Check-up - Cost of a health check-up as per your plan eligibility subject to renewability of the policy. This benefit is over and above the Base Sum Insured for insured over 18 years of age on Policy Period Start Date.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "14. Second Opinion for Critical Illness (Available for Supreme & Elite Plan only) – Available once during Policy period for 11 critical illness.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "twork Hospital if cashless facility is not availed (Re-imbursement Claims) (For Domestic Claims as well as Worldwide Emerge", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "s covered up to 100% of Sum Insured, dur", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "worldwide_ex_usa_canada", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "Worldwide Emergency Hospitalization (excluding US and Canada) (Av", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "not stated in royal-sundaram__lifeline__cis.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": null, + "unit": "text", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "not stated in lifeline__cis.pdf", + "_confidence": "low" + }, + "no_claim_bonus_pct": { + "value": 20, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__cis.pdf", + "source_quote": "um insured; Supreme & Elite - 20% of base sum insured upto a max of 100% of base su", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/royal-sundaram__lifeline__wordings.json b/40-data/policy_facts/royal-sundaram__lifeline__wordings.json index 186f576ab7dbeec10fd91e299a79ed4af9caf15e..f6a30fcebad8efd637b1b5bd09fa6610a523b637 100644 --- a/40-data/policy_facts/royal-sundaram__lifeline__wordings.json +++ b/40-data/policy_facts/royal-sundaram__lifeline__wordings.json @@ -7,146 +7,253 @@ "value": "RSAHLIP24146V032324", "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ifeline Policy Document 1 UIN: RSAHLIP24146V032324 ROYAL S", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "y age for Adults is 18 years onwards and from 91 days to 25years for chil", + "_confidence": "high" }, "max_entry_age": { - "value": null, + "value": 25, "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__brochure.pdf", + "source_quote": "dren, 18 years for proposer or adults. Maximum Entry Age 25 years for dependent children, lifetime entry age for adults. Pol", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "nwards and from 91 days to 25years for chi", + "_confidence": "high" }, "sum_insured_options": { - "value": [ - 200000, - 300000, - 400000, - 500000, - 750000, - 1000000, - 1500000, - 2000000, - 2500000, - 3000000, - 5000000, - 10000000, - 15000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__lifeline__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "iry of the Grace Period. For the purpose of this provision, Grace Period means a period of 15 days in case of monthly payments and 30 days in case of quarterly, half-yearly and yearly payments immediately", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the Insured Person will be allowed a period of 30 days from the date of receipt of the policy to review", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "to the treatment of any illness within 30 days from the first policy commencement d", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "re diagnosed by a physician not more than 36 months prior to the date of commencement of the policy issued by the i", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "l be excluded until the expiry of 24 months of continuous coverage after t", + "_confidence": "high" }, "maternity_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity Benefit during the first 36 months of the co", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__lifeline__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 180, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__lifeline__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 200, + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_note": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12500, + "source_url": "https://www.royalsundaram.in/", + "source_note": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 20, + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "(e) All claims will be subject to 20% co-payment; (f) This benefit is available Worldwide excluding US and Canada (g) Re-load of Sum Insured will not be available for this benefit;", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__lifeline__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired policy period, if the term of policy is up to one year and there is no c", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__lifeline__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__lifeline__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__lifeline__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "3.10 AYUSH Treatment Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines is covered up to 100% of Sum Insured, during each policy year as specified in the policy", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "3.18 Maternity Benefits (For Elite Plan only) a. Maternity Benefits 1. We will cover Medical Expenses for the delivery of Insured Person’s child subject to the following: a. This benefit is available for Insured Person related as legally", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "b. New Born Cover If we have accepted a Maternity Benefits claim as mentioned above, then We will cover: a. Medical Expenses towards the medical treatment of the Insured Person’s new born baby while the Insured Person is Hospitalized as an", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "3.6 Organ Donor Expenses We will cover Inpatient Care Medical Expenses towards the donor for the harvesting of the organ donated provided that: Lifeline Policy Document 13 UIN: RSAHLIP24146V032324 (a) the organ donor is any person in accordance", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "3.9 Re-load of Sum Insured We will provide a 100% Re-load of Sum Insured once in a Policy Year, provided that: a) the Base Sum Insured and No Claim Bonus (if any) is insufficient as a result of previous claims in that Policy Year;", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "3.7 Domiciliary Hospitalization We will cover Medical Expenses for medical treatment taken at home if this continues for an uninterrupted period of 3 days and the condition for which treatment is taken would otherwise have necessitated Hospitalization", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "3.16 Worldwide Emergency Hospitalization (excluding US and Canada) (For Elite Plan only) We will cover Medical Expenses of the Insured Person incurred outside India, up to limits specified in the Product Benefits Table, provided that:", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "3.12 Health Checkup We will arrange for a health checkup as per Your plan eligibility as defined in the Product Benefits Table provided that You or any Insured Person has requested for the same.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "3.14 Second Opinion for Critical Illness (For Supreme and Elite Plan only) We will provide You a second opinion from Network Provider or Medical Practitioner, if an Insured Person is diagnosed with the Critical Illness during the Policy Period", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "s sought. Def. 8. Cashless Facility means a facility extended by the insurer to the insured where the payments, of the cost", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "upto a maximum of 100% of Base Sum Insured of r", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": "worldwide_ex_usa_canada", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "Worldwide Emergency Hospitalization (excluding US and Canada) (Fo", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "Person’s health. Def. 23. Family Floater Policy means a Policy in terms of which, two or more persons of a Family are nam", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": null, + "unit": "text", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "not stated in lifeline__wordings.pdf", + "_confidence": "low" + }, + "no_claim_bonus_pct": { + "value": 20, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/lifeline__wordings.pdf", + "source_quote": "licy for Classic Plan and 20% of Base Sum Insured per Policy Year upto a maximum of", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/royal-sundaram__multiplier__brochure.json b/40-data/policy_facts/royal-sundaram__multiplier__brochure.json index 4f9d9d5fb219a81544fb7ff895544190da44e05d..b7e9b5d76affb64712b321a315159e9128a91eb8 100644 --- a/40-data/policy_facts/royal-sundaram__multiplier__brochure.json +++ b/40-data/policy_facts/royal-sundaram__multiplier__brochure.json @@ -7,139 +7,255 @@ "value": "RSAHLIP23030V012223", "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ier Health Insurance Plan UIN: RSAHLIP23030V012223 03 UIN:", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "For Adults: 18 years to 65 years (Lif", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "For Adults: 18 years to 65 years (Lif", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ren: Dependent Children 91 days to 25 years 1/2/3 years 1- 24 months w", + "_confidence": "high" }, "sum_insured_options": { - "value": [ - 500000, - 750000, - 1000000, - 1500000, - 2000000, - 2500000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__multiplier__brochure.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__multiplier__brochure.pdf", + "_confidence": "low" }, "free_look_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__multiplier__brochure.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__multiplier__brochure.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "xcluded until the expiry of 36 months of continuous coverage afte", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "l be excluded until the expiry of 24 months of continuous coverage, as may", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__multiplier__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__multiplier__brochure.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "are, for a fixed period of 90 days from the date of discharge from the", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 200, + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_note": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12500, + "source_url": "https://www.royalsundaram.in/", + "source_note": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 5, + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Co-payment Options - 5%, 10%, 15%, 20% Monthly, Quarterly, Half Yearly, Annual", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "atient Care Covered up to Sum Insured Room Rent No Room Rent Capping Modern Treatments Covered up to Sum Insured Pre and Post", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "ren 91 days to 25 years 1/2/3 years 1- 24 months wait", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__multiplier__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__multiplier__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__multiplier__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "Ayush Treatment The company shall indemnify medical expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy system of medicines during each policy year up to sum", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "Maternity Expenses: (Code - Excl 18) The above is an indicative list. For the complete list of exclusions, please refer to the detailed policy terms and conditions.", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "not stated in royal-sundaram__multiplier__brochure.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "Organ Donor Expenses We will cover inpatient care medical expenses towards the donor for the harvesting of the organ donated provided that: a) the organ donor is any person in accordance with the Transplantation of Human", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "Flexi Reload Benefit 1. Available upto 100% of Base Sum Insured. 2. This benefit is available even for same illness for same Insured Person in the same Policy year. This benefit will be available after exhaustion of Base Su", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "Domiciliary Hospitalisation We will cover medical expenses up to sum insured for medical treatment taken at home if this continues for an uninterrupted period of 3 days and the condition for which treatment is taken would", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "not stated in multiplier__brochure.pdf", + "_confidence": "low" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "Disease Management, Preventive Healthcare & Wellness Benefit to offer various health related articles via email, videos on specific health topics etc.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "4X Multiplier Benefit In Life Threatening Conditions, an additional amount equivalent to 4 (Four) times of Sum Insured and No Claim Bonus will be available to the Insured Persons for all claims admissible during the Polic", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "not stated in royal-sundaram__multiplier__brochure.pdf", + "_confidence": "low" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "up to a maximum of 100% of base sum insured of r", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "not stated in royal-sundaram__multiplier__brochure.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "Individual basis or on a Family Floater basis. In case of a family floater policy, one family will share a single", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "No Room Rent Capping", + "unit": "text", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "Covered up to Sum Insured No Room Rent Capping Covered up to Sum Insured 60/90 days, Covered upto Sum Insured", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 20, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "No Claim Bonus We will increase your sum insured by 20% of base", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/royal-sundaram__multiplier__cis.json b/40-data/policy_facts/royal-sundaram__multiplier__cis.json index 96916dad724d5677c3748da6f26190598cdf11e0..34029bbfbd8cd06dc13f9505ff0528c318805ad7 100644 --- a/40-data/policy_facts/royal-sundaram__multiplier__cis.json +++ b/40-data/policy_facts/royal-sundaram__multiplier__cis.json @@ -7,139 +7,253 @@ "value": "RSAHLIP23030V012223", "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Road, Chennai - 600 002 1 UIN: RSAHLIP23030V012223 CUSTOME", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__multiplier__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__multiplier__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__multiplier__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 500000, - 750000, - 1000000, - 1500000, - 2000000, - 2500000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__multiplier__cis.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "iry of the Grace Period. For the purpose of this provision, Grace Period means a period of 15 days in case of monthly payments and 30 days in case of quarterly, half-yearly and yearly payments immediately", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the Insured Person will be allowed a period of 30 days from the date of receipt of the policy to review", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "od • Initial waiting Period: 30 days for all illness (not applicable on renewal or for acci", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "es • Pre-existing diseases: Covered after 36 months (Covered with 5", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ts) •Specific Waiting periods: 24 months for 16 diseases • Pre-existin", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__multiplier__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__multiplier__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ted medical expenses incurred within 90 days from discharge. • Day-care", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 200, + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_note": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12500, + "source_url": "https://www.royalsundaram.in/", + "source_note": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in multiplier__cis.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", - "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__brochure.pdf", + "source_quote": "atient Care Covered up to Sum Insured Room Rent No Room Rent Capping Modern Treatments Covered up to Sum Insured Pre and Post", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired policy period, if the term of policy is up to one year and there is no c", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__multiplier__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__multiplier__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__multiplier__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": "• AYUSH Treatment: Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines is covered up to 100% of Sum Insured, during each policy year as specified", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": "Not covered.", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": "not stated in royal-sundaram__multiplier__cis.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": "• Organ Donor Expenses: Medical Expenses for an organ donor’s treatment for harvesting organ. Organ donor expenses will be covered within up to the sum insured for the patient insured with us i.e. recipient of the Organ", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": "• Flexi Reload of Sum Insured: We will Reload Your Sum Insured, once in a Policy Year, up to 100% of Base Sum Insured, subject to the following I. Flexi Re-load will be triggered only if Base Sum Insured and No Claim Bonus", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": "• Domiciliary Hospitalization: Medical Expenses up to Sum Insured for medical treatment taken at home if the treatment continues for an uninterrupted period of 3 days and the condition for which treatment is taken would otherwise", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": "not stated in multiplier__cis.pdf", + "_confidence": "low" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": "• Annual Health Check-up: Cost of a health check-up as per eligibility of insured. This benefit is over and above the Base Sum Insured.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": "• Second Opinion for Critical Illness: Available once during Policy period for 22 critical illness.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": "twork Hospital if cashless facility is not availed (Re-imbursement Claims) G.1 G.1.1 G.1.2 Multiplier Health Insurance Plan", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": "s covered up to 100% of Sum Insured, dur", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": "not stated in royal-sundaram__multiplier__cis.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": ". If the policy is issued on a floater basis, the Reload Sum Insured will also be available on floater basis; Pr", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": null, + "unit": "text", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": "not stated in multiplier__cis.pdf", + "_confidence": "low" + }, + "no_claim_bonus_pct": { + "value": 20, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__cis.pdf", + "source_quote": "No Claim Bonus: • 20% increas", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/royal-sundaram__multiplier__wordings.json b/40-data/policy_facts/royal-sundaram__multiplier__wordings.json index 788928d960b36abebfb98afde2b353d04543ab0f..016a7903f281ba08b3990cb52ec13ce2e590c292 100644 --- a/40-data/policy_facts/royal-sundaram__multiplier__wordings.json +++ b/40-data/policy_facts/royal-sundaram__multiplier__wordings.json @@ -7,31 +7,29 @@ "value": "RSAHLIP23030V012223", "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "1 UIN- RSAHLIP23030V012223 ` Multi", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "For Adults: 18 years to 65 years (Lif", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "For Adults: 18 years to 65 years (Lif", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ren: Dependent Children 91days to 25 yrs Policy Period 1/2/3 Years 1-", + "_confidence": "high" }, "sum_insured_options": { "value": [ @@ -44,102 +42,227 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "eline Cover 1 Sum Insured 5 Lakhs, 7.5 Lakhs, 10 Lakhs, 15 Lakhs, 20 Lakhs, 25 Lakhs 2 In", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "iry of the Grace Period. For the purpose of this provision, Grace Period means a period of 15 days in case of monthly payments and 30 days in case of quarterly, half-yearly and yearly payments immediately", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the Insured Person will be allowed a period of 30 days from the date of receipt of the policy to review", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "to the treatment of any illness within 30 days from the first policy commencement d", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "re diagnosed by a physician not more than 36 months prior to the date of commencement of the policy issued by the i", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Specific waiting period1 24 months wait", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__multiplier__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__multiplier__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post hospitalization expenses 60/90 days, Covere", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 200, + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_note": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12500, + "source_url": "https://www.royalsundaram.in/", + "source_note": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Voluntary Co-payment[ Co-payment Options- 5%, 10%, 15%, 20% 23 Instalment payment option Available- Monthly, Quarterly, Half Yearly, Annual", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { - "value": null, + "value": 0, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "nt Care Covered up to Sum Insured 3 Room Rent No Room rent capping 4 Modern treatments Covered Up to Sum Insured 5 Pre", + "_confidence": "high" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "s to 25 yrs Policy Period 1/2/3 Years 1- 24 mon", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__multiplier__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__multiplier__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__multiplier__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "AYUSH Treatment Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines is covered up to 100% of Sum Insured, during each policy year as specified in the policy schedule.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "Maternity Expenses (Code – Excl18): i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy;", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "not stated in royal-sundaram__multiplier__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "Organ Donor Expenses We will cover Inpatient Care Medical Expenses towards the donor for the harvesting of the organ donated provided that: (a) the organ donor is any person in accordance with the Transplantation of Human Organs Act, 1994", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "Flexi Reload Benefit We will Reload Your Sum Insured, once in a Policy Year, up to 100% of Base Sum Insured, subject to the following: the Base Sum Insured and No Claim Bonus (if any) is insufficient as a result of previous claims in that Policy Year;", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "Domiciliary Hospitalization We will cover Medical Expenses for medical treatment taken at home if this continues for an uninterrupted period of 3 days and the condition for which treatment is taken would otherwise have necessitated Hospitalization", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "F.2.9 Territorial Jurisdiction The geographical scope of this Policy applies to events within India. All admitted or payable claims shall be settled in India in Indian rupees.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "Annual Health Check-up We will arrange for a health check-up as per Your eligibility as defined in the Product Benefits Table provided that You or any Insured Person has requested for the same.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "Second Opinion for Critical Illness We will provide You a second opinion from Medical Practitioner, if an Insured Person is diagnosed with the Critical Illness during the Policy Period.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "ace period. C.1.6 Cashless Facility means a facility extended by the insurer to the insured where the payments, of the cost", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "up to a maximum of 100% of Base Sum Insured of r", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "not stated in royal-sundaram__multiplier__wordings.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "ed Person’s health. C.2.7 Family Floater Policy means a Policy in terms of which, two or more persons of a Family are nam", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "No Room Rent Cap", + "unit": "text", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "Room Rent No Room rent capping 4 Modern treatments Covered Up to Sum Insured 5 Pre and Post hospitalization expenses 60/90 days, Covered upto Sum Insured", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 20, + "unit": "%", + "source_pdf_path": "rag/corpus/royal-sundaram/multiplier__wordings.pdf", + "source_quote": "No Claim Bonus We will increase Your Sum Insured by 20% of Base", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/royal-sundaram__presecure-advantage__wordings.json b/40-data/policy_facts/royal-sundaram__presecure-advantage__wordings.json index 753c60ac97ee7cbf198b3d05d54e4272662b3aea..007bd52acc4373866bf1a8b0c49dda74fe75e9d5 100644 --- a/40-data/policy_facts/royal-sundaram__presecure-advantage__wordings.json +++ b/40-data/policy_facts/royal-sundaram__presecure-advantage__wordings.json @@ -7,132 +7,211 @@ "value": "RSAHLIP25036V012425", "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Advantage Policy Document UIN- RSAHLIP25036V012425 Royal S", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "For Adults: 18 years to 65 years (Lif", + "_confidence": "high" }, "max_entry_age": { - "value": null, + "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Other UW conditions 20 Entry age For Adults: 18 years to 65 years (Lifelong renewability), For dependent Children: Depende", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ren: Dependent Children 91 days to 25 years 21 Policy Period 1/2/3 Yea", + "_confidence": "high" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__presecure-advantage__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Grace Period means a period of 30 days in case of one year immediately following the Policy Period End Date during whi", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the Insured Person will be allowed a period of 30 days from the date of receipt of the policy to review", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "to the treatment of any illness within 30 days from the first policy commencement d", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "re diagnosed by a physician not more than 36 months prior to the date of commencement of the policy issued by the i", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Specific waiting period1 24 months wait", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__presecure-advantage__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 15, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre hospitalization expenses 15 days, Covere", + "_confidence": "high" }, "post_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post Hospitalization Expenses 30 days, Covere", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 200, + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_note": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12500, + "source_url": "https://www.royalsundaram.in/", + "source_note": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 50, + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "ealth Coach 12 Co pay 50% co-pay shall be applicable for ever", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1, + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "a) Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home –Up to 1% of Sum Insured. b) Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses up to 2% of Sum Insured", + "_confidence": "medium" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired policy period, if the term of policy is up to one year and there is no P", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__presecure-advantage__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__presecure-advantage__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__presecure-advantage__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", + "source_quote": "4.2 AYUSH Treatment Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines is covered up to 100% of Sum Insured, during each policy year", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", + "source_quote": "r. Maternity Expenses (Code – Excl18): i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy;", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", + "source_quote": "not stated in royal-sundaram__presecure-advantage__wordings.pdf", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", + "source_quote": "4.6 Domiciliary Hospitalization We will cover Medical Expenses for medical treatment taken at home if this continues for an uninterrupted period of 3 days and the condition for which treatment is taken would otherwise", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", + "source_quote": "7. Territorial Jurisdiction The geographical scope of this Policy applies to events within India. All admitted or payable claims shall be settled in India in Indian rupees.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", + "source_quote": "race period. 3.8. Cashless Facility means a facility extended by the insurer to the insured where the payments, of the cost", + "_confidence": "high" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", + "source_quote": "not stated in royal-sundaram__presecure-advantage__wordings.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", + "source_quote": "of the insured person. b. Family Floater Policy: The Policy shall automatically terminate in the case of death of a", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "1% of Sum Insured per day", + "unit": "text", + "source_pdf_path": "rag/corpus/royal-sundaram/presecure-advantage__wordings.pdf", + "source_quote": "3 Room Rent /ICU Charges 1% of SI/ 2% of SI 4 Day care treatments Covered up to SI 5 Modern treatments 50% Of SI", + "_confidence": "high" } } diff --git a/40-data/policy_facts/royal-sundaram__surrosafe__wordings.json b/40-data/policy_facts/royal-sundaram__surrosafe__wordings.json index 4155a7db32ff5464551bd0dc8c7b62213cf825e2..10240b4ee6fb60be7080ff820b3966e74f769dc4 100644 --- a/40-data/policy_facts/royal-sundaram__surrosafe__wordings.json +++ b/40-data/policy_facts/royal-sundaram__surrosafe__wordings.json @@ -7,132 +7,211 @@ "value": "RSAHLIP24110V012324", "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "surance Policy Document 1 UIN: RSAHLIP24110V012324 Royal S", + "_confidence": "high" }, "min_entry_age": { - "value": 18, - "unit": "years", - "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" }, - "max_renewal_age": { + "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "grace period will be allowed maximum only once for a period of 30 days for payme", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "to the treatment of any illness within 30 days from the first policy commencement d", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "re diagnosed by a physician not more than 36 months prior to the date of commencement of the policy issued by the i", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ion requiring inpatient care, for a fixed period of 60 days from the date of discharge from the ho", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 200, + "source_url": "https://www.royalsundaram.in/health-insurance/lifeline/", + "source_note": "Per insurer baseline (Royal Sundaram Lifeline lists ~200 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12500, + "source_url": "https://www.royalsundaram.in/", + "source_note": "12500+ Cashless hospitals (homepage, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1, + "unit": "%", "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "1. Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home up to 1% of the sum insured per day. 2. Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses up to actuals amount subject to sum insured", + "_confidence": "medium" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired policy period, if the term of policy is up to one year and there is no c", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", + "source_quote": "8. AYUSH Treatment- Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines is covered up to 100% of Sum Insured, during each policy year as specified in the pol", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", + "source_quote": "D1. Surrogate Cover By opting this cover, the Company shall indemnify the reasonable and customary medical expenses, incurred for Hospitalization of the Insured Person during the policy year, up to Sum Insured as specified in Policy schedule, arising out of pregnancy and also covering post- partum delivery", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", + "source_quote": "9.Territorial Jurisdiction The geographical scope of this Policy applies to events within India. All admitted or payable claims shall be settled in India in Indian rupees.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" + }, + "critical_illness_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", + "source_quote": "grace period. 6. Cashless Facility means a facility extended by the insurer to the insured where the payments, of the cost", + "_confidence": "high" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", + "source_quote": "not stated in royal-sundaram__surrosafe__wordings.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "1% of Sum Insured per day", + "unit": "text", + "source_pdf_path": "rag/corpus/royal-sundaram/surrosafe__wordings.pdf", + "source_quote": "1. Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home up to 1% of the sum insured per day.", + "_confidence": "high" } } diff --git a/40-data/policy_facts/sbi-general__arogya-supreme__brochure.json b/40-data/policy_facts/sbi-general__arogya-supreme__brochure.json index 9932f399a4dcbfd2674a3d3b47e733a46199335c..293e5eff1e8e83bd726743833cb19ee3cb015749 100644 --- a/40-data/policy_facts/sbi-general__arogya-supreme__brochure.json +++ b/40-data/policy_facts/sbi-general__arogya-supreme__brochure.json @@ -7,146 +7,251 @@ "value": "SBIHLIP21043V012122", "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "he Policy? Arogya Supreme UIN: SBIHLIP21043V012122 Sum Ins", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "y age for adults is 18 years to 65 years & for dependent children is 91 d", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "r adults is 18 years to 65 years & for dependent children", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ent children is 91 days to 25 years What Ar", + "_confidence": "high" }, "sum_insured_options": { - "value": [ - 300000, - 400000, - 500000, - 600000, - 700000, - 800000, - 1000000, - 1500000, - 2000000, - 2500000, - 5000000, - 7500000, - 10000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-supreme__brochure.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Lifelong Renewability l A grace period of 30 days is allowed for renewal of", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-supreme__brochure.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ods? Generic Policy Waiting Period 30 Days, Except for Accidents Specifi", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ears Pre-existing Diseases 3 Years Hypertensio", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ents Specific Illnesses & Procedures 2 Years Pre-existin", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalization cover 30 Days 60 Days 60 Days Post-Ho", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-Hospitalization cover 60 Days 90 Days 180 Days Domicil", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, + "value": 537, + "unit": "count", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Day Care Procedures (537 Day Care Procedures Covered) Covered up to Sum Insured as per indicative Day care list", + "_confidence": "medium" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18324, + "source_url": "https://www.sbigeneral.in/", + "source_note": "18,324 network hospitals (homepage service-infrastructure stat, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Copayment 10% / 20% Co-payment available 10% / 20% Co-payment available 10% / 20% Co-payment available", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in arogya-supreme__brochure.pdf (room rent is a Single Private Room category restriction for the Rs.3-4 Lakh SI tier, not a percentage-of-SI cap; the only '1% of Sum Insured' clause in this PDF is the air-ambulance benefit)", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__brochure.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "15. Alternative Treatment / AYUSH We will pay Medical Expenses up to the Sum Insured on your Hospitalization in Hospital or AYUSH Hospital or AYUSH Day Care Centre for any of the following Alternative Treatments prescribed by Medical Practitioner.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "Sterility and Infertility l Maternity l War and war-like situations l Injury or disease caused by or contributed to by nuclear weapons/materials l Treatment taken outside India l Circumcision", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "not stated in sbi-general__arogya-supreme__brochure.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "14. Organ Donor Expenses We will pay Medical Expenses up to the Sum Insured towards organ donor's Hospitalization for harvesting of the donated organ where an Insured Person is the recipient, subject to conditions mentioned in Policy wordings.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "18. Sum Insured Refill We will refill 100% Basic Sum Insured on complete or partial utilization of your existing Policy Sum Insured in a Policy Year, including Cumulative Bonus or Enhanced Cumulative Bonus.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "11. Domiciliary Hospitalization We will pay the Medical Expenses incurred on Domiciliary Hospitalisation, up to the Sum Insured as specified in the Policy Schedule.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "17. Domestic Emergency Assistance Services (including Air Ambulance) We will provide Emergency medical assistance as below when you are traveling within India 150 kilometers or more away from your residential address mentioned in the Policy Schedule for domestic services.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "1. Preventive Health Check-Up: You will be eligible for a preventive health check-up every year st from 1 renewal year.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "Major Illness – Benefit (Survival - 30 days ; IWP - 90 days) (Eligibility =>18 yrs) Cover up to 100% of Sum Insured or maximum up to `25 Lakhs whichever is lower", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "not stated in sbi-general__arogya-supreme__brochure.pdf", + "_confidence": "low" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "up to a maximum of 100% of Basic Sum Insured prov", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "not stated in sbi-general__arogya-supreme__brochure.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "Respect Of Individual And Family Floater Basis Age of the members insured Coverage opted on individual basis cover", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "For `3 Lakhs & `4 Lakhs - Single Private AC Room (1% restriction as an option available) For `5 Lakhs - Single pvt AC Room (Upgrade option available (excluding suite & above))", + "unit": "text", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "Room Rent For `3 Lakhs & `4 Lakhs - Single Private AC Room (1% restriction as an option available) For `5 Lakhs - Single pvt AC Room (Upgrade option available (excluding suite & above))", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 15, + "unit": "%", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "Cumulative Bonus On Renewal of the Policy with us, we will pay 15% up to a", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/sbi-general__arogya-supreme__cis.json b/40-data/policy_facts/sbi-general__arogya-supreme__cis.json index cffa4f4e2427984a2474e46aa7ae08f9bc21d45b..3084342bdfdb5d8a6c6f439d6bb7453590bf7cfa 100644 --- a/40-data/policy_facts/sbi-general__arogya-supreme__cis.json +++ b/40-data/policy_facts/sbi-general__arogya-supreme__cis.json @@ -7,145 +7,251 @@ "value": "SBIHLIP21043V012122", "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "imited | Arogya Supreme | UIN: SBIHLIP21043V012122 Tollfre", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 300000, - 400000, - 500000, - 600000, - 800000, - 1000000, - 1500000, - 2000000, - 2500000, - 5000000, - 7500000, - 10000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "cy if you do not want it, within 30 days from the beginning of the policy. For de", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "8) • Initial Waiting Period: 30 days • Specific Waiting Periods ◦24 months for Internal Con", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "19 • Pre-Existing diseases: 36 months 7. Waiting peri", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ys • Specific Waiting Periods ◦24 months for Internal Congenital disea", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 90, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" }, "day_care_treatments_count": { "value": null, - "unit": null, + "unit": "procedures", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18324, + "source_url": "https://www.sbigeneral.in/", + "source_note": "18,324 network hospitals (homepage service-infrastructure stat, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "6. Co-Payment: 10% or 20% Co-Payment as specified in the Policy Schedule, shall be applied on each and every admissible claim after Deductible wherever applicable under this Policy.", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", - "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "not stated in arogya-supreme__brochure.pdf (room rent is a Single Private Room category restriction for the Rs.3-4 Lakh SI tier, not a percentage-of-SI cap; the only '1% of Sum Insured' clause in this PDF is the air-ambulance benefit)", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "15. Alternative Treatment / AYUSH: We will pay Medical Expenses up to the Sum Insured as specified in the Policy Schedule for Alternative Treatments like Ayurvedic , Unani, Siddha and Homeopathy", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "12. Sterility and Infertility (Code-Excl 17) 13. Maternity (Code-Excl 18)", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "14. Organ Donor Expenses: We will pay Medical Expenses up to the amount specified in the Policy Schedule, towards organ donor’s Hospitalization.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "18. Sum Insured Refill: We will refill 100% Basic Sum Insured on complete or partial utilization of your existing Policy Sum Insured including Cumulative Bonus or Enhanced Cumulative Bonus (if applicable) during the Policy Year.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "11. Domiciliary Hospitalization: We will pay the Medical Expenses up to the Sum Insured as specified in the Policy Schedule.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "Emergency medical assistance when you are travelling within India 150 kilometers or more away from your residential address as mentioned in the Policy Schedule for domestic services.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "1.Preventive Health Check-Up: You will be eligible for a preventive health check-up as per the defined list every year from 1st renewal year.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "2. Major Illness Benefit: We will pay 100% of Sum Insured or maximum up to Rs. 25,00,000/- whichever is less if the Insured Person suffers from listed major illnesses.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "-authorization of cashless facility - within 1 hour from receipt of complete documents. ii. TAT for cashless final bill set", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "not stated in sbi-general__arogya-supreme__cis.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "red Name Base Sum Insured Family Floater Sum Insured Sr. No. Insured Name Base Sum Insured Note: This is the base Sum In", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "For Rs.3 Lakhs & Rs. 4 Lakhs - Single Private AC Room (1% restriction as an option available) For Rs. 5 Lakhs - Single pvt AC Room (upgrade option available)", + "unit": "text", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "Room Rent For Rs.3 Lakhs & Rs. 4 Lakhs - Single Private AC Room (1% restriction as an option available) For Rs. 5 Lakhs - Single pvt AC Room (upgrade option available)", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 15, + "unit": "%", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__cis.pdf", + "source_quote": "Cumulative Bonus: In case of claim free year, you will be eligible for 15% of Base", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/sbi-general__arogya-supreme__wordings.json b/40-data/policy_facts/sbi-general__arogya-supreme__wordings.json index 8dbbbc76739d4ed8071c8499b4a30ec2505ab5b4..63e72fbf495b44f44c88f47a0214cdbd21d1aeb2 100644 --- a/40-data/policy_facts/sbi-general__arogya-supreme__wordings.json +++ b/40-data/policy_facts/sbi-general__arogya-supreme__wordings.json @@ -7,145 +7,253 @@ "value": "SBIHLIP21043V012122", "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "No: 144 | Arogya Supreme, UIN: SBIHLIP21043V012122 | SBI G", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ility: For adults aged 18 years or older, presence of severe documen", + "_confidence": "high" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-supreme__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "overed from 91 days and up to 25 years of age.", + "_confidence": "high" }, "sum_insured_options": { - "value": [ - 300000, - 400000, - 500000, - 600000, - 800000, - 1000000, - 1500000, - 2000000, - 2500000, - 5000000, - 7500000, - 10000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-supreme__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "rly instalment options, a Grace Period of 30 days is applicable. ii. During", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of 30 days beginning from the date of", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "to the treatment of any Illness within 30 days from the first Policy Commencement D", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "re diagnosed by a physician not more than 36 months prior to the date of commencement of the policy issued by the i", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Specific waiting period means a period up to 24 months from", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-supreme__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 180, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-supreme__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 142, + "source_url": "https://www.sbigeneral.in/health-insurance", + "source_note": "Per insurer baseline (SBI General health plans cover ~142 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18324, + "source_url": "https://www.sbigeneral.in/", + "source_note": "18,324 network hospitals (homepage service-infrastructure stat, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "6. Co-Payment On availing this option, 10% or 20% Co-Payment as specified in the Policy Schedule, shall be applied on each and every admissible claim after Deductible wherever applicable under this Policy", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", - "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__brochure.pdf", + "source_quote": "not stated in arogya-supreme__brochure.pdf (room rent is a Single Private Room category restriction for the Rs.3-4 Lakh SI tier, not a percentage-of-SI cap; the only '1% of Sum Insured' clause in this PDF is the air-ambulance benefit)", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired Policy Period, if the term of Policy upto one year and there is no C", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-supreme__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": "15. Alternative Treatment / AYUSH We will pay Medical Expenses up to the Sum Insured as specified in the Policy Schedule, as listed under Section C.1 on Your Hospitalization in Hospital or AYUSH Hospital or AYUSH Day Care Ce", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": "XV. Maternity (Code-Excl 18 Medical treatment expenses traceable to child-birth (including complicated deliveries and caesarean sections incurred during Hospitalization) except ectopic pregnancy; Expenses towards miscarriage (unless due to an accident) and law", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": "not stated in sbi-general__arogya-supreme__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": "14. Organ Donor Expenses We will pay Medical Expenses up to the Sum Insured as specified in the Policy Schedule, towards organ donor’s Hospitalization for harvesting of the donated organ where an Insured Person is the recipient, p", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": "18. Sum Insured Refill We will refill 100% Basic Sum Insured on complete or partial utilization of Your existing Policy Sum Insured including Cumulative Bonus or Enhanced Cumulative Bonus (if applicable) during the Policy Year.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": "11. Domiciliary Hospitalization We will pay the Medical Expenses up to the Sum Insured as specified in the Policy Schedule, incurred on Domiciliary Hospitalization.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": "III. Treatment taken outside India. IV. Circumcision unless necessary for treatment of a disease, illness or injury not excluded hereunder, or, as may be necessitated due to an accident", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": "1. Preventive Health Check-Up: You will be eligible for a preventive health check-up as listed below at every year from 1st renewal year during which You have held Our Arogya Supreme Policy irrespective of claims made under the Po", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": "2. Major Illness Benefit We will pay 100% of Sum Insured or maximum up to Rs. 25,00,000/- whichever is lower as specified in the Policy Schedule, If the Insured Person who is aged 18 years or above covered under this Policy suffer", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": "r grace period. 7 Cashless Facility means a facility extended by the insurer to the insured where the payments, of the cost", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": "cumulated up to 100% of Basic Sum Insured iv.", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": "not stated in sbi-general__arogya-supreme__wordings.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": ". If the Policy is issued on a floater basis, the Sum Insured Refill will be available on a floater basis for al", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Room rent and boarding expenses as provided by the Hospital/Nursing home subject to below limits • 1% of base Sum Insured (excluding cumulative / enhanced cumulative bonus) OR • Single private Air-Conditioned room OR • At actuals up to Sum Insured", + "unit": "text", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": "Room rent and boarding expenses as provided by the Hospital/Nursing home subject to below limits • 1% of base Sum Insured (excluding cumulative / enhanced cumulative bonus) OR • Single private Air-Conditioned room OR • At actuals up to Sum Insured", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 15, + "unit": "%", + "source_pdf_path": "rag/corpus/sbi-general/arogya-supreme__wordings.pdf", + "source_quote": "Cumulative Bonus On each Renewal of the Policy with Us, We will pay 15% of Basi", + "_confidence": "medium" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/sbi-general__arogya-top-up__wordings.json b/40-data/policy_facts/sbi-general__arogya-top-up__wordings.json index 69120ddb65393e5c76c8eb777e3042a92fcbd618..b710982377aff3f74ac5e53a14d2cb820b121191 100644 --- a/40-data/policy_facts/sbi-general__arogya-top-up__wordings.json +++ b/40-data/policy_facts/sbi-general__arogya-top-up__wordings.json @@ -7,132 +7,232 @@ "value": "SBIHLIP22137V032122", "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "44 | Arogya Top-Up Policy UIN: SBIHLIP22137V032122 | SBI G", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "can be renewed within the Grace Period of 30 days to maintain available dur", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of 30 days beginning from the date of", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "re diagnosed by a physician not more than 36 months prior to the date of commencement of the Policy issued by the I", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 12, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "l be excluded until the expiry of 90 Days/12 months of continuous coverage exclusi", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "imed under this head is limited to 90 days for each of the admitted hospitalisation and domic", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 142, + "source_url": "https://www.sbigeneral.in/health-insurance", + "source_note": "Per insurer baseline (SBI General health plans cover ~142 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18324, + "source_url": "https://www.sbigeneral.in/", + "source_note": "18,324 network hospitals (homepage service-infrastructure stat, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired Policy Period, if the term of Policy upto one year and there is no C", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", + "source_quote": "6. Alternative treatment: taken in a government hospital or in any institute recognized by government and/or accredited by quality council of India/national accreditation board on health.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", + "source_quote": "limit: Reasonable and customary charges towards maternity expenses during hospitalisation", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", + "source_quote": "9. Organ donor: The Medical Expenses for an organ donor’s treatment for the harvesting of the organ donated including pre and post hospitalization as stated in scope of cover above, provided that:", + "_confidence": "high" + }, + "restoration_benefit": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", + "source_quote": "7. Domiciliary hospitalisation: Insurer will cover reasonable and customary charges towards domiciliary hospitalization including pre and post hospitalization expenses.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" + }, + "preventive_health_checkup": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" + }, + "critical_illness_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", + "source_quote": "Grace Period. 7) Cashless Facility means a facility extended by the Insurer to the Insured where the payments, of the cost", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", + "source_quote": "make the payment of claim as per the contract only in Indian Rupees and within India only. In cas", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/arogya-top-up__wordings.pdf", + "source_quote": "not stated in sbi-general__arogya-top-up__wordings.pdf", + "_confidence": "low" } } diff --git a/40-data/policy_facts/sbi-general__health-alpha__cis.json b/40-data/policy_facts/sbi-general__health-alpha__cis.json index 8d1ab5c8e2ca919501117a1b06f3cd661caf3a2d..2364e97cc04b42d079187fa823209141ab32373b 100644 --- a/40-data/policy_facts/sbi-general__health-alpha__cis.json +++ b/40-data/policy_facts/sbi-general__health-alpha__cis.json @@ -7,132 +7,237 @@ "value": "SBIHLIP26038V012526", "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "SBI General Health Alpha, UIN: SBIHLIP26038V012526 Call (T", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "lation: The insured will be allowed a period of at least 30 days from the date of receipt of the policy to review", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "r 1. Initial Waiting Period – 30 days (not applicable in case of continuous renewal or Accid", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 36, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": ". 3. Pre-Existing Diseases Waiting Period- 24 months. 4. Bariatric S", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "iod- 24 months for listed conditions. 3. Pre-Existing Diseases Waiting Period- 2", + "_confidence": "high" }, "maternity_waiting_months": { - "value": null, + "value": 24, "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", + "source_quote": "ng due to Critical Illness Cover. 12.4. Maternity and Child Care Cover A Waiting Period of 24 months shall apply for all Claims under the benefit 3.3. Maternity", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalization – Covers Medical Expenses for 30/60/90 days prior t", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-Hospitalization – Covers Medical Expenses for 60/90/120/180 days after d", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 142, + "source_url": "https://www.sbigeneral.in/health-insurance", + "source_note": "Per insurer baseline (SBI General health plans cover ~142 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18324, + "source_url": "https://www.sbigeneral.in/", + "source_note": "18,324 network hospitals (homepage service-infrastructure stat, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", + "source_quote": "3. AYUSH Treatment – Covers Medical Expenses for In-Patient Treatment under Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", + "source_quote": "4. Organ Donor – Covers Medical Expenses of donor for any organ transplant surgery conducted on Insured.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", + "source_quote": "8. Restore Benefit- Restoration of Base Sum Insured unlimited times during the Policy Year after payment of a Claim. Restored Sum Insured will be available for subsequent claims.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", + "source_quote": "4. Domiciliary Treatment – Covers Medical Expenses of Domiciliary Hospitalization.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", + "source_quote": "5. Health Check Up – Covers expenses of preventive Health", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", + "source_quote": "Base Cover Option 2: Personal Accident 1. Accidental Death (AD)- Lump sum payment to the Nominee/Legal Heir/Assignee on Death of Insured within 12 months from the date of Accident.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", + "source_quote": "-authorization of cashless facility - within 1 hour from receipt of complete documents. ii. TAT for cashless Ĥnal bill sett", + "_confidence": "high" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", + "source_quote": "to mother's Sum Insured. For Floater Policy: up to Policy Sum Insured. 14. Child Vaccination- Up to 3000. 15. Assisted Reproduction Treat", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__cis.pdf", + "source_quote": "not stated in sbi-general__health-alpha__cis.pdf", + "_confidence": "low" } } diff --git a/40-data/policy_facts/sbi-general__health-alpha__wordings.json b/40-data/policy_facts/sbi-general__health-alpha__wordings.json index ed7b8017ffbb67ca0ff3fd732534c3aa76cdbeaf..0ba6f760165fb0235cbd7641a7cbf34988fb3ef9 100644 --- a/40-data/policy_facts/sbi-general__health-alpha__wordings.json +++ b/40-data/policy_facts/sbi-general__health-alpha__wordings.json @@ -7,132 +7,239 @@ "value": "SBIHLIP26038V012526", "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "SBI General Health Alpha, UIN: SBIHLIP26038V012526 | SBI G", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ed: i. For adults aged 18 years or older, presence of severe obesity", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ailable for 18 years to 65 years of age. Dependent child c", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "be covered from 91 days to 25 years provide", + "_confidence": "high" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-alpha__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "rly instalment options, a Grace Period of 30 days is applicable. ii. During", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of 30 days beginning from the date of", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "2.3. First Thirty Days Waiting Period (Code-Excl 03): i. Expenses related to the treatment o", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 36, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "re diagnosed by a physician not more than 24 months prior to the date of commencement of the Policy issued by the I", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "l be excluded until the expiry of 24 months of continuous coverage after t", + "_confidence": "high" }, "maternity_waiting_months": { - "value": null, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "ng due to Critical Illness Cover. 12.4. Maternity and Child Care Cover A Waiting Period of 24 months shall apply for all Claims under the benefit 3.3. Maternity", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": 90, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__health-alpha__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 180, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__health-alpha__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 142, + "source_url": "https://www.sbigeneral.in/health-insurance", + "source_note": "Per insurer baseline (SBI General health plans cover ~142 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18324, + "source_url": "https://www.sbigeneral.in/", + "source_note": "18,324 network hospitals (homepage service-infrastructure stat, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-alpha__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-alpha__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired Policy Period, if the term of Policy upto one year and there is no C", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-alpha__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-alpha__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-alpha__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", + "source_quote": "AYUSH Treatment We will indemnify the Insured Person up to the limit speciĤed in the Policy Schedule, for the Medical Expenses, if during the Policy Year, any of the Insured Person undergoes In-Patient Treatment or treatment taken", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", + "source_quote": "r this beneĤt shall not exceed the Maternity limit opted and speciĤed in the Policy Schedule. viii. This beneĤt waives oģ the Standard 13.1(o). Maternity (Code-Excl 18) to the extent mentioned u", + "_confidence": "medium" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", + "source_quote": "not stated in sbi-general__health-alpha__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", + "source_quote": "3.1(d). Organ Donor We will indemnify the Insured Person up to the limit speciĤed in the Policy Schedule, for the Medical Expenses incurred during In-Patient Treatment, in respect during the Policy Year, provided:", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", + "source_quote": "Restore Benefit We shall restore the Base Sum Insured unlimited times during the Policy Year after occurrence and payment of Claim amount under the Policy, provided:", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", + "source_quote": "3(d). Domiciliary Treatment We will indemnify the Insured Person up to a limit speciĤed in the Policy Schedule, for the Medical Expenses incurred for Domiciliary Hospitalization during the Policy Year, provided that the condition", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", + "source_quote": "re Cover will not be available for Global Cover. xi. Pre and Post Hospitalization expenses shall be excluded under this beneĤt. xii. In case of Planned Hospitalization, prior intimation at least 7", + "_confidence": "medium" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", + "source_quote": "8.1. Health Check Up The Insured may avail a health check-up, only for Preventive Test, up to a limit speciĤed in the Policy Schedule, provided:", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", + "source_quote": "Section 7 Benefit Based Covers 7.1. Critical Illness We shall pay lump sum amount to the Insured Person/Nominee/Legal Heir/Assignee as speciĤed in the Policy Schedule, if the Insured Person is diagnosed with any of the below listed Critical Illness, during the", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", + "source_quote": "e Period. 2.1(i). Cashless Facility means a facility extended by the Company to the Insured where the payments, of the cost", + "_confidence": "high" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", + "source_quote": "not stated in sbi-general__health-alpha__wordings.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", + "source_quote": "ctive of Policy Tenure or Policy Type (Individual or Floater). v. We have accepted Claim under BeneĤt 3(a). In-Patient Treatment,", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": null, + "unit": "%", + "source_pdf_path": "rag/corpus/sbi-general/health-alpha__wordings.pdf", + "source_quote": "not stated in sbi-general__health-alpha__wordings.pdf", + "_confidence": "low" } } diff --git a/40-data/policy_facts/sbi-general__health-edge__cis.json b/40-data/policy_facts/sbi-general__health-edge__cis.json index 50466e9e8892de512bd0dd8490f82e4daf7aa47a..d07d4cc739fb012caba6e9b5c383f330c670e52a 100644 --- a/40-data/policy_facts/sbi-general__health-edge__cis.json +++ b/40-data/policy_facts/sbi-general__health-edge__cis.json @@ -7,132 +7,230 @@ "value": "SBIHLIP23173V012223", "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "| Health Edge Insurance, UIN: SBIHLIP23173V012223 Tollfre", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__health-edge__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__health-edge__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__health-edge__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-edge__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__health-edge__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "lation: The insured will be allowed a period of at least 30 days from the date of receipt of the policy to review", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "se E Initial Waiting Period: 30 days for all illnesses (not applicable in case of continuou", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 36, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "over Pre-Existing diseases: Covered after 24 months. 9. Clause G. C", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ts). Specific Waiting Periods • 24 months for Internal Congenital disea", + "_confidence": "high" }, "maternity_waiting_months": { "value": 48, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity Expenses - Maternity Expenses (48 months waiting p", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-hospitalization Medical Expenses - Covered prior to 30 days of hosp", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-hospitalization Medical Expenses - Covered post 60 days of hosp", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 142, + "source_url": "https://www.sbigeneral.in/health-insurance", + "source_note": "Per insurer baseline (SBI General health plans cover ~142 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18324, + "source_url": "https://www.sbigeneral.in/", + "source_note": "18,324 network hospitals (homepage service-infrastructure stat, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "17 Co-payment -10% or 20% Co-Payment as specified in the policy schedule, shall be applied on each and every admissible claim as applicable.", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-edge__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-edge__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-edge__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-edge__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-edge__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", + "source_quote": "8. AYUSH Treatment – Covers Medical Expenses up to the Sum Insured towards In patient hospitalization under AYUSH Hospital.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", + "source_quote": "Women Care Benefit 12. Maternity Expenses - Maternity Expenses (48 months waiting period) incurred up to the amount specified against this benefit.", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", + "source_quote": "13. Newborn Baby Cover - Medical Expenses Up to Base Sum Insured, incurred in respect of a new born baby.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", + "source_quote": "5. Unlimited Refill (Related and Unrelated Illness both) - Triggers Unlimited Refill (Anyone Illness Waiver) up to 100% of Base Sum Insured with the first paid claim itself and is available for all subsequent claims in a Policy Year.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", + "source_quote": "15. Global Treatment Medical Expenses for Planned In patient care taken outside India up to Base Sum Insured", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", + "source_quote": "9. Stay Fit Health Check-Up - A health check-up up to Rs 5000 once in the Policy Year to all insured adult members above age 18 years on individual basis.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", + "source_quote": "7. Critical Illness Cover- A lump sum amount of INR 3,00,000, as specified in the Policy Schedule against this benefit If the Insured Person who is aged between 18 to 45 years.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", + "source_quote": "-authorization of cashless facility - within 1 hour from receipt of complete documents. ii. TAT for cashless final bill set", + "_confidence": "high" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", + "source_quote": "not stated in sbi-general__health-edge__cis.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", + "source_quote": "red Name Base Sum Insured Family Floater Sum Insured Note: This is the base Sum Insured for policy. Please refer the pol", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": null, + "unit": "text", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", + "source_quote": "not stated in sbi-general__health-edge__cis.pdf", + "_confidence": "low" + }, + "no_claim_bonus_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__cis.pdf", + "source_quote": "nefit - Sum Insured is increased by 50% of the Base Sum Insured in respect of each claim free Policy Year as spec", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/sbi-general__health-edge__wordings.json b/40-data/policy_facts/sbi-general__health-edge__wordings.json index 15e138d8472a859a048f41192e3807ab19da59a7..273e0aca31f210869b385ca4fe8c2d8bf352c8ae 100644 --- a/40-data/policy_facts/sbi-general__health-edge__wordings.json +++ b/40-data/policy_facts/sbi-general__health-edge__wordings.json @@ -7,132 +7,232 @@ "value": "SBIHLIP23173V012223", "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "| Health Edge Insurance, UIN: SBIHLIP23173V012223 | SBI G", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "days Min – 18 years and Max -65 years Entry", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "00/Hospitalization] [Min - 18 years/Max - 65 years] INR 50K", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ly adopted) between the Age 91 days to Age 30 years. If the chil", + "_confidence": "high" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-edge__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "rly instalment options, a Grace Period of 30 days is applicable. ii. During", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of 30 days beginning from the date of", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Period 30 Days Initial Waiting Period (Excluding Accidental Hospita", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 36, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "re diagnosed by a physician not more than 24 months prior to the date of commencement of the policy issued by the i", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Specific waiting period means a period up to 24 months from", + "_confidence": "high" }, "maternity_waiting_months": { "value": 48, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity Expenses: 48 months, Assisted", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": 30, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__health-edge__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__health-edge__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 142, + "source_url": "https://www.sbigeneral.in/health-insurance", + "source_note": "Per insurer baseline (SBI General health plans cover ~142 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18324, + "source_url": "https://www.sbigeneral.in/", + "source_note": "18,324 network hospitals (homepage service-infrastructure stat, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "D.15 Co-payment On availing this option, 10% or 20% Co-Payment as specified in the Policy Schedule, shall be applied on each and every admissible claim wherever applicable under this Policy, once the Co-Payment", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-edge__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired Policy Period, if the term of Policy upto one year and there is no C", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-edge__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-edge__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__health-edge__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", + "source_quote": "C.8 AYUSH Treatment The Company shall indemnify the Medical Expenses incurred by the Insured Person for Inpatient Care under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", + "source_quote": "D.12 Women Care Benefit D.12.1 Maternity Expenses On availing this option, We will indemnify the Medical Expenses incurred up to the amount specified against this Benefit in the Policy Schedule for the", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", + "source_quote": "D.12.2 New Born Baby Cover On availing this option, the Company will indemnify up to the Sum Insured specified against this Benefit in the Policy Schedule for the Medical Expenses incurred in respect of a New B", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", + "source_quote": "D.5 Unlimited Refill (Related and Unrelated Illness both) On availing this option, this benefit is triggered and becomes payable for each and every claim from the first claim itself in a policy year.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", + "source_quote": "Global Treatment We will pay the Medical Expenses incurred towards the Insured Person’s Inpatient Care outside India during the Policy Period caused solely and directly due to any of the below listed Illness or", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", + "source_quote": "C.9 Stay Fit Health Check-Up The Insured Person may avail a health check-up, only for Preventive Test, up to a sub-limit as specified in Your Policy Schedule.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", + "source_quote": "Irrespective of the type of Policy the benefits under this Section shall be available on an individual basis to each Insured Person whose age is between 18 to 45 years, up to the limits specified in the Policy Schedule.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", + "source_quote": "epresentative. 5. Cashless Facility means a facility extended by the insurer to the insured where the payments, of the cost", + "_confidence": "high" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", + "source_quote": "not stated in sbi-general__health-edge__wordings.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", + "source_quote": ") or all Insured Persons (on Floater basis) during the Policy Year basis, for the following covers and in this", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Room Rent ICU Charges Basis of Payment - Indemnity Actuals up to Sum Insured", + "unit": "text", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", + "source_quote": "Room Rent ICU Charges Basis of Payment - Indemnity Actuals up to Sum Insured Basis of Payment - Indemnity Pre-hospitalization Medical Expenses (up to Sum Insured)", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/sbi-general/health-edge__wordings.pdf", + "source_quote": "pplied, Sum Insured is increased by 50% (as specified in the Policy Schedule) of the Base Sum Insured of immediate preceding Policy Year in r", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/sbi-general__super-health-insurance__cis.json b/40-data/policy_facts/sbi-general__super-health-insurance__cis.json index 43c19366d103a99bcfaf41bbadcade08fe4955d2..f4b4f40dc5408612ae182228f19c863bcb0f6bba 100644 --- a/40-data/policy_facts/sbi-general__super-health-insurance__cis.json +++ b/40-data/policy_facts/sbi-general__super-health-insurance__cis.json @@ -7,132 +7,237 @@ "value": "SBIHLIP24141V022324", "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "| Super Health Insurance UIN: SBIHLIP24141V022324 | Add O", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__super-health-insurance__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__super-health-insurance__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__super-health-insurance__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-health-insurance__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__super-health-insurance__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "lation: The insured will be allowed a period of at least 30 days from the date of receipt of the policy to review", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "RIOD Initial Waiting Period: 30 days for all illnesses (not applicable in case of continuou", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": 36, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ion. Pre-Existing diseases: Covered after 24 months. Exclusions (Wh", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__super-health-insurance__cis.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-health-insurance__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalisation Medical Expenses- covered prior to 60 days of hosp", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-Hospitalisation Medical Expenses- covered post 90/180 days of hosp", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 142, + "source_url": "https://www.sbigeneral.in/health-insurance", + "source_note": "Per insurer baseline (SBI General health plans cover ~142 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18324, + "source_url": "https://www.sbigeneral.in/", + "source_note": "18,324 network hospitals (homepage service-infrastructure stat, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "3. Co-payment- 10% or 20% Co-Payment as speciĤed in the Policy Schedule, shall be applied on each and every admissible claim 4. Aggregate Deductible- The Insured Person shall bear on his/her own accou", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-health-insurance__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-health-insurance__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-health-insurance__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-health-insurance__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-health-insurance__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", + "source_quote": "15. AYUSH Treatment– Covers Medical Expenses up to the Sum Insured towards Inpatient hospitalization under AYUSH Hospital.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", + "source_quote": "20. Maternity Expenses (including Pre and Post Natal check-ups) - Medical Expenses incurred towards Maternity Expenses including Pre-natal Medical Expenses & Post-natal check-ups incurred in respect o", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", + "source_quote": "21. New Born Baby Cover- Up to the amount speciĤed for the Medical Expenses incurred in respect of a New Born Baby. 22. Child Vaccination Cover The expenses towards vaccination of child till he/she co", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", + "source_quote": "11. Organ Donor Expenses- Medical Expenses towards organ donor’s Hospitalization for harvesting of the donated organ.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", + "source_quote": "12. ReInsure BeneĤt (Related and Unrelated illness both)- Sum insured will get reinstated unlimited times upto 100%/200% of Sum Insured for subsequent claims in a Policy Year.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", + "source_quote": "7. Domiciliary Hospitalization- Medical Expenses incurred for the Insured Person’s Domiciliary Hospitalization during the Policy Period following an Illness or Injury.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", + "source_quote": "25. Medical Treatment abroad (Listed Major illness, Diagnosis in India) - Medical Expenses incurred towards the Insured Person’s Inpatient Care outside India caused solely and directly due to any of the listed Illness/Procedures.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", + "source_quote": "19. Annual Health Check-up -Avail a health check-up for listed Preventive purposes.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", + "source_quote": "3. Health Multiplier (Listed 37 Serious Illness)- Sum Insured for serious Illness (listed in Policy wordings) would be enhanced by a multiplier as mentioned in the Policy Schedule.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", + "source_quote": "-authorization of cashless facility - within 1 hour from receipt of complete documents. ii. TAT for cashless Ĥnal bill sett", + "_confidence": "high" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", + "source_quote": "not stated in sbi-general__super-health-insurance__cis.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", + "source_quote": "Both Indemnity and BeneĤt Family Floater Sum Insured Sr. No. Insured Name Base Sum Insured Individual Sum Insured Sr. No", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__cis.pdf", + "source_quote": "Cumulative Bonus- We will increase 50% of the", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/sbi-general__super-health-insurance__wordings.json b/40-data/policy_facts/sbi-general__super-health-insurance__wordings.json index ffae1c2a6bb5aa9b96d5f714db33704be4359a2b..c28893e7aa9b0da0d3910c7da330c64cdb805b8b 100644 --- a/40-data/policy_facts/sbi-general__super-health-insurance__wordings.json +++ b/40-data/policy_facts/sbi-general__super-health-insurance__wordings.json @@ -7,132 +7,239 @@ "value": "SBIHLIP24141V022324", "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "| Super Health Insurance UIN: SBIHLIP24141V022324. | SBI", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "nite Min - 18 years Min - 18 years Min - 18", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "0/Hospitalization ] [Min - 18 years/Max - 65 years] Covered", + "_confidence": "high" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ly adopted) between the Age 91 days to Age 30 years. If the chil", + "_confidence": "high" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-health-insurance__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "can be renewed within the Grace Period of 30 days to maintain continuity of", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of 30 days beginning from the date of", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": ": I) First Thirty Days Waiting Period (Code-Excl 03): a) Expenses related to the treatment o", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "re diagnosed by a physician not more than 36 months prior to the date of commencement of the policy issued by the i", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "l be excluded until the expiry of 24 months of continuous coverage after t", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-health-insurance__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalization Medical Expenses 60 Days 60 Days 60 Days 60 Days 60 Days", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-Hospitalization Medical Expenses 90 Days 90 Days 90 Days 90 Days 180 Days (up to Sum Insured) Pre-Hos", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 142, + "source_url": "https://www.sbigeneral.in/health-insurance", + "source_note": "Per insurer baseline (SBI General health plans cover ~142 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18324, + "source_url": "https://www.sbigeneral.in/", + "source_note": "18,324 network hospitals (homepage service-infrastructure stat, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Co-payment On availing this option, 10% or 20% Co-Payment as speciĤed in the Policy Schedule, shall be applied on each and every admissible claim after Deductible wherever applicable under this Policy, once the", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-health-insurance__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired Policy Period, if the term of Policy upto one year and there is no C", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-health-insurance__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-health-insurance__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-health-insurance__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", + "source_quote": "AYUSH Treatment We shall indemnify the Medical Expenses incurred by the Insured Person for Inpatient Care under Ayurveda, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the Sub-", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", + "source_quote": "C.20.1. Maternity Expenses (including Pre and Post Natal check- ups) We will indemnify the Medical Expenses incurred up to the amount speciĤed against this BeneĤt in the Policy Schedule for the Maternity Expenses includi", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", + "source_quote": "New Born Baby Cover We will indemnify up to the amount speciĤed against this BeneĤt in the Policy Schedule for the Medical Expenses incurred in respect of a New Born Baby whose cla", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", + "source_quote": "Organ Donor Expenses We will pay Medical Expenses up to the Sum Insured as speciĤed in the Policy Schedule, towards organ donor’s Hospitalization for harvesting of the donated organ where an Insured Person is the recipie", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", + "source_quote": "ReInsure Benefit (Related and Unrelated Illness both) This beneĤt is triggered and becomes payable for each and every claim from the Ĥrst claim itself in a policy year.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", + "source_quote": "Domiciliary Hospitalization We will indemnify on Reimbursement basis only, the Medical Expenses incurred for the Insured Person’s Domiciliary Hospitalization during the Policy Period following an Illness or Injury.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", + "source_quote": "Medical Treatment abroad (Listed Major Illness, Diagnosis in India) We will pay the Medical Expenses incurred towards the Insured Person’s Inpatient Care outside India during the Policy Period caused solely and directly", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", + "source_quote": "Health Check-up The Insured Person may avail a health check-up, only for preventive purposes, up to a sub-limit as speciĤed in Your Policy Schedule.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", + "source_quote": "Section C.6 (Day Care Treatment) or Section C.14 (Modern Treatments) or Section C.15 (AYUSH Treatments) then the Base Sum Insured for such serious Illness would be enhanced by a multiplier as mentioned in the Policy Schedule, provided that;", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", + "source_quote": "Grace Period. 6. Cashless Facility means a facility extended by the insurer to the insured where the payments, of the cost", + "_confidence": "high" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", + "source_quote": "dia and the treatment is taken in India only. e. No", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", + "source_quote": ") or all Insured Persons (on Floater basis) during the Policy Year. 30. Waiting Period means a period from the", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/sbi-general/super-health-insurance__wordings.pdf", + "source_quote": "Cumulative Bonus Enhanced Cumulative Bonus (ECB) will be applied by 50% of the", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/sbi-general__super-top-up__cis.json b/40-data/policy_facts/sbi-general__super-top-up__cis.json index 701cb47925aa60e30a2bc0710dfc83bef861dbc0..5f1bf413dd6a6c8fe8fd1a3f0ef64e53b6e3679e 100644 --- a/40-data/policy_facts/sbi-general__super-top-up__cis.json +++ b/40-data/policy_facts/sbi-general__super-top-up__cis.json @@ -7,132 +7,258 @@ "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__cis.pdf", + "_confidence": "low" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__super-top-up__cis.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__super-top-up__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__super-top-up__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__super-top-up__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "lation: The insured will be allowed a period of at least 30 days from the date of receipt of the policy to review", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "18) Initial Waiting Period – 30 days for all illnesses (not applicable in case of continuou", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ons. Pre-Existing diseases: Covered after 24 months. In case of a c", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "ds • 24 months for Internal Congenital diseases, Diseases of gall bladder includin", + "_confidence": "high" }, "maternity_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Maternity Expenses • 36 months for Globa", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", + "source_quote": "up to Sum Insured Within Sum Insured Pre-Hospitalization 60 Days Within Sum Insured Post-Hospitalization 90 Days/180 Day", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 90, "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", + "source_quote": "lization 60 Days Within Sum Insured Post-Hospitalization 90 Days/180 Days Within Sum Insured Day Care Treatment All day", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 142, + "source_url": "https://www.sbigeneral.in/health-insurance", + "source_note": "Per insurer baseline (SBI General health plans cover ~142 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18324, + "source_url": "https://www.sbigeneral.in/", + "source_note": "18,324 network hospitals (homepage service-infrastructure stat, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__cis.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "7. AYUSH Treatment (In-patient hospitalization) – We will indemnity Medical Expenses up to the Sum Insured 8. Domiciliary Hospitalization – We will Reimburse the Medical Expenses incurred for the Insu", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "1. Maternity Expenses – We will indemnify the Medical Expenses incurred up to the amount speciĤed against this BeneĤt in the Policy Schedule for the Maternity Expenses.", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "2. New-Born Baby Cover – We will indemnify up to the amount speciĤed against this BeneĤt in the Policy Schedule for the Medical Expenses incurred in respect of a New Born Baby.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "5. Organ Donor – We will indemnity Medical Expenses up to the Sum Insured as speciĤed in the Policy Schedule, towards organ donor’s Hospitalization for harvesting of the donated organ.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "10. Unlimited Restore Benefit – We shall restore the Base Sum Insured unlimited times during the Policy Year after occurrence and payment of claim amount under the Policy.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "8. Domiciliary Hospitalization – We will Reimburse the Medical Expenses incurred for the Insured Person’s Domiciliary Hospitalization during the Policy Period following an Illness or Injury.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "5. Global Cover – We will indemnify the Medical Expenses incurred towards the Insured Person’s Inpatient Care outside India caused solely and directly due to any of the listed Illness/Procedures.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "2. Stay Fit Health Check-up – The Insured Person may avail a health check-up, only for Preventive purposes, up to a sub-limit as speciĤed in Your Policy Schedule", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "9. Personal Accident Cover (Accidental Death & Permanent Total Disability) – If the Primary Insured Person, sustains an injury, from an Accident, during the Policy Period and if such injury shall within twelve calendar m", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "-authorization of cashless facility - within 1 hour from receipt of complete documents. TAT for cashless Ĥnal bill settleme", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "ject to maximum cap of 100% of the Sum Insured unde", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": 1, + "unit": "hours", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "pre-authorization of cashless facility - within 1 hour from re", + "_confidence": "medium" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "not stated in sbi-general__super-top-up__cis.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "any Limited | SBIG Health Super Top-Up, UIN: SBIHLIP25035V012425 Tollfree: 18001021111 | Visit: www.sbigen", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Reduction in Room Rent – We shall allow the insured to opt the Room Rent category Actuals to Single Private A.C Room or Twin Sharing Room for hospitalizations.", + "unit": "text", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "11. Reduction in Room Rent – We shall allow the insured to opt the Room Rent category Actuals to Single Private A.C Room or Twin Sharing Room for hospitalizations.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 10, + "unit": "%", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__cis.pdf", + "source_quote": "Cumulative Bonus which will increase 10% of the", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/sbi-general__super-top-up__wordings.json b/40-data/policy_facts/sbi-general__super-top-up__wordings.json index 5de06c937ac08c22bd04295870c19a4b6354e053..9aee7c040302643705153966f08a2e4a5be2721f 100644 --- a/40-data/policy_facts/sbi-general__super-top-up__wordings.json +++ b/40-data/policy_facts/sbi-general__super-top-up__wordings.json @@ -7,132 +7,190 @@ "value": "SBIHLIP25035V012425", "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "SBIG Health Super Top-Up, UIN: SBIHLIP25035V012425 | SBI G", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in sbi-general__super-top-up__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "between the Age 91 days to Age 25 years. If the", + "_confidence": "high" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "can be renewed within the Grace Period of 30 days to maintain continuity of", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "free look period of 30 days beginning from the date of", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "4.1 First Thirty Days Waiting Period (Code-Excl 03): i. Expenses related to the treatment o", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "re diagnosed by a physician not more than 24 months prior to the date of commencement of the policy issued by the i", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "l be excluded until the expiry of 24 months of continuous coverage after t", + "_confidence": "high" }, "maternity_waiting_months": { - "value": null, + "value": 36, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insured shall be allowed to change the 36 months Waiting Period for Maternity Expenses as speciĤed in Section 4 to 48 months, 24 months", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "up to Sum Insured Within Sum Insured Pre-Hospitalization 60 Days Within Sum Insured Post-Hospitalization 90 Days/180 Day", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 90, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "lization 60 Days Within Sum Insured Post-Hospitalization 90 Days/180 Days Within Sum Insured Day Care Treatment All day", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 142, + "source_url": "https://www.sbigeneral.in/health-insurance", + "source_note": "Per insurer baseline (SBI General health plans cover ~142 day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 18324, + "source_url": "https://www.sbigeneral.in/", + "source_note": "18,324 network hospitals (homepage service-infrastructure stat, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "pired Policy Period, if the term of Policy up to one year and there is no C", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in sbi-general__super-top-up__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", + "source_quote": "3.5 AYUSH Treatment We will indemnify the Insured Person for the Medical Expenses which are incurred on treatment under Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy up to the Sum Insured in excess of Deductible as spe", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", + "source_quote": "3.6 Domiciliary Hospitalization We will indemnify the Insured Person, to the extent of Sum Insured subject to Deductible for the Reasonable and Customary Charges for Medical Expenses incurred towards the Domiciliary Hospitalizatio", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", + "source_quote": "grace period. 7) Cashless Facility means a facility extended by the Company to the Insured where the payments, of the cost", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", + "source_quote": "not stated in sbi-general__super-top-up__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", + "source_quote": "not stated in sbi-general__super-top-up__wordings.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "super_top_up", + "unit": "enum", + "source_pdf_path": "rag/corpus/sbi-general/super-top-up__wordings.pdf", + "source_quote": "OLICY WORDING SBIG HEALTH SUPER TOP-UP SBI General Insurance Company Limited Section 1: Preamble Section 2", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/star-health__family-health-optima.json b/40-data/policy_facts/star-health__family-health-optima.json index ea4a8f8afe0a5d1c3d13d94686d0cadff9f17314..e7d27f6527a3f1c82aa2dbec7a35e839a5f43ea0 100644 --- a/40-data/policy_facts/star-health__family-health-optima.json +++ b/40-data/policy_facts/star-health__family-health-optima.json @@ -14,41 +14,48 @@ "source_quote": "Family includes Insured Person, Spouse / Live in partner / Same Sex partner, dependent children between 16 days and 25 years of age" }, "max_entry_age": { - "value": null, + "value": 65, "unit": "years", - "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "Adult entry per Policy Schedule (Family Health Optima: 18+ years; no max entry cap; mandatory copay for 61+ entrants)" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "Lifelong renewability" + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "For Adults: 18 years to 65 years", + "_confidence": "high" }, "sum_insured_options": { - "value": null, + "value": [ + 500000, + 1000000, + 1500000, + 2000000, + 2500000 + ], "unit": "INR", - "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "Loyalty Bonus: For the Sum Insured options Rs.3,00,000/- and above ... (SI grid: 3L/4L/5L/10L/15L/20L/25L per Policy Schedule)" + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "Sum Insured options of ₹10 L and above only", + "_confidence": "medium" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "30-day waiting period for illness (standard IRDAI Excl03 applied)" + "source_quote": "not stated in family-health-optima__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": 36, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "1. Pre-Existing Diseases - Code Excl 01 ... shall be excluded until the expiry of 36 months of continuous coverage" + "source_quote": "ment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "2. Specified disease / procedure waiting period - Code Excl 02 ... shall be excluded until the expiry of 24 months of continuous coverage" + "source_quote": "not stated in family-health-optima__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "18. Maternity - Code Excl 18 (maternity excluded as standard; optional Maternity expenses cover offered separately with waiting period)" + "source_quote": "not stated in star-health__family-health-optima.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, @@ -58,32 +65,39 @@ "post_hospitalization_days": { "value": 90, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "7. Post-Hospitalization medical expenses incurred for a period of 90 days from [date of discharge]" + "source_quote": "nder the policy. 7. Post-Hospitalization medical expenses incurred for a period of 90 days from the date of discharge from the hospital towards Consul", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "2. Day Care Treatment: We will cover the [day care treatments]; list of day care procedures in policy annexure (no fixed count in wording body)" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "given under 'Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems' (AYUSH covered up to Sum Insured)" + "source_quote": "AYUSH Treatment: Inpatient Hospitalizations Expenses incurred on treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in a AYUSH Hospital is payable up to the Sum Insured.", + "_confidence": "high" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "18. Maternity - Code Excl 18 ... Medical treatment expenses traceable to childbirth ... except ectopic pregnancy (excluded in base)" + "source_quote": "Maternity - Code Excl 18 i.", + "_confidence": "high" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "Maternity excluded in base; newborn baby coverage available only with optional Maternity add-on" + "source_quote": "not stated in family-health-optima__wordings.pdf", + "_confidence": "low" }, "organ_donor_expenses": { - "value": true, + "value": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "Organ Donor expenses covered (standard inclusion across Star Health flagship products)" + "source_quote": "not stated in family-health-optima__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 10, @@ -91,54 +105,89 @@ "source_quote": "14. Loyalty Bonus: For the Sum Insured options Rs.3,00,000/- and above, the Insured Person shall be eligible for a Loyalty Bonus of 10% of the expiring Sum Insured subject to a maximum accumulation of 100%" }, "restoration_benefit": { - "value": "Automatic Restoration of Sum Insured: 100% each time, available 3 times per policy year (only for unrelated illnesses)", + "value": true, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "15. Automatic Restoration of Sum Insured ... Such Automatic Restoration is available 3 times at 100% each time, during the Policy Period." + "source_quote": "Automatic Restoration is available 3 times at 100% each time, during the Policy Period", + "_confidence": "medium" }, "room_rent_capping": { "value": "Per eligible room category in Policy Schedule (proportionate deduction if higher room category opted)", "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "the eligible room rent/room category stated 2,00,000/-" + "source_quote": "Single Standard A/C Room", + "_confidence": "medium" }, "copayment_pct": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "If Insured Persons whose age at the time of entry is 61 years and above, the voluntary co-payment will be in addition to the mandatory co-payment (mandatory copay for 61+ entrants; voluntary copay options at 10%/20% for premium discount)" + "value": 20, + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "Co-payment of 20% of each and every claim amount for fresh as well as renewal policies for Insured Persons whose age at the time of entry is 61 years and abo", + "_confidence": "high" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible" + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "not stated in star-health__family-health-optima.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; Star Health advertises 14,000+ network hospitals on its website" + "value": 14000, + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "Cashless facility supported through Star Health network (in-house claim processing)" + "source_quote": "Cashless facility: Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy Terms and conditions, are directly made to the network provider by the insurer to t", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric; not extracted" + "source_quote": "not stated in star-health__family-health-optima.pdf", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "not stated in star-health__family-health-optima.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "Indemnity-based family floater health policy" + "source_quote": "Cancer Care requiring medical assistance g", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/star-health/family-health-optima__wordings.pdf", "completeness_pct": 82, - "notes": "Star Health FHO: 60/90 pre/post hospitalization (post = 90 days, shorter than many peers' 180). Auto Restoration 3 times. 10% Loyalty Bonus annually. Mandatory copay 61+ entrants." + "notes": "Star Health FHO: 60/90 pre/post hospitalization (post = 90 days, shorter than many peers' 180). Auto Restoration 3 times. 10% Loyalty Bonus annually. Mandatory copay 61+ entrants. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "road ambulance expenses up to Rs", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text", + "_confidence": "medium" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "Domiciliary Hospitalization: Domiciliary hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home und", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "Preventive Health Check-up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } } diff --git a/40-data/policy_facts/star-health__family-health-optima__brochure.json b/40-data/policy_facts/star-health__family-health-optima__brochure.json index 96d53141160e6f5aa807233418794623f1b1347f..ca3add4dfbf544aaef900c1a5e827e9a66f3f3ee 100644 --- a/40-data/policy_facts/star-health__family-health-optima__brochure.json +++ b/40-data/policy_facts/star-health__family-health-optima__brochure.json @@ -7,31 +7,29 @@ "value": "SHAHLIP26046V092526", "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Family Health Optima Insurance Plan SHAHLIP26046V092526", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured (SI) For Adults: 18 years to 65 years For Dependent Children: 16 days to 25 years (Floater Policy)", + "_confidence": "high" }, "max_entry_age": { "value": 65, "unit": "years", "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured (SI) For Adults: 18 years to 65 years For Dependent Children: 16 days to 25 years (Floater Policy)", + "_confidence": "high" }, "min_child_entry_age": { "value": 16, "unit": "days", "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured (SI) For Adults: 18 years to 65 years For Dependent Children: 16 days to 25 years (Floater Policy)", + "_confidence": "high" }, "sum_insured_options": { "value": [ @@ -43,102 +41,212 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Insured (SI) ₹5 L, ₹10 L, ₹15 L, ₹20 L and ₹25 L Policy Tenure 1 and 2 years", + "_confidence": "high" }, "grace_period": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__family-health-optima__brochure.pdf", + "_confidence": "low" }, "free_look_period": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__family-health-optima__brochure.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "eriod: 30 days Specified Disease/Procedure Waiting Period: 24 months Pre-existing Diseases Waiting Period: 36 months Assisted Reproduction Treatment: 36 months", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "eriod: 30 days Specified Disease/Procedure Waiting Period: 24 months Pre-existing Diseases Waiting Period: 36 months Assisted Reproduction Treatment: 36 months", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "eriod: 30 days Specified Disease/Procedure Waiting Period: 24 months Pre-existing Diseases Waiting Period: 36 months Assisted Reproduction Treatment: 36 months", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__family-health-optima__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Coverage for medical expenses incurred up to 60 days immediately before the Insured Person is hospitalized.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Coverage for medical expenses incurred up to 90 days immediately after the Insured Person is discharged from the hospital.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf" }, "network_hospital_count": { "value": 14000, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 20, + "unit": "%", "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "This policy is subject to Co-payment of 20% of each and every claim amount for fresh as well as renewal policies for Insured Persons whose age at the time of entry is 61 years and above.", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": "single_private_ac_room", + "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Single Private A/C Room", + "_confidence": "medium" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2 + ], "unit": "years", "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Insured (SI) ₹5 L, ₹10 L, ₹15 L, ₹20 L and ₹25 L Policy Tenure 1 and 2 years Instalment Facility Monthly, Quarterly and Half-yearly options are available.", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__family-health-optima__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__family-health-optima__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__family-health-optima__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "not stated in family-health-optima__brochure.pdf", + "_confidence": "low" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "not stated in family-health-optima__brochure.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "not stated in family-health-optima__brochure.pdf", + "_confidence": "low" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "restored 3 times in a Policy Year by 100% each time upon exhaustion of the limit of coverage", + "_confidence": "medium" + }, + "domiciliary_treatment": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "not stated in family-health-optima__brochure.pdf", + "_confidence": "low" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "We will arrange for a Preventive Health Check-up at our Network Providers for the applicable package as specified below as per opted Sum Insured.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "not stated in star-health__family-health-optima__brochure.pdf", + "_confidence": "low" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "The Insured Person shall be eligible for a Loyalty Bonus of 10% of the expiring Sum Insured subject to a maximum accumulation of 100% of the Sum Insured.", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "not stated in star-health__family-health-optima__brochure.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "not stated in star-health__family-health-optima__brochure.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "For Dependent Children: 16 days to 25 years (Floater Policy)", + "_confidence": "high" + }, + "room_rent_capping": { + "value": "Single Private A/C Room", + "unit": "text", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "Single Private A/C Room", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 10, + "unit": "%", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__brochure.pdf", + "source_quote": "The Insured Person shall be eligible for a Loyalty Bonus of 10% of the expiring Sum Insured subject to a maximum accumulation of 100% of the Sum Insured.", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/star-health__family-health-optima__wordings.json b/40-data/policy_facts/star-health__family-health-optima__wordings.json index 22803b47e83250f460d14e3dc8e277387e0c31e0..85cbad91f5859fa3508ae4d0af875320562f2809 100644 --- a/40-data/policy_facts/star-health__family-health-optima__wordings.json +++ b/40-data/policy_facts/star-health__family-health-optima__wordings.json @@ -7,35 +7,36 @@ "value": "SHAHLIP26046V092526", "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Family Health Optima Insurance Plan | UIN : SHAHLIP26046V092526 | POL / FHO / V.26 / 2026", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__family-health-optima__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__family-health-optima__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": 16, "unit": "days", "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "dependent children between 16 days and 25 years of age not exceeding 3 in number.", + "_confidence": "high" }, "sum_insured_options": { "value": [ + 100000, + 200000, 300000, + 400000, 500000, 1000000, 1500000, @@ -44,102 +45,212 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured (Rs.) Limit (Rs.) 1,00,000/- Up to 2,000/- per day 2,00,000/- 3,00,000/- Up to 5,000/- per day 4,00,000/- 5,00,000/- Single Standard A/C Room 10,00,000/- 15,00,000/- 20,00,000/- 25,00,000/-", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the policy shall terminate and can be renewed within the Grace Period of 30 days.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Policyholder shall be allowed free look period of thirty days from date of receipt of the policy document whether electronically or otherwise to review the terms and conditions of the policy.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "following listed Conditions, surgeries/ treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__family-health-optima__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "expenses incurred for a period not exceeding 60 days prior to the date of hospitalization, for the disease/illness, injury sustained following an admissible claim for hospitalization under the policy.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-Hospitalization medical expenses incurred for a period of 90 days from the date of discharge from the hospital towards Consultant fees, Diagnostic charges, Medicines and Drugs", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf" }, "network_hospital_count": { "value": 14000, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 20, + "unit": "%", "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "This policy is subject to co-payment of 20% of each and every claim amount for fresh as well as renewal policies for Insured Persons whose age at the time of entry is 61 years and above.", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": "single_private_ac_room", + "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Single Standard A/C Room", + "_confidence": "medium" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2 + ], "unit": "years", "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Note: In case of two-year policy, total number of wellness points earned in two-year period will be divided by two.", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__family-health-optima__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__family-health-optima__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__family-health-optima__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "AYUSH Treatment: Inpatient Hospitalizations Expenses incurred on treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in a AYUSH Hospital is payable up to the Sum Insured.", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "not stated in family-health-optima__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "not stated in family-health-optima__wordings.pdf", + "_confidence": "low" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "Automatic Restoration is available 3 times at 100% each time, during the Policy Period", + "_confidence": "medium" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "Domiciliary Hospitalization: Domiciliary hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home und", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "Health Check-up: We will arrange for a Preventive Health Check-up at Our Network Providers for the applicable package as specified below as per opted Sum Insured and subject t", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy Terms and conditions, are directly made to the network provider by the insurer", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "For the Sum Insured options Rs.3,00,000/- and above, the Insured Person shall be eligible for a Loyalty Bonus of 10% of the expiring Sum Insured subject to a maximum accumulation of 100% of the Sum Insured.", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "not stated in star-health__family-health-optima__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "All claims under this policy shall be payable in Indian currency.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "dependent children between 16 days and 25 years of age not exceeding 3 in number. Dependent Parent / Parents in law.", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Single Private A/C Room", + "unit": "text", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "Single Standard A/C Room", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 10, + "unit": "%", + "source_pdf_path": "rag/corpus/star-health/family-health-optima__wordings.pdf", + "source_quote": "For the Sum Insured options Rs.3,00,000/- and above, the Insured Person shall be eligible for a Loyalty Bonus of 10% of the expiring Sum Insured subject to a maximum accumulation of 100% of the Sum Insured.", + "_confidence": "high" } } diff --git a/40-data/policy_facts/star-health__health-premier.json b/40-data/policy_facts/star-health__health-premier.json index 7e34e6fab82d40542eefe565463d1657685cb06f..7df4f3c62629071e6249ddc1d68997f86afd23f4 100644 --- a/40-data/policy_facts/star-health__health-premier.json +++ b/40-data/policy_facts/star-health__health-premier.json @@ -5,90 +5,102 @@ "uin_code": { "value": "SHAHLIP22226V012122", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "CY Unique Identification No.: SHAHLIP22226V012122 PREAMBLE Insured granted by the insurer without an associated increase in premium. The proposal, declaration and other documents given by the proposer" + "source_quote": "1 of 12 Unique Identification No.: SHAHLIP22226V012122 Star Health Premier Insurance Policy PO", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in star-health__health-premier.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in star-health__health-premier.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in star-health__health-premier.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "the treatment of any illness within 30 days from the first 16 Outpatient Expenses In addition to Sum Insured policy commencement date shall be excluded except claims arising due to an accident, provid" + "source_quote": "not stated in health-premier__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "\"Pre-existing disease (PED)\" means any condition, ailment, injury or disease: a) that is/are diagnosed by a physician not more than 36 mon", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 24, + "value": null, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "not stated in health-premier__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in star-health__health-premier.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "Pre-hospitalization Expenses: Medical expenses incurred up to 60 days immediately before the insured person is hospitalized.", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 90, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "Post Hospitalization Expenses: Medical expenses incurred up to 90 days immediately after the insured person is discharged from the hosp", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf" }, "ayush_coverage": { - "value": true, + "value": null, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "mpany's authorized personnel. AYUSH Day Care Centre: AYUSH Day Care Centre means and includes Community Day Care Treatment: Day care treatment means medical treatment, and/or surgical Health Centre (C" + "source_quote": "not stated in health-premier__wordings.pdf", + "_confidence": "low" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "Maternity - Code Excl 18 i.", + "_confidence": "high" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in health-premier__wordings.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "Organ Donor Expenses: In patient hospitalization expenses incurred for organ date specified in the schedule. transplantation from the Donor to the Recipient Insured Person are payable provided the cla" + "source_quote": "11. Organ Donor Expenses: In patient hospitalization expenses incurred for organ transplantation from the Donor to the Recipient Insured Person are payable provided the claim for transplantation is payable", + "_confidence": "high" }, "no_claim_bonus_pct": { - "value": null, + "value": 20, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "Cumulative bonus calculated at 20% of sum insured for each claim free year subject to a maximum of 100% of the sum insured", + "_confidence": "high" }, "restoration_benefit": { "value": "Restoration of Sum Insured: There shall be automatic restoration of the", @@ -103,37 +115,45 @@ "copayment_pct": { "value": 20, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "Policy shall be subject to a Copayment of 20% applicable to claim amount admissible and payable as per the terms and 7. Medical Concierge Services: The Insured can a" + "source_quote": "Copayment of 20% applicable to claim amount admissible and payable as per the terms and conditions of the Policy", + "_confidence": "high" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in star-health__health-premier.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 14000, + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "on of less than 10,00,000 and Cashless facility: Cashless facility means a facility extended by the insurer to the insured at least 15 in-patient beds in all other places; where the payments, of the c" + "source_quote": "Cashless facility: Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the insurer to t", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in star-health__health-premier.pdf", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_quote": "not stated in star-health__health-premier.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "bove 20 lakhs 5,00,000/- will indemnify the Insured Person such expenses as are reasonably and necessarily incurred under the heads given below but not exceeding the Limit of Coverage stated in the" + "source_quote": "Cancers) who are estimated to live for few months, if the natural", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", @@ -142,4 +162,4 @@ "completeness_pct": 60, "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/star-health__health-premier__brochure.json b/40-data/policy_facts/star-health__health-premier__brochure.json index f4f978deac75e4c9bf32cceec4c7c8d4ea4e396e..136557ded6fde4284d93fa9b468109cf18f53ef2 100644 --- a/40-data/policy_facts/star-health__health-premier__brochure.json +++ b/40-data/policy_facts/star-health__health-premier__brochure.json @@ -7,31 +7,29 @@ "value": "SHAHLIP22226V012122", "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Star Health Premier Insurance Policy Unique Identification No.: SHAHLIP22226V012122", + "_confidence": "high" }, "min_entry_age": { "value": 50, "unit": "years", "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "For Adults: Min - 50 years for primary member & Max - Up to Any Age (Oldest member will be consider as primary member)", + "_confidence": "high" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__health-premier__brochure.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": 91, "unit": "days", "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "For Dependent Children: Min - 91 days & Max - Up to 25 years", + "_confidence": "high" }, "sum_insured_options": { "value": [ @@ -44,102 +42,206 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured Options Rs.10,00,000/-, Rs.20,00,000/-, Rs.30,00,000/-, Rs.50,00,000/-, Rs.75,00,000/- and Rs.1,00,00,000/-", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of thirty days from date of receipt of the policy document whether electronically or otherwise to review the terms and conditions of the policy, and to return the same if not acceptable.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with insurer.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__health-premier__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "9. Pre-hospitalization Expenses: Medical expenses incurred up to 60 days immediately before the insured person is hospitalized.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post Hospitalization Expenses: Medical expenses incurred up to 90 days immediately after the insured person is discharged from the hospital.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf" }, "network_hospital_count": { "value": 14000, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 20, + "unit": "%", "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Co-payment (Applicable for Insured persons whose age at the time of entry is above 65 years): Each and every claim under the Policy shall be subject to a Copayment of 20% applicable to claim amount admissible and payable as per the terms and conditions of the Policy even for renewals.", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in health-premier__brochure.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy Term - One year / Two years / Three years: For policies more than one year, the Sum Insured is for each year, without any carry over benefit thereof.", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__health-premier__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__health-premier__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__health-premier__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_quote": "not stated in health-premier__brochure.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_quote": "11. Organ Donor Expenses: In patient hospitalization expenses incurred for organ transplantation from the Donor to the Recipient Insured Person are payable provided the claim for transplantation is payable", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_quote": "automatic restoration of the Sum Insured once by 100% subject to the following; 1", + "_confidence": "medium" + }, + "domiciliary_treatment": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_quote": "not stated in health-premier__brochure.pdf", + "_confidence": "low" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_quote": "health checkup reports: If following medical records of the person proposed for insurance are submitted, Company may offer a discount of 10% on the applicable premium, subjec", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_quote": "not stated in star-health__health-premier__brochure.pdf", + "_confidence": "low" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_quote": "Cumulative Bonus: The insured person will be eligible for Cumulative bonus calculated at 20% of sum insured for each claim free year subject to a maximum of 100% of the sum insured", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_quote": "not stated in star-health__health-premier__brochure.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_quote": "not stated in star-health__health-premier__brochure.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "senior_citizen", + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_quote": "indemnity health insurance product which covers expenses incurred for hospitalisation due to Illness or Accident. This policy has been devised as the result of our meticulous research to provide the much needed protection to the individuals who are 50 year", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": null, + "unit": "text", + "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_quote": "not stated in health-premier__brochure.pdf", + "_confidence": "low" + }, + "no_claim_bonus_pct": { + "value": 20, + "unit": "%", + "source_pdf_path": "rag/corpus/star-health/health-premier__brochure.pdf", + "source_quote": "Cumulative Bonus: The insured person will be eligible for Cumulative bonus calculated at 20% of sum insured for each claim free year subject to a maximum of 100% of the sum insured", + "_confidence": "high" } } diff --git a/40-data/policy_facts/star-health__health-premier__wordings.json b/40-data/policy_facts/star-health__health-premier__wordings.json index 1d3b9b4c3fbda5f75ad04596b86a6d990ec55706..8fec2f2bbd810365d821c4d094494474ff32c012 100644 --- a/40-data/policy_facts/star-health__health-premier__wordings.json +++ b/40-data/policy_facts/star-health__health-premier__wordings.json @@ -7,31 +7,29 @@ "value": "SHAHLIP22226V012122", "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Unique Identification No.: SHAHLIP22226V012122 Star Health Premier Insurance Policy POL / SHP / V.8 / 2025", + "_confidence": "high" }, "min_entry_age": { - "value": 50, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__health-premier__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__health-premier__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__health-premier__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -44,102 +42,205 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured (Rs.) Limit Upto (Rs.) Individual SI Floater SI 10,00,000/- 3,000/- 4,000/- 20,00,000/- 4,000/- 6,000/- 30,00,000/- 4,500/- 6,500/- 50,00,000/- 5,000/- 7,500/- 75,00,000/- 7,000/- 10,000/- 1,00,00,000/-", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "and can be renewed within the Grace Period of 30 days to maintain continuity o f benefits without break", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of thirty days from date of receipt of the policy document whether electronically or", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with insurer.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__health-premier__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "9. Pre-hospitalization Expenses: Medical expenses incurred up to 60 days immediately before the insured person is hospitalized.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post Hospitalization Expenses: Medical expenses incurred up to 90 days immediately after the insured person is discharged from the hospital.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf" }, "network_hospital_count": { "value": 14000, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 20, + "unit": "%", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "for Insured persons whose age at the time of entry is above 65 years) Each and every claim under the Policy shall be subject to a Copayment of 20% applicable to claim amount admissible and payable as per the terms and conditi", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": 1, + "unit": "%", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent: Room Rent means the amount charged by a Hospital towards Room and Boarding expenses and shall include the associated medical expenses", + "_confidence": "medium" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2 + ], "unit": "years", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "In case of two year policy, total number of wellness points earned in two year period will be divided by two.", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__health-premier__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__health-premier__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__health-premier__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_quote": "not stated in health-premier__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_quote": "11. Organ Donor Expenses: In patient hospitalization expenses incurred for organ transplantation from the Donor to the Recipient Insured Person are payable provided the claim for transplantation is payable", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_quote": "automatic restoration of the Sum Insured once by 100% subject to the following :- 1", + "_confidence": "medium" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_quote": "Domiciliary Hospitalization: Domiciliary hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home und", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_quote": "Health checkup will not impact Cumulative bonus 18", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_quote": "Cumulative bonus calculated at 20% of sum insured for each claim free year subject to a maximum of 100% of the sum insured", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_quote": "not stated in star-health__health-premier__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_quote": "All claims under this policy shall be payable in Indian currency", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "senior_citizen", + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_quote": "Unique Identification No.: SHAHLIP22226V012122 Star Health Premier Insurance Policy", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "1% of SI per day or Rs 20,000/day whichever lower", + "unit": "text", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_quote": "Room Rent: Room Rent means the amount charged by a Hospital towards Room and Boarding expenses and shall include the associated medical expenses", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 20, + "unit": "%", + "source_pdf_path": "rag/corpus/star-health/health-premier__wordings.pdf", + "source_quote": "Cumulative bonus calculated at 20% of sum insured for each claim free year subject to a maximum of 100% of the sum insured", + "_confidence": "high" } } diff --git a/40-data/policy_facts/star-health__senior-citizens-red-carpet.json b/40-data/policy_facts/star-health__senior-citizens-red-carpet.json index a505845ae731c675a36dcb05adac08fbeb05490c..cd12a0e0bdc9f71468d3351a4e51f26af98b8997 100644 --- a/40-data/policy_facts/star-health__senior-citizens-red-carpet.json +++ b/40-data/policy_facts/star-health__senior-citizens-red-carpet.json @@ -5,141 +5,172 @@ "uin_code": { "value": "SHAHLIP26041V082526", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "arpet Health Insurance Policy SHAHLIP26041V082526 1 Medical Underwriting / Pre-Policy Medical Check-up: The company may ask the members Senior Citizens Red Carpet Senior Citizens Red Carpet to be prop" + "source_quote": "Unique Identification No.: SHAHLIP26041V082526 Eligibility • Entry age between 60 and 75 years • Guaranteed Lifelong ren", + "_confidence": "high" }, "min_entry_age": { - "value": null, + "value": 60, "unit": "days", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Min entry age not found" + "source_quote": "Entry age between 60 and 75 years • Guaranteed Lifelong renewals", + "_confidence": "high" }, "max_entry_age": { - "value": null, + "value": 75, "unit": "years", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Lifelong renewability: ly without break • Guaranteed Lifelong renewals Coverage Policy Term: The policy is available for 1/2/3 years which can be renewed. Where the 1. Hospitalization Cover: Room, Boarding and Nursing expen" + "source_quote": "Entry age between 60 and 75 years • Guaranteed Lifelong renewals", + "_confidence": "high" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in star-health__senior-citizens-red-carpet.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "eatment of any illness within 30 days from the first policy Burn(s) or Cancer or as part of medically necessary treatment to remove a direct and commencement date shall be excluded except claims arisi" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered B", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 12, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 12 months of continuous coverage after the date of inception of the", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exc", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in star-health__senior-citizens-red-carpet.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "Pre Hospitalization medical expenses incurred for a period not exceeding 30 days prior to the date of hospitalization, for disease/illn", + "_confidence": "high" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "not stated in star-health__senior-citizens-red-carpet.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "ating doctor is maintained 9. AYUSH Treatment: Medical expenses for Inpatient Hospitalization incurred on treatment d. Insured can avail ‘’Home Care Treatment’’ service on cashless basis from the list" + "source_quote": "AYUSH Treatment: Medical expenses for Inpatient Hospitalization incurred on treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in a AYUSH Hospital is payable up to the Sum Insured.", + "_confidence": "high" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "Maternity - Code Excl 18 a.", + "_confidence": "high" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in senior-citizens-red-carpet__brochure.pdf", + "_confidence": "low" }, "organ_donor_expenses": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Organ donor cover not extracted" + "source_quote": "not stated in senior-citizens-red-carpet__brochure.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in star-health__senior-citizens-red-carpet.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Restoration benefit not found in extracted text" + "source_quote": "not stated in star-health__senior-citizens-red-carpet.pdf", + "_confidence": "low" }, "room_rent_capping": { - "value": null, + "value": "Up to 1% of the Sum Insured (per day, varies by Sum Insured)", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "Room Rent Limit (per day) Rs.1,00,000/- to Rs.5,00,000/- Up to 1% of the Sum Insured", + "_confidence": "high" }, "copayment_pct": { "value": 30, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "nt: This policy is subject to co-payment of 30% for all claims. 6 7 Sublimits C laim Illustration for Sublimit and Co-pay: Treatment for Cerebro Vascular Accident (Ind" + "source_quote": "co-payment of 30% for all claims", + "_confidence": "high" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in star-health__senior-citizens-red-carpet.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 14000, + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "e Care Treatment’’ service on cashless basis from the list of under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in a AYUSH our Network service providers given in our website ‘’www.star" + "source_quote": "Emergency Hospitalization (Cashless/Reimbursement): Within 24 hours of date and time of Hospitalization if the Insured Person has been hospitalized in an Emergency", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in star-health__senior-citizens-red-carpet.pdf", + "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", + "source_quote": "not stated in star-health__senior-citizens-red-carpet.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "Default indemnity (no explicit alternate type detected)" + "source_quote": "Cancer care requiring medical assistance g", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", "supporting_source_pdfs": [], "completeness_pct": 50, - "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." + "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "preventive_health_checkup" + ] + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", + "source_quote": "Preventive Health Check-up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/star-health__senior-citizens-red-carpet__brochure.json b/40-data/policy_facts/star-health__senior-citizens-red-carpet__brochure.json index 3bb87d50c1f7bf9ddcf7f361c2f75d52c16b404a..b2b4a233fa5ec1eccba09facf3da18548ebfd04f 100644 --- a/40-data/policy_facts/star-health__senior-citizens-red-carpet__brochure.json +++ b/40-data/policy_facts/star-health__senior-citizens-red-carpet__brochure.json @@ -7,31 +7,29 @@ "value": "SHAHLIP26041V082526", "unit": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Senior Citizens Red Carpet Health Insurance Policy SHAHLIP26041V082526", + "_confidence": "high" }, "min_entry_age": { "value": 60, "unit": "years", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Eligibility • Entry age between 60 and 75 years • Guaranteed Lifelong renewals", + "_confidence": "high" }, "max_entry_age": { "value": 75, "unit": "years", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Eligibility • Entry age between 60 and 75 years • Guaranteed Lifelong renewals", + "_confidence": "high" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__senior-citizens-red-carpet__brochure.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -48,102 +46,171 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured Options Sum Insured on Individual Basis (Rs.) 1,00,000/- 2,00,000/- 3,00,000/- 4,00,000/- 5,00,000/- 7,50,000/- Sum Insured on Individual & Floater Basis (Rs.) 10,00,000/- 15,00,000/- 20,00,000/- 25,00,000/-", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the policy shall terminate and can be renewed within the Grace Period of 30 days.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Policyholder shall be allowed free look period of thirty days from date of receipt of the policy document whether electronically or otherwise to review the terms and conditions of the policy.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 12, "unit": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 12 months of continuous coverage after the date of inception of the first policy with insurer", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of following listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__senior-citizens-red-carpet__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "medical expenses incurred for a period not exceeding 30 days prior to the date of hospitalization, for disease/illness, injury sustained following an admissible claim for hospitalization under the policy", + "_confidence": "high" }, "post_hospitalization_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__senior-citizens-red-carpet__brochure.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf" }, "network_hospital_count": { "value": 14000, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 30, + "unit": "%", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Co-Payment: This policy is subject to co-payment of 30% for all claims.", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { "value": null, - "unit": "percent", + "unit": "%", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in senior-citizens-red-carpet__brochure.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Policy Term: The policy is available for 1/2/3 years which can be renewed.", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__senior-citizens-red-carpet__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__senior-citizens-red-carpet__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__senior-citizens-red-carpet__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", + "source_quote": "AYUSH Treatment: Medical expenses for Inpatient Hospitalization incurred on treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in a AYUSH Hospital is payable up to the Sum Insured.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", + "source_quote": "Health Check-up: We will arrange for a Preventive Health Check-up at Our Network Providers for the applicable package as specified below as per opted Sum Insured and subject t", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", + "source_quote": "Emergency Hospitalization (Cashless/Reimbursement): Within 24 hours of date and time of Hospitalization if the Insured Person has been hospitalized in an Emergency.", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", + "source_quote": "not stated in star-health__senior-citizens-red-carpet__brochure.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", + "source_quote": "not stated in star-health__senior-citizens-red-carpet__brochure.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "senior_citizen", + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", + "source_quote": "Senior Citizens Red Carpet Health Insurance Policy Senior Citizens Red Carpet Health Insurance Policy Turning sixty is a major milestone", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": null, + "unit": "text", + "source_pdf_path": "rag/corpus/star-health/senior-citizens-red-carpet__brochure.pdf", + "source_quote": "not stated in senior-citizens-red-carpet__brochure.pdf", + "_confidence": "low" } } diff --git a/40-data/policy_facts/star-health__star-assure.json b/40-data/policy_facts/star-health__star-assure.json index 912b25374b25c10323cb1c6276b000f6526a8de5..14bf3663bae59f5d3fc355147f4936c72c5d15b3 100644 --- a/40-data/policy_facts/star-health__star-assure.json +++ b/40-data/policy_facts/star-health__star-assure.json @@ -5,90 +5,102 @@ "uin_code": { "value": "SHAHLIP26048V032526", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "icy Unique Identification No: SHAHLIP26048V032526 i. Having qualified registered AYUSH PREAMBLE Medical Practitioner(s) in charge; The proposal, declaration and other ii. H aving dedicated AYUSH thera" + "source_quote": "Unique Identification No: SHAHLIP26048V032526 STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED Registered Office: No. 1,", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in star-health__star-assure.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in star-health__star-assure.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in star-health__star-assure.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "plant and related any illness within 30 days from the first surgeries. policy commencement date shall be 14. Congenital Internal disease / excluded except claims arising due to defect – {except for Un" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered B", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 30 months of continuous coverage after the date of inception of the fir", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exc", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in star-health__star-assure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "Pre-Hospitalization Expenses: Medical expenses incurred up to 60 days immediately before the Insured Person is hospitalized.", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 180, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "Post-Hospitalization Expenses: Medical expenses incurred up to 180 days immediately after the Insured Person is discharged from the hos", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": ". Having qualified registered AYUSH PREAMBLE Medical Practitioner(s) in charge; The proposal, declaration and other ii. H aving dedicated AYUSH therapy sections documents given by the proposer sh" + "source_quote": "AYUSH Treatment: Medical expenses for Inpatient Hospitalization incurred on treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in a AYUSH Hospital is payable up to the Sum Insured.", + "_confidence": "high" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "Maternity – Code Excl 18 (Except to the extent covered under Coverage 15) i.", + "_confidence": "high" }, "newborn_coverage": { "value": true, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "New Born Baby: Newborn baby means baby means a person who holds a valid registration bor" + "source_quote": "New Born baby cover", + "_confidence": "high" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "Organ Donor Expenses: In patient ‘’www.starhealth.in’’ hospitalization expenses incurred for organ transplantation from the Donor to v. Claim under this benefit forms part the Recipient Insured Person" + "source_quote": "9. Organ Donor Expenses: In patient hospitalization expenses incurred for organ transplantation from the Donor to the Recipient Insured Person are payable provided the claim for transplantation is payable", + "_confidence": "high" }, "no_claim_bonus_pct": { - "value": null, + "value": 25, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "Cumulative bonus calculated at 25% of Sum Insured for each claim free year and maximum up to 100% of the Sum Insured.", + "_confidence": "high" }, "restoration_benefit": { "value": "Restoration – illustration", @@ -96,44 +108,53 @@ "source_quote": "Restoration – illustration" }, "room_rent_capping": { - "value": null, + "value": "No cap", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "Room rent capping not extracted (only definition found, no explicit cap)" + "source_quote": "Room Rent: Room Rent means the amount charged by a Hospital towards Room and Boarding expenses and shall include the associated medical expenses.", + "_confidence": "medium" }, "copayment_pct": { "value": 10, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "nts earned in two year period co-payment of 10% of each and every will be divided by two. claim amount for fresh as well as renewal *Please refer the Illustrations to" + "source_quote": "co-payment of 10% of each and every claim amount for fresh as well as renewal policies for Insured Person whose age at the time of entry is 61 years and abov", + "_confidence": "high" }, "deductible_amount": { "value": 50000, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "for an Sum Insured aggregate deductible of Rs.50,000 in a year, lets Room Rent , Boarding, understand how this deductible will be applied Nursing Expenses, Surgeon, Anesthe" + "source_quote": "aggregate deductible of Rs.50,000 in a year, lets understand how this deductible will be applied First Policy Yea", + "_confidence": "medium" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 14000, + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "practitioner AND must comply Cashless facility: Cashless facility means a with all minimum criterion as under- facility extended by the insurer to the insured i. has qualified nursing staff under its " + "source_quote": "Cashless facility: Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy Terms and conditions, are directly made to the network provider by the insurer to t", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in star-health__star-assure.pdf", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "source_quote": "not stated in star-health__star-assure.pdf", + "_confidence": "low" }, "policy_type": { "value": "hospital-cash", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "Hospital cash / daily benefit policy" + "source_quote": "hospital cash policies which will apply before any benefits are payable b", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", @@ -142,4 +163,4 @@ "completeness_pct": 55, "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/star-health__star-assure__wordings.json b/40-data/policy_facts/star-health__star-assure__wordings.json index 122b03d54ccf96a6219912b64d6aaca90aab54e3..c5e7d31a6241a1b55725ff37972e11379b144049 100644 --- a/40-data/policy_facts/star-health__star-assure__wordings.json +++ b/40-data/policy_facts/star-health__star-assure__wordings.json @@ -7,141 +7,251 @@ "value": "SHAHLIP26048V032526", "unit": null, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Star Health Assure Insurance Policy | UIN : SHAHLIP26048V032526 | POL / HA / V.12 / 2026", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__star-assure__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__star-assure__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": 16, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Family includes Insured Person, spouse, dependent children between 16 days and 25 years of age not exceeding 3 in number, Dependent Parent and Dependent Parents in law.", + "_confidence": "high" }, "sum_insured_options": { "value": [ 500000, + 750000, 1000000, 1500000, 2000000, 2500000, 5000000, 7500000, - 10000000 + 10000000, + 20000000 ], "unit": "INR", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured in Lakhs (Rs.) Limit Per Policy Period (Rs.) 5/7.5/10/15/20/25 2,00,000 50/75/100/200 4,00,000", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the policy shall terminate and can be renewed within the Grace Period of 30 days.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Policyholder shall be allowed free look period of thirty days from date of receipt of the policy document whether electronically or otherwise to review the terms and conditions of the policy.", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of the listed Conditions, surgeries/ treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-assure__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-Hospitalization Expenses: Medical expenses incurred up to 60 days immediately before the Insured Person is hospitalized.", + "_confidence": "high" }, "post_hospitalization_days": { - "value": 90, + "value": 180, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post-Hospitalization Expenses: Medical expenses incurred up to 180 days immediately after the Insured Person is discharged from the hospital.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf" }, "network_hospital_count": { "value": 14000, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 10, + "unit": "%", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "co-payment of 10% of each and every claim amount for fresh as well as renewal policies for Insured Person whose age at the time of entry is 61 years and abov", + "_confidence": "high" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-assure__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2 + ], "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "In case of two year policy, total number of wellness points earned in two year period will be divided by two.", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-assure__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-assure__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-assure__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "source_quote": "AYUSH Treatment: Medical expenses for Inpatient Hospitalization incurred on treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in a AYUSH Hospital is payable up to the Sum Insured.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "source_quote": "Expenses for a Delivery including Delivery by Caesarean section (including pre-natal and postnatal expenses) up to 10% of the Sum Insured is payable, subject to the following: i", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "source_quote": "New Born baby cover", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "source_quote": "9. Organ Donor Expenses: In patient hospitalization expenses incurred for organ transplantation from the Donor to the Recipient Insured Person are payable provided the claim for transplantation is payable", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "source_quote": "restored to 100%", + "_confidence": "medium" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "source_quote": "Domiciliary Hospitalization: Domiciliary hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home un", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "source_quote": "Health Check-up: We will arrange for a Preventive Health Check-up at Our Network Providers for the applicable limits as specified below as per opted Sum Insured and subject to", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the Policy Terms and conditions, are directly made to the network provider", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "source_quote": "The Insured Person will be eligible for Cumulative bonus calculated at 25% of Sum Insured for each claim free year and maximum up to 100% of the Sum Insured.", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "source_quote": "not stated in star-health__star-assure__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "source_quote": "The Insured Person is in India and the treatment is in India only.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "source_quote": "Family includes Insured Person, spouse, dependent children between 16 days and 25 years of age not exceeding 3 in number, Dependent Parent and Dependent Parents in law.", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 25, + "unit": "%", + "source_pdf_path": "rag/corpus/star-health/star-assure__wordings.pdf", + "source_quote": "The Insured Person will be eligible for Cumulative bonus calculated at 25% of Sum Insured for each claim free year and maximum up to 100% of the Sum Insured.", + "_confidence": "high" } } diff --git a/40-data/policy_facts/star-health__star-cancer-care-platinum__wordings.json b/40-data/policy_facts/star-health__star-cancer-care-platinum__wordings.json index ece7e2161452a10423b4a3283226789bb80ad0ae..63b3a1c3ed34b84dd170bbfd6dc948feb588dc11 100644 --- a/40-data/policy_facts/star-health__star-cancer-care-platinum__wordings.json +++ b/40-data/policy_facts/star-health__star-cancer-care-platinum__wordings.json @@ -3,24 +3,22 @@ "policy_name": "Star Cancer Care Platinum", "insurer_slug": "star-health", "uin_code": { - "value": null, + "value": "SHAHLIP22031V022122", "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", - "source_quote": "" + "source_quote": "SHAHLIP22031V022122 Star Cancer Care Platinum Insurance Policy", + "_confidence": "high" }, "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-cancer-care-platinum__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-cancer-care-platinum__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": 30, @@ -33,14 +31,16 @@ "source_quote": "Initial waiting period 30 days" }, "maternity_coverage": { - "value": null, + "value": false, "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", - "source_quote": "" + "source_quote": "Maternity - Code Excl 18 i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-cancer-care-platinum__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": true, @@ -65,12 +65,14 @@ "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-cancer-care-platinum__wordings.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-cancer-care-platinum__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, @@ -83,39 +85,47 @@ "source_quote": "Post Hospitalization Expenses: Medical expenses incurred up to 60 days" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", - "source_quote": "" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf" }, "network_hospital_count": { "value": null, - "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", - "source_quote": "" + "unit": "hospitals", + "source_pdf_path": null, + "source_quote": "not stated in star-health__star-cancer-care-platinum__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-cancer-care-platinum__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-cancer-care-platinum__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-cancer-care-platinum__wordings.pdf", + "_confidence": "low" }, "policy_type": { "value": "critical_illness", "source_pdf_path": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", - "source_quote": "classified as critical_illness from PDF heuristics" + "source_quote": "Cancer Care Platinum Insurance Policy POL / SCCP / V", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/star-health/star-cancer-care-platinum__wordings.pdf", "completeness_pct": 41, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/star-health__star-cardiac-care-platinum.json b/40-data/policy_facts/star-health__star-cardiac-care-platinum.json index dea0cd4bc4558a1be26fef37af5b7f59e7fbb038..f8b8db9d2d99a60bfe8d511caa548502bf4d8914 100644 --- a/40-data/policy_facts/star-health__star-cardiac-care-platinum.json +++ b/40-data/policy_facts/star-health__star-cardiac-care-platinum.json @@ -5,85 +5,96 @@ "uin_code": { "value": "SHAHLIP22033V022122", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "UM Unique Identification No.: SHAHLIP22033V022122 PREAMBLE Cumulative Bonus: Cumulative Bonus means any increase or addition in the Sum The proposal and declaration given by the proposer and other doc" + "source_quote": "1 of 10 Unique Identification No.: SHAHLIP22033V022122 Star Cardiac Care Insurance Policy-Plat", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in star-health__star-cardiac-care-platinum.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in star-health__star-cardiac-care-platinum.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in star-health__star-cardiac-care-platinum.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "the treatment of any illness within 30 days from the first reproductive technologies such as IVF, ZIFT, GIFT, ICSI policy commencement date shall be excluded except claims arising due to an accident, " + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered B", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "\"Pre-existing disease (PED)\" means any condition, ailment, injury or disease: a) that is/are diagnosed by a physician not more than 36 mon", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exc", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in star-health__star-cardiac-care-platinum.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": null, + "value": 30, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "Pre-hospitalization Expenses: Medical expenses incurred up to 30 days immediately before the insured person is hospitalized.", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 60, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "Post Hospitalization Expenses: Medical expenses incurred up to 60 days immediately after the insured person is discharged from the hosp", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "and all premium paid thereon AYUSH Day Care Centre: AYUSH Day Care Centre means and includes Community shall be forfeited to the Company in the event of misrepresentation, mis-description or non- Heal" + "source_quote": "AYUSH Treatment: Medical expenses for Inpatient Hospitalization incurred on treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in a AYUSH Hospital is payable up to the sum insured.", + "_confidence": "high" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "Maternity - Code Excl 18 a.", + "_confidence": "high" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "organ_donor_expenses": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "Organ donor cover not extracted" + "source_quote": "not stated in star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": 10, @@ -91,9 +102,10 @@ "source_quote": "Cumulative bonus calculated at 10% of basic sum insured for each claim free year sub" }, "restoration_benefit": { - "value": "Restoration of Basic Sum Insured (Applicable for Section 1 Only): 1 RF ablation for lumbar and cervical facet joint 50,000/- 65,000/- 75,000/-", + "value": true, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "Restoration of Basic Sum Insured (Applicable for Section 1 Only): 1 RF ablation for lumbar and cervical facet joint 50,000/- 65,000/- 75,000/-" + "source_quote": "automatic restoration of the Basic Sum Insured once by 100% upon exhaustion of the limit of coverage during the policy period", + "_confidence": "medium" }, "room_rent_capping": { "value": "Single Private AC Room Part of the sum insured", @@ -101,39 +113,47 @@ "source_quote": "Single Private AC Room Part of the sum insured" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in star-health__star-cardiac-care-platinum.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 14000, + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "s or injury that is likely to Cashless facility: Cashless facility means a facility extended by the insurer to the insured respond quickly to treatment which aims to return the person to his or her st" + "source_quote": "Cashless facility: Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the insurer to t", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in star-health__star-cardiac-care-platinum.pdf", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_quote": "not stated in star-health__star-cardiac-care-platinum.pdf", + "_confidence": "low" }, "policy_type": { "value": "benefit", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "Specialty cardiac/critical illness — benefit-based lump-sum on diagnosis" + "source_quote": "Cardiac Care Insurance Policy-Platinum POL / CAR-P / V", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", @@ -142,4 +162,4 @@ "completeness_pct": 65, "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/star-health__star-cardiac-care-platinum__wordings.json b/40-data/policy_facts/star-health__star-cardiac-care-platinum__wordings.json index f94018d1fb119ea700d923c3cda07f91cce352cf..1e536e0ead6598c545a4b86351a66bb04a15dce8 100644 --- a/40-data/policy_facts/star-health__star-cardiac-care-platinum__wordings.json +++ b/40-data/policy_facts/star-health__star-cardiac-care-platinum__wordings.json @@ -7,132 +7,197 @@ "value": "SHAHLIP22033V022122", "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Unique Identification No.: SHAHLIP22033V022122 Star Cardiac Care Insurance Policy-Platinum POL / CAR-P / V.8 / 2025", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of thirty days from date of receipt of the policy document whether electronically or otherwise to review the terms and conditions of the policy, and to return the same if not acceptable", + "_confidence": "high" }, "initial_waiting_period_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Pre-hospitalization Expenses: Medical expenses incurred up to 30 days immediately before the insured person is hospitalized.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post Hospitalization Expenses: Medical expenses incurred up to 60 days immediately after the insured person is discharged from the hospital.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf" }, "network_hospital_count": { "value": 14000, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "premium for the unexpired policy period, in respect of policies with policy term more than 1 year and risk coverage for such policy years has not commenced.", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_quote": "AYUSH Treatment: Medical expenses for Inpatient Hospitalization incurred on treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in a AYUSH Hospital is payable up to the sum insured.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_quote": "not stated in star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_quote": "not stated in star-health__star-cardiac-care-platinum__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_quote": "All claims under this policy shall be payable in Indian currency.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "disease_specific", + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_quote": "Star Cardiac Care Insurance Policy-Platinum POL / CAR-P / V.8 / 2025", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Per policy schedule; proportionate deduction on associated medical expenses if higher room chosen", + "unit": "text", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care-platinum__wordings.pdf", + "source_quote": "Single Private A/c Room", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/star-health__star-cardiac-care.json b/40-data/policy_facts/star-health__star-cardiac-care.json index c34f75dbc18d6eb3f9291f0e15007220bb75fc06..d84e31e4ec58db0d5c07974466cec4441bc1fbf6 100644 --- a/40-data/policy_facts/star-health__star-cardiac-care.json +++ b/40-data/policy_facts/star-health__star-cardiac-care.json @@ -5,95 +5,108 @@ "uin_code": { "value": "SHAHLIP22032V052122", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "CY Unique Identification No.: SHAHLIP22032V052122 PREAMBLE policy that provides that the policyholder/insured will bear a specified percentage of the The proposal and declaration given by the proposer" + "source_quote": "1 of 9 Unique Identification No.: SHAHLIP22032V052122 Star Cardiac Care Insurance Policy POL", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in star-health__star-cardiac-care.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in star-health__star-cardiac-care.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in star-health__star-cardiac-care.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "the treatment of any illness within 30 days from the first d. Reversal of sterilization policy commencement date shall be excluded except claims arising due to an accident, provided the same are cover" + "source_quote": "not stated in star-cardiac-care__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "\"Pre-existing disease (PED)\" means any condition, ailment, injury or disease: a) that is/are diagnosed by a physician not more than 36 mon", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exc", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in star-health__star-cardiac-care.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "tion 3 - Out-Patient Expenses 30 days prior to the date of hospitalization, for the disease/illness, injury sustained Expenses reasonably and necessarily incurred at any Networked Facility in India he" + "source_quote": "on medical expenses incurred for a period not exceeding 30 days prior to the date of hospitalization, for the disease/illness, in", + "_confidence": "high" }, "post_hospitalization_days": { - "value": 60, + "value": 30, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "ation expenses incurred up to 60 days after discharge from the The limit of benefit under this Section is Rs.500/- per event subject to a maximum of hospital. The amount payable shall not exceed the s" + "source_quote": "on medical expenses incurred for a period not exceeding 30 days prior to the date of hospitalization, for the disease/illness, in", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "e accessible to the insurance AYUSH Day Care Centre: AYUSH Day Care Centre means and includes Community company's authorized personnel. Health Centre (CHC), Primary Health Centre (PHC), Dispensary, Cl" + "source_quote": "AYUSH Treatment: Medical expenses for Inpatient Hospitalization incurred on treatment under Ayurveda, Unani, Sidha and Homeopathy systems of medicines in a AYUSH Hospital is payable up to the sum insured.", + "_confidence": "high" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "Maternity - Code Excl 18 a.", + "_confidence": "high" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in star-cardiac-care__wordings.pdf", + "_confidence": "low" }, "organ_donor_expenses": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "Organ donor cover not extracted" + "source_quote": "not stated in star-cardiac-care__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "NCB % not extracted; product may use booster/recharge structure" + "source_quote": "not stated in star-health__star-cardiac-care.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "Restoration benefit not found in extracted text" + "source_quote": "not stated in star-health__star-cardiac-care.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": "room category occupied by the insured person whilst undergoing treatment in some of the", @@ -103,37 +116,45 @@ "copayment_pct": { "value": 10, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "3. This policy is subject to Co-payment of 10% of each and every claim amount for fresh the same would be reduced to the extent of prior coverage as well as renewal p" + "source_quote": "Co-payment of 10% of each and every claim amount for fresh as well as renewal policies for insured persons whose age at the time of entry is 61years and abov", + "_confidence": "high" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in star-health__star-cardiac-care.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 14000, + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "ical condition leading to the Cashless facility: Cashless facility means a facility extended by the insurer to the insured impairment of normal physiological function and requires medical treatment; w" + "source_quote": "Cashless facility: Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the insurer to t", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in star-health__star-cardiac-care.pdf", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_quote": "not stated in star-health__star-cardiac-care.pdf", + "_confidence": "low" }, "policy_type": { "value": "benefit", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "Specialty cardiac/critical illness — benefit-based lump-sum on diagnosis" + "source_quote": "Cardiac Care Insurance Policy POL / CAR / V", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", @@ -142,4 +163,4 @@ "completeness_pct": 65, "notes": "Pattern-based extraction from local PDF via pdfplumber. Insurer-level metrics (CSR, network count) left null pending downstream backfill." } -} \ No newline at end of file +} diff --git a/40-data/policy_facts/star-health__star-cardiac-care__wordings.json b/40-data/policy_facts/star-health__star-cardiac-care__wordings.json index 49617bb99fdf3f384ce375c5a943158018dca364..e90db6b772e8038ddf4cb5aef0f9a87c1e9300d7 100644 --- a/40-data/policy_facts/star-health__star-cardiac-care__wordings.json +++ b/40-data/policy_facts/star-health__star-cardiac-care__wordings.json @@ -4,34 +4,32 @@ "insurer_slug": "star-health", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", "uin_code": { - "value": "SHAHLIP22032V022122", + "value": "SHAHLIP22032V052122", "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Unique Identification No.: SHAHLIP22032V052122 Star Cardiac Care Insurance Policy POL / CAR / V.19 / 2025", + "_confidence": "high" }, "min_entry_age": { - "value": 10, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__star-cardiac-care__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__star-cardiac-care__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -40,102 +38,169 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured Rs.3,00,000/- Rs.4,00,000/-", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of thirty days from date of receipt of the policy document whether electronically or otherwise to review the terms and conditions of the policy, and to return the same if not acceptable", + "_confidence": "high" }, "initial_waiting_period_days": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "medical expenses incurred for a period not exceeding 30 days prior to the date of hospitalization, for the disease/illness, injury sustained following an admissible claim under the policy", + "_confidence": "high" }, "post_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Post Hospitalization expenses incurred up to 60 days after discharge from the hospital", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf" }, "network_hospital_count": { "value": 14000, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1 + ], "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "premium for the unexpired policy period, in respect of policies with policy term more than 1 year and risk coverage for such policy years has not commenced.", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-cardiac-care__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_quote": "AYUSH Treatment: Medical expenses for Inpatient Hospitalization incurred on treatment under Ayurveda, Unani, Sidha and Homeopathy systems of medicines in a AYUSH Hospital is payable up to the sum insured.", + "_confidence": "high" + }, + "critical_illness_cover": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_quote": "not stated in star-cardiac-care__wordings.pdf", + "_confidence": "low" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_quote": "Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_quote": "not stated in star-health__star-cardiac-care__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_quote": "All claims under this policy shall be payable in Indian currency.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": "disease_specific", + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_quote": "Star Cardiac Care Insurance Policy POL / CAR / V.19 / 2025", + "_confidence": "medium" + }, + "room_rent_capping": { + "value": "Per policy schedule", + "unit": "text", + "source_pdf_path": "rag/corpus/star-health/star-cardiac-care__wordings.pdf", + "source_quote": "Room Rent: Room Rent means the amount charged by a Hospital towards Room and Boarding expenses and shall include the associated medical expenses", + "_confidence": "medium" } } diff --git a/40-data/policy_facts/star-health__star-comprehensive.json b/40-data/policy_facts/star-health__star-comprehensive.json index bebed6b43166f6d1c00804ee7bf6d49b24cd212c..646d1f0811634fac28fe2019f35ed26eaf82b33d 100644 --- a/40-data/policy_facts/star-health__star-comprehensive.json +++ b/40-data/policy_facts/star-health__star-comprehensive.json @@ -8,42 +8,53 @@ "source_quote": "Star Comprehensive Insurance Policy | UIN : SHAHLIP26044V092526" }, "min_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "Newborn baby (defined as upto 90 days); dependent entry standard 91 days" + "source_quote": "not stated in star-comprehensive__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "Adult entry per Policy Schedule (Star Comprehensive: 18+ years; max entry typically 65 years per brochure)" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "Lifelong renewability" + "source_quote": "not stated in star-health__star-comprehensive.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [500000, 750000, 1000000, 1500000, 2000000, 2500000, 5000000, 7500000, 10000000], + "value": [ + 500000, + 750000, + 1000000, + 1500000, + 2000000, + 2500000, + 5000000, + 7500000, + 10000000 + ], "unit": "INR", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "Sum Insured 5,00,000 / 7,50,000 / 10,00,000 to 25,00,000 / 50,00,000 / 75,00,000 / 1,00,00,000 (Delivery and New Born SI grid)" + "source_quote": "Sum Insured Rs. 5,00,000/- 1,200/- 7,50,000/- 1,500/- 10,00,000/- 2,100/- 15,00,000/- 2,400/- 20,00,000/- 3,000/- 25,00,000/- 3,300/- 50,00,000/-, 75,00,000/- and 1,00,00,000/- 5,000/-", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "30-day waiting period for illness (standard IRDAI Excl03 applied)" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered B", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 12, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "Pre-Existing Diseases: Code Excl 01 ... shall be excluded until the expiry of 12 months of continuous coverage after the date of inception of the first policy with insurer" + "source_quote": "ment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 12 months of continuous coverage after the date of inception of the first policy with insure", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "2. Specified disease / procedure waiting period - Code Excl 02 ... shall be excluded until the expiry of 24 months of continuous coverage" + "source_quote": "treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exc", + "_confidence": "high" }, "maternity_waiting_months": { "value": 24, @@ -61,24 +72,29 @@ "source_quote": "6. Post-Hospitalization Expenses: Medical expenses incurred for a period up to 90 days from the date of discharge" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "2. Day Care Treatment: We will cover ... All Day Care Treatments (no fixed count enumerated in wording)" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "treatments given under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH covered)" + "source_quote": "AYUSH Treatment: Medical expenses for Inpatient Hospitalization incurred on treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines in a AYUSH Hospital is payable up to the Sum Insured.", + "_confidence": "high" }, "maternity_coverage": { "value": true, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "14. Delivery and New Born A. Expenses for a Delivery including Delivery by Caesarean Section (including pre-natal and post-natal expenses) ... subject to a maximum of 2 deliveries in the entire life time of the Insured Person" + "source_quote": "14. Delivery and New Born A", + "_confidence": "high" }, "newborn_coverage": { - "value": true, + "value": null, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "B. Expenses up to the limits mentioned in the table below, incurred in a hospital/nursing home on treatment of the New-born ... including any congenital disorders" + "source_quote": "not stated in star-comprehensive__wordings.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, @@ -98,47 +114,81 @@ "room_rent_capping": { "value": "Per eligible room category in Policy Schedule (proportionate deduction if higher category opted)", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "proportion to the room rent limit / room (proportionate deduction clause applies)" + "source_quote": "Room Rent: Room Rent means the amount charged by a Hospital towards Room and Boarding expenses and shall include the associated medical expenses", + "_confidence": "medium" }, "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "Mandatory copay for 61+ entrants (standard Star Health clause; voluntary copay 10%/20% optional)" + "source_quote": "not stated in star-health__star-comprehensive.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible" + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "not stated in star-health__star-comprehensive.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric (Star Health 14,000+)" + "value": 14000, + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "Cashless facility through Star Health in-house claims" + "source_quote": "Cashless Facility: Cashless Facility means a facility extended by the insurer to the insured where the payments, of the cost of treatment undergone by the insured in accordance with the Policy Terms and conditions, are directly made to the network provider by the insurer to th", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric; not extracted" + "source_quote": "not stated in star-health__star-comprehensive.pdf", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "not stated in star-health__star-comprehensive.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "Indemnity-based comprehensive individual / family floater plan" + "source_quote": "Hospital Cash Benefit are not applicable for this Section", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/star-health/star-comprehensive__wordings.pdf", "completeness_pct": 88, - "notes": "Star Comprehensive: 12-month PED (best in class), 100% NCB for SI ≥ 7.5L per claim-free year, maternity covered with 24-month waiting + newborn cover." + "notes": "Star Comprehensive: 12-month PED (best in class), 100% NCB for SI ≥ 7.5L per claim-free year, maternity covered with 24-month waiting + newborn cover. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment", + "preventive_health_checkup" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "road ambulance expenses incurred for the following are payable :- i", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text", + "_confidence": "medium" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "Domiciliary Hospitalization: Domiciliary Hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home un", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "Preventive Health Check-up", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/star-health__star-comprehensive__wordings.json b/40-data/policy_facts/star-health__star-comprehensive__wordings.json index ea86de7afcea04dd0ed8fe498bcdaf63093c5f00..7b1b1a5c3abef621a9e1e160509b8004065afdee 100644 --- a/40-data/policy_facts/star-health__star-comprehensive__wordings.json +++ b/40-data/policy_facts/star-health__star-comprehensive__wordings.json @@ -7,31 +7,29 @@ "value": "SHAHLIP26044V092526", "unit": null, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Star Comprehensive Insurance Policy | UIN : SHAHLIP26044V092526 | POL / COMP / V.24 / 2025", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__star-comprehensive__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" - }, - "max_renewal_age": { - "value": 999, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__star-comprehensive__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in star-health__star-comprehensive__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": [ @@ -47,102 +45,219 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Sum Insured on Floater Basis: Limit per Policy Period for each treatment / procedure Rs. 5,00,000/- 1,25,000/- 50,000/- 2,50,000/- 1,25,000/- 2,50,000/- 50,000/- 7,50,000/- 1,25,000/- 50,000/- 2,50,000/- 1,25,000/- 2,75,000/- 60,000/- 10,00,000/-", + "_confidence": "medium" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "and can be renewed within the Grace Period of 30 days.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The Policyholder shall be allowed free look period of thirty days from date of receipt of the policy document whether electronically or otherwise", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer.", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 36, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "surgeries/ treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-comprehensive__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Medical expenses incurred for a period not exceeding 60 days prior to the date of hospitalization are payable subject to an admissible hospitalization claim.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Medical expenses incurred for a period up to 90 days from the date of discharge from the hospital wherever recommended by the Medical Practitioner", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf" }, "network_hospital_count": { "value": 14000, - "unit": null, - "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_url": "https://www.starhealth.in/", + "source_note": "14,000+ network hospitals across India (per official Star Health communications, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-comprehensive__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { - "value": null, - "unit": "percent", + "value": "single_private_ac_room", + "unit": null, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Room Rent: Room Rent means the amount charged by a Hospital towards Room and Boarding expenses and shall include the associated medical expenses", + "_confidence": "medium" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2 + ], "unit": "years", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "unt in premium, weightage and the calculation in case of two year policy. The wellness services and ac", + "_confidence": "medium" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-comprehensive__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-comprehensive__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in star-health__star-comprehensive__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "AYUSH Treatment: Medical expenses for Inpatient Hospitalization incurred on treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines in a AYUSH Hospital is payable up to the Sum Insured.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "14. Delivery and New Born A", + "_confidence": "high" + }, + "newborn_coverage": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "not stated in star-comprehensive__wordings.pdf", + "_confidence": "low" + }, + "organ_donor_expenses": { + "value": null, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "not stated in star-comprehensive__wordings.pdf", + "_confidence": "low" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "automatic restoration of the Basic Sum Insured by 100% immediately upon exhaustion of the Basic Sum Insured and accrued Cumulative Bonus if any, once during the Policy Period", + "_confidence": "medium" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "Domiciliary Hospitalization: Domiciliary Hospitalization means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home un", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "Health Check-up: We will arrange for a Preventive Health Check- up at Our Network Providers for the applicable package as specified below as per opted Sum Insured and subject", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "Cashless Facility means a facility extended by the insurer to the insured where the payments, of the cost of treatment undergone by the insured in accordance with the Policy Terms and conditions, are directly made to the network provider by the insurer", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "the Insured Person would be entitled to the benefit of Cumulative Bonus calculated at 50% of the Basic Sum Insured under this policy following after every claim free year up to a maximum of 100%.", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "not stated in star-health__star-comprehensive__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "All claims under this policy shall be payable in Indian currency.", + "_confidence": "medium" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "not stated in star-health__star-comprehensive.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "Single Private A/C Room or per-day cap per SI tier", + "unit": "text", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "Room Rent: Room Rent means the amount charged by a Hospital towards Room and Boarding expenses and shall include the associated medical expenses", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/star-health/star-comprehensive__wordings.pdf", + "source_quote": "the Insured Person would be entitled to the benefit of Cumulative Bonus calculated at 50% of the Basic Sum Insured under this policy following after every claim free year up to a maximum of 100%.", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/star-health__star-hospital-cash__brochure.json b/40-data/policy_facts/star-health__star-hospital-cash__brochure.json index 0b4d5e73454dc4db3d9ec58ad8ada9f042886dfd..6400f82230ce4860721c8da178cd9e07a5759134 100644 --- a/40-data/policy_facts/star-health__star-hospital-cash__brochure.json +++ b/40-data/policy_facts/star-health__star-hospital-cash__brochure.json @@ -3,24 +3,22 @@ "policy_name": "Star Hospital Cash", "insurer_slug": "star-health", "uin_code": { - "value": null, + "value": "SHAHLIP20046V011920", "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "Star Hospital Cash Insurance Policy Unique Identification No.: SHAHLIP20046V011920", + "_confidence": "high" }, "min_entry_age": { - "value": null, + "value": 18, "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "Adults between 18 years and 65 years · Dependent children: 91 days to 25 years(who are economically dependent on their parents).", + "_confidence": "high" }, "max_entry_age": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, + "value": 65, "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "Adults between 18 years and 65 years · Dependent children: 91 days to 25 years(who are economically dependent on their parents).", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, @@ -30,22 +28,27 @@ "initial_waiting_period_days": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-hospital-cash__brochure.pdf", + "_confidence": "low" }, "maternity_coverage": { - "value": null, + "value": true, + "unit": "boolean", "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "05 Child Birth Hospital Cash Not Available Available. Note: This benefit is subject to a waiting period of 2 years from the first commencement of this Star Hospital Cash Insurance Policy. Only female insured persons are eligible for this benefit", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-hospital-cash__brochure.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-hospital-cash__brochure.pdf", + "_confidence": "low" }, "cashless_treatment_supported": { "value": true, @@ -55,67 +58,81 @@ "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-hospital-cash__brochure.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-hospital-cash__brochure.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-hospital-cash__brochure.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-hospital-cash__brochure.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-hospital-cash__brochure.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-hospital-cash__brochure.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "value": 540, + "source_url": "https://www.starhealth.in/health-insurance/daycare-treatment-and-procedures/", + "source_note": "Per insurer baseline (Star Health day-care procedures page; 540+ procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf" }, "network_hospital_count": { "value": null, - "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "unit": "hospitals", + "source_pdf_path": null, + "source_quote": "not stated in star-health__star-hospital-cash__brochure.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-hospital-cash__brochure.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-hospital-cash__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "" + "source_quote": "not stated in star-health__star-hospital-cash__brochure.pdf", + "_confidence": "low" }, "policy_type": { "value": "hospital_cash", "source_pdf_path": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", - "source_quote": "classified as hospital_cash from PDF heuristics" + "source_quote": "STAR HOSPITAL CASH INSURANCE POLICY Star Hospital Cash Insurance Policy provides additional protection & takes care of your incidental expenses", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/star-health/star-hospital-cash__brochure.pdf", "completeness_pct": 14, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } } \ No newline at end of file diff --git a/40-data/policy_facts/tata-aig__criti-medicare__wordings.json b/40-data/policy_facts/tata-aig__criti-medicare__wordings.json index 17035ab6d1ce565bed86d0f76f6fd0c337359cec..37d7801b6799f6a10b2d69503f3bea3d7a360078 100644 --- a/40-data/policy_facts/tata-aig__criti-medicare__wordings.json +++ b/40-data/policy_facts/tata-aig__criti-medicare__wordings.json @@ -10,112 +10,129 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__criti-medicare__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__criti-medicare__wordings.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 48, + "unit": "months", "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "ii. Pre-existing Diseases Waiting Period a. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 48 mont", + "_confidence": "high" }, "initial_waiting_period_days": { - "value": null, + "value": 90, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "eriod a. Expenses related to the treatment of any illness within 90 days (applicable for Section 2 A: Critical Illness and Section", + "_confidence": "high" }, "maternity_coverage": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__criti-medicare__wordings.pdf", + "_confidence": "low" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__criti-medicare__wordings.pdf", + "_confidence": "low" }, "ayush_coverage": { "value": null, + "unit": "boolean", "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__criti-medicare__wordings.pdf", + "_confidence": "low" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "Cashless facility" + "source_quote": "2. Cashless facility Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance wit", + "_confidence": "high" }, "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__criti-medicare__wordings.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__criti-medicare__wordings.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__criti-medicare__wordings.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__criti-medicare__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__criti-medicare__wordings.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__criti-medicare__wordings.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "value": 540, + "source_url": "https://www.tataaig.com/health-insurance/medicare", + "source_note": "Per insurer baseline (Tata AIG product pages state 540+ day care procedures)", + "_confidence": "medium" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "value": 12000, + "source_url": "https://www.tataaig.com/", + "source_note": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__criti-medicare__wordings.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__criti-medicare__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__criti-medicare__wordings.pdf", + "_confidence": "low" }, "policy_type": { - "value": "group", + "value": null, "source_pdf_path": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", - "source_quote": "classified as group from PDF heuristics" + "source_quote": "not stated in tata-aig__criti-medicare.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/tata-aig/criti-medicare__wordings.pdf", "completeness_pct": 14, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } } \ No newline at end of file diff --git a/40-data/policy_facts/tata-aig__medicare-lite.json b/40-data/policy_facts/tata-aig__medicare-lite.json index b4097259e72183157fdffe0265004f412d4672ea..928a874e21fa00ac785a699046e3add0a0b2625a 100644 --- a/40-data/policy_facts/tata-aig__medicare-lite.json +++ b/40-data/policy_facts/tata-aig__medicare-lite.json @@ -5,90 +5,102 @@ "uin_code": { "value": "TATHLIP24132V012324", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "• TATA AIG MediCare LITE UIN: TATHLIP24132V012324 Page 1 of 7 TATA AIG MediCare LITE Sr. No. Title Description Policy Clause No. 6. Exclusions Standard Exclusion: V. Any existing disease mentioned as " + "source_quote": "TATA AIG MediCare LITE UIN: TATHLIP24132V012324", + "_confidence": "high" }, "min_entry_age": { "value": null, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "Min entry age not found" + "source_quote": "not stated in tata-aig__medicare-lite.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "Max renewal age not specified; check Policy Schedule" + "source_quote": "not stated in tata-aig__medicare-lite.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "not stated in tata-aig__medicare-lite.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "Default IRDAI 30-day waiting period applies (not explicitly quoted in extracted snippet)" + "source_quote": "7. Waiting Period I. Initial Waiting Period of 30 days. 8. i. Financial limits of coverage", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "Periods of 24 months for Specified Disease/Procedure III. Pre-existing disease Waiting Section (3) Period 36 months The Policy will pay only up to the limits specified hereunder", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": 36, + "value": 24, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "ection (3) Period of 30 days. Specified Disease/Procedure Period 36 months 8. i. Financial limits of The Policy will pay only up to the limits specified hereunder for the following diseases/procedures" + "source_quote": "Periods of 24 months for Specified Disease/Procedure III. Pre-existing disease Waiting Section (3) Period 36 months The Policy will pay only up to the limits specified hereunder", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "not stated in tata-aig__medicare-lite.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "24 hrs. B15. Hearing Aid B2. Pre-Hospitalisation Expenses - 60 days B16. Daily Cash for choosing Shared B3. Post-Hospitalisation Expenses - 180 days Accommodation B4. Day Care Treatment B17. Daily Cas" + "source_quote": "B2. Pre-Hospitalisation Expenses - 60 days", + "_confidence": "high" }, "post_hospitalization_days": { "value": 180, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "Cash for choosing Shared B3. Post-Hospitalisation Expenses - 180 days Accommodation B4. Day Care Treatment B17. Daily Cash for Accompanying an Insured Child B5. Organ Donor B18. Second Opinion B6. Dom" + "source_quote": "B3. Post-Hospitalisation Expenses - 180 days", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 540, + "source_url": "https://www.tataaig.com/health-insurance/medicare", + "source_note": "Per insurer baseline (Tata AIG product pages state 540+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "mum up to 100% of the Sum B8. AYUSH Benefit - In-Patient or Day Care Insured. Alternatively a no claim discount of 1% can be opted. Treatment B9. Ambulance Cover B21. Wellness Services B10. Health Che" + "source_quote": "B8. AYUSH Benefit - In-Patient or Day Care Treatment", + "_confidence": "high" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "elative. XII. Maternity (Code-Excl18) VII. Provision or fitting of hearing aids, spectacles or contact lenses. Non-Medical Exclusions: VIII. Alopecia, baldness, wigs or toupees, medical supplies. I. H" + "source_quote": "XII. Maternity (Code-Excl18)", + "_confidence": "high" }, "newborn_coverage": { - "value": false, + "value": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "Newborn cover not found; typically tied to maternity option" + "source_quote": "not stated in tata-aig__medicare-lite.pdf", + "_confidence": "low" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "Organ Donor B18. Second Opinion B6. Domiciliary Treatment B20. Cumulative Bonus/No Claim Discount - 50% B7. Restore Benefit - Once during the Policy increase in Cumulative Bonus for every claim Year f" + "source_quote": "B5. Organ Donor", + "_confidence": "high" }, "no_claim_bonus_pct": { "value": 50, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "Cumulative Bonus/No Claim Discount - 50% B7. Restore Benefit - Once during the Policy incr" + "source_quote": "B20. Cumulative Bonus/No Claim Discount - 50%", + "_confidence": "high" }, "restoration_benefit": { "value": "Restore Benefit - Once during the Policy", @@ -101,19 +113,22 @@ "source_quote": "Single private room" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in tata-aig__medicare-lite.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "No base deductible (or only optional voluntary deductible add-on)" + "source_quote": "not stated in tata-aig__medicare-lite.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 12000, + "source_url": "https://www.tataaig.com/", + "source_note": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -123,17 +138,21 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in tata-aig__medicare-lite.pdf", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "source_quote": "not stated in tata-aig__medicare-lite.pdf", + "_confidence": "low" }, "policy_type": { - "value": "indemnity", + "value": "both_indemnity_and_benefit", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "r>> 3. Type of Insurance Both indemnity & benefit 4. Sum Insured (Basis) <> As per Sum Insured mentioned in Policy Schedule . (Along with amount) 5. Policy Coverage B1. In-Patient" + "source_quote": "3. Type of Insurance Both indemnity & benefit", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-14", diff --git a/40-data/policy_facts/tata-aig__medicare-lite__cis.json b/40-data/policy_facts/tata-aig__medicare-lite__cis.json index be18ca88d67ebb62ce49ee2f7bcd9e3ce8f19701..8ecc9ebb8981f5f3b92f36c90c5060f67b415085 100644 --- a/40-data/policy_facts/tata-aig__medicare-lite__cis.json +++ b/40-data/policy_facts/tata-aig__medicare-lite__cis.json @@ -7,132 +7,237 @@ "value": "TATHLIP24132V012324", "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "TATA AIG MediCare LITE UIN: TATHLIP24132V012324", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Free Look Period: The insured person shall be provided a Free Look Period of thirty days beginning from the date of receipt of the Policy Document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "7. Waiting Period I. Initial Waiting Period of 30 days. 8. i. Financial limits of coverage", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Periods of 24 months for Specified Disease/Procedure III. Pre-existing disease Waiting Section (3) Period 36 months The Policy will pay only up to the limits specified hereunder", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Periods of 24 months for Specified Disease/Procedure III. Pre-existing disease Waiting Section (3) Period 36 months The Policy will pay only up to the limits specified hereunder", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 180, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.tataaig.com/health-insurance/medicare", + "source_note": "Per insurer baseline (Tata AIG product pages state 540+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12000, + "source_url": "https://www.tataaig.com/", + "source_note": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { - "value": null, - "unit": "percent", + "value": 30, + "unit": "%", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "If the Insured Person avails treatment outside Our network of “Valued Provider-Pan India”, then a Co-Payment of 30% will be applicable for each such claim resulting from admission of the Insured Person in a Hosp", + "_confidence": "medium" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "source_quote": "B8. AYUSH Benefit - In-Patient or Day Care Treatment", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "source_quote": "XII. Maternity (Code-Excl18)", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "source_quote": "B5. Organ Donor B6. Domiciliary Treatment", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "source_quote": "B7. Restore Benefit - Once during the Policy Year", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "source_quote": "B6. Domiciliary Treatment B7. Restore Benefit - Once during the Policy Year", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "source_quote": "B10. Health Checkup B11. Compassionate Travel", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "source_quote": "9. Claims/Claims Procedure Claim Procedure: For Cashless Service: Notify us at least 48 hours before the planned Hospitalisation.", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "source_quote": "B20. Cumulative Bonus/No Claim Discount - 50% increase in Cumulative Bonus for every claim free year. Maximum up to 100% of the Sum Insured.", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "source_quote": "not stated in tata-aig__medicare-lite__cis.pdf", + "_confidence": "low" + }, + "room_rent_capping": { + "value": "Room category: Up to Single private room", + "unit": "text", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "source_quote": "Room category: Up to Single private room.", + "_confidence": "high" + }, + "no_claim_bonus_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/tata-aig/medicare-lite__cis.pdf", + "source_quote": "B20. Cumulative Bonus/No Claim Discount - 50% increase in Cumulative Bonus for every claim free year. Maximum up to 100% of the Sum Insured.", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/tata-aig__medicare-premier.json b/40-data/policy_facts/tata-aig__medicare-premier.json index 0a5e5d2007bc4199ea864bdc0843d97be56eccfd..8d203b15b90a0c9d9fdf701041685b1fb3a9faa7 100644 --- a/40-data/policy_facts/tata-aig__medicare-premier.json +++ b/40-data/policy_facts/tata-aig__medicare-premier.json @@ -8,32 +8,31 @@ "source_quote": "IRDA of India Registration No.:108 • CIN: U85110MH2000PLC128425 • UIN: TATHLIP21257V022021" }, "min_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "Newborn baby (aged upto 90 days); dependent child entry standard 91 days" + "source_quote": "not stated in tata-aig__medicare-premier.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "Adult entry per Policy Schedule (Tata AIG MediCare Premier brochure: 18-65 years)" - }, - "max_renewal_age": { "value": null, + "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "Lifelong renewability" + "source_quote": "not stated in tata-aig__medicare-premier.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "Sum Insured options per Policy Schedule (MediCare Premier: 5L/7.5L/10L/15L/20L/25L/30L/50L/1Cr)" + "source_quote": "not stated in tata-aig__medicare-premier.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { - "value": 30, + "value": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "30-day waiting period for illness (standard IRDAI Excl03)" + "source_quote": "not stated in tata-aig__medicare-premier.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { "value": 24, @@ -43,7 +42,8 @@ "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "Specified Disease/Procedure Waiting Period (Code-Excl02): Expenses ... shall be excluded until the expiry of 24 months of continuous coverage" + "source_quote": "a. Expenses related to the treatment of the listed C o n d i t i o n s , s u r g e r i e s / treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident.", + "_confidence": "high" }, "maternity_waiting_months": { "value": 48, @@ -51,24 +51,29 @@ "source_quote": "B21. Maternity Cover We will cover for Maternity Expenses upto a maximum of Rs. 50,000/- per policy subject to a waiting period of 4 years of continuous coverage" }, "pre_hospitalization_days": { - "value": 60, + "value": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "B2. Pre-Hospitalization expenses We will cover for expenses for Pre-Hospitalization consultations, investigations and medicines incurred upto 60 days before the date of admission" + "source_quote": "not stated in tata-aig__medicare-premier.pdf", + "_confidence": "low" }, "post_hospitalization_days": { - "value": 90, + "value": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "B3. Post-Hospitalization expenses ... incurred upto 90 days after discharge from the hospital." + "source_quote": "not stated in tata-aig__medicare-premier.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "B4. Day Care Procedures ... The list of such day care procedures covered is available on our website (www.tataaig.com)" + "value": 540, + "source_url": "https://www.tataaig.com/health-insurance/medicare", + "source_note": "Per insurer baseline (Tata AIG product pages state 540+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "qualified registered AYUSH Medical Practitioner (AYUSH coverage standard inclusion)" + "source_quote": "B8. AYUSH Benefit We will cover for expenses incurred for treatment as in-patient in an Ayush Hospital.", + "_confidence": "high" }, "maternity_coverage": { "value": true, @@ -83,12 +88,14 @@ "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "Organ Donor Expenses (standard inclusion in Tata AIG MediCare Premier)" + "source_quote": "B5. Organ Donor We will cover for Medical and surgical Expenses of the organ donor for harvesting the organ where an Insured Person is the recipient provided that:", + "_confidence": "high" }, "no_claim_bonus_pct": { - "value": null, + "value": 50, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "Cumulative Bonus accrued ... The maximum cumulative bonus shall not exceed 100% of the Sum Insured in any Policy Year (rate per claim-free year per Policy Schedule, typically 50%)" + "source_quote": "50% cumulative bonus will be applied on the Sum Insured for next policy year under the Policy after every claim free Policy Year, provided that the Policy is renewed with Us and without a break. The maximum cumulative bonus shall not exceed 100% of the Sum Insured in any Policy Year.", + "_confidence": "high" }, "restoration_benefit": { "value": "Restore Benefit: automatic restoration of Basic Sum Insured upon exhaustion, once per policy period", @@ -96,49 +103,76 @@ "source_quote": "B7. Restore benefits We will automatically restore the Basic Sum Insured upon exhaustion of the Sum Insured and accrued Cumulative Bonus, during the policy period. This benefit can be availed once during the policy period" }, "room_rent_capping": { - "value": "Per Policy Schedule (Single Private AC Room or higher; voluntary copay for higher category)", + "value": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "Room Rent means the amount charged (per Policy Schedule entitlement)" + "source_quote": "not stated in tata-aig__medicare-premier.pdf", + "_confidence": "low" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "No mandatory base copay (voluntary copay add-on)" + "source_quote": "not stated in tata-aig__medicare-premier.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible" + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "not stated in tata-aig__medicare-premier.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; Tata AIG advertises 7,200+ network hospitals" + "value": 12000, + "source_url": "https://www.tataaig.com/", + "source_note": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { - "value": true, + "value": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "Cashless facility through Network Provider (standard)" + "source_quote": "not stated in tata-aig__medicare-premier.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric; not extracted" + "source_quote": "not stated in tata-aig__medicare-premier.pdf", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "not stated in tata-aig__medicare-premier.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "Indemnity-based comprehensive plan" + "source_quote": "Preamble While the policy is in force, if the Insured Person contracts any disease or suffers from any illness or sustains bodily injury through accident and if such event requires the insured Person to incur expenses for Medically Necessary Treatment, We will indemnify You", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", "completeness_pct": 85, - "notes": "Tata AIG MediCare Premier: 24-month PED, maternity ₹50K (₹60K girl child) with 4-year waiting, restore benefit once per policy period." + "notes": "Tata AIG MediCare Premier: 24-month PED, maternity ₹50K (₹60K girl child) with 4-year waiting, restore benefit once per policy period. | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "ambulance_cover", + "domiciliary_treatment" + ] + }, + "ambulance_cover": { + "value": true, + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "B9. Ambulance Cover We will cover for expenses incurred on transportation of Insured Person in a registered ambulance to a Hospital for admission in case of an Emergency or from one hospital to another hospital for better medical facilities and treatment, subject to Rs. 5000 per Hospitalization.", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "B6. Domiciliary Treatment We will cover for expenses related to Domiciliary Hospitalization of the insured person if the treatment exceeds beyond three days. The treatment must be for management of an illness and not for enteral feedings or end of life care.", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/tata-aig__medicare-premier__cis.json b/40-data/policy_facts/tata-aig__medicare-premier__cis.json index 8bbbe447b71398d4623d71eca94eea28d44627bf..8bd71af992935250dca5af1fe1934aa074bf0120 100644 --- a/40-data/policy_facts/tata-aig__medicare-premier__cis.json +++ b/40-data/policy_facts/tata-aig__medicare-premier__cis.json @@ -7,138 +7,244 @@ "value": "TATHLIP26052V052526", "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "TATA AIG MediCare Premier UIN: TATHLIP26052V052526", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 5000000, - 7500000, - 10000000, - 20000000, - 30000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" }, "grace_period": { - "value": 30, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Free Look Period: The Insured Person shall be provided a free look period of thirty days beginning from the date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "7. Waiting Period I. Initial Waiting Period of 30 days. Specified Disease/Procedure. 8. i. Financial limits of coverage", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "for III. Pre-Existing disease Waiting Section (3) Period 24 months. The Policy will pay only up to the limits specified hereunder for the following diseases/procedures.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "for III. Pre-Existing disease Waiting Section (3) Period 24 months. The Policy will pay only up to the limits specified hereunder for the following diseases/procedures.", + "_confidence": "high" }, "maternity_waiting_months": { - "value": 36, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "B2. Pre-Hospitalisation Expenses - 60 days B3. Post-Hospitalisation Expenses - Up to 200 days", + "_confidence": "high" }, "post_hospitalization_days": { "value": 200, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "B2. Pre-Hospitalisation Expenses - 60 days B3. Post-Hospitalisation Expenses - Up to 200 days", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.tataaig.com/health-insurance/medicare", + "source_note": "Per insurer baseline (Tata AIG product pages state 540+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12000, + "source_url": "https://www.tataaig.com/", + "source_note": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" }, "policy_term_options_years": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_quote": "year B8. AYUSH Benefit - In-Patient or Day Care Treatment B9. Ambulance Cover B10. Health Checkup B11. Compassionate Travel B12. Consumables Benefit", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_quote": "nion B21. Maternity Cover - Maternity Expenses after Section (2) 3 years of continuous coverage B22. Delivery Complications Cover B23. First Year Vaccinations", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_quote": "rage B22. Delivery Complications Cover B23. First Year Vaccinations B24. Prolonged Hospitalisation Benefit B25. High End Diagnostics B26. OPD Treatment", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_quote": "dures B5. Organ Donor B6. Domiciliary Treatment B7. Restore Benefit - Once during the Policy year B8. AYUSH Benefit - In-Patient or Day Care Treatment", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_quote": "tment B7. Restore Benefit - Once during the Policy year B8. AYUSH Benefit - In-Patient or Day Care Treatment B9. Ambulance Cover B10. Health Checkup", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_quote": "Donor B6. Domiciliary Treatment B7. Restore Benefit - Once during the Policy year B8. AYUSH Benefit - In-Patient or Day Care Treatment B9. Ambulance Cover", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_quote": "over B10. Health Checkup B11. Compassionate Travel B12. Consumables Benefit B13. Global Cover for Planned Hospitalisation", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_quote": "year B8. AYUSH Benefit - In-Patient or Day Care Treatment B9. Ambulance Cover B10. Health Checkup B11. Compassionate Travel B12. Consumables Benefit", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_quote": "9. Claims/Claims Procedure Claim Procedure: For Cashless Service: Notify us at least 48 hours before the planned Hospitalisation.", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_quote": "B30. No Claim Bonus - For every claim free year: i. Cumulative Bonus: 50% of the base Sum Insured of the expiring Policy, maximum", + "_confidence": "medium" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": null, + "unit": "enum", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_quote": "not stated in tata-aig__medicare-premier__cis.pdf", + "_confidence": "low" + }, + "no_claim_bonus_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__cis.pdf", + "source_quote": "B30. No Claim Bonus - For every claim free year: i. Cumulative Bonus: 50% of the base Sum Insured of the expiring Policy, maximum", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/tata-aig__medicare-premier__wordings.json b/40-data/policy_facts/tata-aig__medicare-premier__wordings.json index a5b7379a4b7a778180c2444e18bdf08eae48349e..2f48c0433b21b63faf50ba7ac43703df6290bc7b 100644 --- a/40-data/policy_facts/tata-aig__medicare-premier__wordings.json +++ b/40-data/policy_facts/tata-aig__medicare-premier__wordings.json @@ -4,141 +4,251 @@ "insurer_slug": "tata-aig", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", "uin_code": { - "value": "TATHLIP26052V052526", + "value": "TATHLIP21257V022021", "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "IRDA of India Registration No.:108 • CIN: U85110MH2000PLC128425 • UIN: TATHLIP21257V022021", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-premier__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-premier__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-premier__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 5000000, - 7500000, - 10000000, - 20000000, - 30000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-premier__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of fifteen days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not accep", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "iii. 30 Days Waiting Period (Code-Excl03): a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "i. Pre-existing Diseases Waiting Period (Code-Excl01) a. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "related to the treatment of the listed C o n d i t i o n s , s u r g e r i e s / treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident.", + "_confidence": "medium" }, "maternity_waiting_months": { - "value": 36, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare-premier__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "We will cover for expenses for Pre- H o s p i t a l i z a t i o n c o n s u l t a t i o n s , investigations and medicines incurred upto 60 days before the date of admission to the hospital.", + "_confidence": "high" }, "post_hospitalization_days": { - "value": 200, + "value": 90, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "B3. Post-Hospitalization expenses We will cover for expenses for Post- H o s p i t a l i z a t i o n c o n s u l t a t i o n s , investigations and medicines incurred upto 90 days after discharge from the hospital.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.tataaig.com/health-insurance/medicare", + "source_note": "Per insurer baseline (Tata AIG product pages state 540+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12000, + "source_url": "https://www.tataaig.com/", + "source_note": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-premier__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-premier__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "premium for the policy period shall be paid before the policy commencement date with an option of policy tenure 1/2/3 years", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-premier__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-premier__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-premier__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "B8. AYUSH Benefit We will cover for expenses incurred for treatment as in-patient in an Ayush Hospital.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "B21. Maternity Cover We will cover for Maternity Expenses upto a maximum of Rs. 50,000/- per policy subject to a waiting period of 4 years of continuous coverage under this policy subject to IRDAI portability guidelines.", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "B22. New Born Baby Cover We will cover for medical expenses incurred for the medically necessary treatment of the new born baby upto Rs.10,000/- for complications related to delivery if claim is admitted under the maternity benefit (B21).", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "B5. Organ Donor We will cover for Medical and surgical Expenses of the organ donor for harvesting the organ where an Insured Person is the recipient provided that:", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "B7. Restore benefits We will automatically restore the Basic Sum Insured upon exhaustion of the Sum Insured and accrued Cumulative Bonus, during the policy period. This benefit can be availed once during the policy period", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "B6. Domiciliary Treatment We will cover for expenses related to Domiciliary Hospitalization of the insured person if the treatment exceeds beyond three days. The treatment must be for management of an illness and not for enteral feedings or end of life care.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "B13. Global Cover We will cover for Medical Expenses of the Insured Person incurred outside India, upto the sum insured, provided that the diagnosis was made in India and the insured travels abroad for treatment.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "B10. Health Checkup We will cover for expenses for a Preventive Health Check-up upto 1% of sum insured subject to a maximum of Rs. 10,000/- per policy.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "4. Cashless facility Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insur", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "The maximum cumulative bonus shall not exceed 100% of the Sum Insured in any Policy Year.", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "not stated in tata-aig__medicare-premier__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "The expenses must be incurred within India and shall not exceed Rs. 20,000 during a policy year.", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "In case of family floater policy, the sum insured for all or any of the benefits shall be on a per policy per year basis unless explicitly stated to the contrary.", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/tata-aig/medicare-premier__wordings.pdf", + "source_quote": "B30. Cumulative Bonus i. 50% cumulative bonus will be applied on the Sum Insured for next policy year under the Policy after every claim free Policy Year, provided that the Policy is renewed with Us and without a break.", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/tata-aig__medicare-select.json b/40-data/policy_facts/tata-aig__medicare-select.json index 390b2b2ad69cc50c52f0c2848d4ab281d0661673..21827fb500a5ea27706e5dc6b89bbc288876a13e 100644 --- a/40-data/policy_facts/tata-aig__medicare-select.json +++ b/40-data/policy_facts/tata-aig__medicare-select.json @@ -14,21 +14,30 @@ "source_quote": "uitability Entry Age: Minimum Child- 0 days Dependent children between 0 days and 5 years can be insured only when both parents are getting insured. Adult- 18 years Entry Age: Maximum Child- 25 years " }, "max_entry_age": { - "value": null, + "value": 25, "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "Max entry age not explicitly stated; check Policy Schedule" - }, - "max_renewal_age": { - "value": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "Lifelong renewability: it Cover Ceasing age There is no maximum cover ceasing age under this policy. Policy Term 1 Year/ 2 Years/ 3 Years Coverage Options Individual/Family floater Age of Proposer 18 years or above Relation" + "source_quote": "are getting insured. Adult- 18 years Entry Age: Maximum Child- 25 years Adult- No limit Cover Ceasing age There is no maximum co", + "_confidence": "high" }, "sum_insured_options": { - "value": null, + "value": [ + 500000, + 750000, + 1000000, + 1500000, + 2000000, + 2500000, + 5000000, + 7500000, + 10000000, + 20000000, + 30000000 + ], "unit": "INR", "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "Sum Insured options not enumerated in extracted text; check Policy Schedule" + "source_quote": "Suitability 1. Sum Insured options (in ₹) : • 15 Lacs • 20 Lacs • 25 Lacs • 5 Lacs • 7.5 Lacs • 10 Lacs 2. Zone(s)", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, @@ -36,34 +45,41 @@ "source_quote": "Gastric bypass surgeries iii. 30 Days Waiting Period (Code- Excl 03): a. Expenses related to the treatment of any Illness within 30 days from the first Policy commencement date shall be excluded excep" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "PED waiting period not extracted; check Section 5 / Excl01" + "source_quote": "Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first Policy with Us.", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "Default IRDAI 24-month specific-disease waiting (not explicitly quoted)" + "source_quote": "Specified Disease/Procedure Waiting Period (Code- Excl02): a. Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date o", + "_confidence": "medium" }, "maternity_waiting_months": { - "value": null, + "value": 24, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "Maternity waiting not specified or maternity excluded" + "source_quote": "Maternity Care : We will cover Maternity Expenses, Delivery Complications of a New Born Baby and First year Vaccinations of the New Born Baby, subject to a waiting period of 2 years of continuous coverage of the insured person(s) under this cover with Us.", + "_confidence": "high" }, "pre_hospitalization_days": { - "value": null, + "value": 90, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "Pre-hospitalization days not extracted" + "source_quote": "Pre-Hospitalization expenses: Covers Medical Expenses incurred upto 90 days prior to the date of admission to the Hospital.", + "_confidence": "high" }, "post_hospitalization_days": { - "value": null, + "value": 90, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "Post-hospitalization days not extracted" + "source_quote": "Post-Hospitalization expenses: Covers Medical Expenses incurred upto 90 days immediately after the Insured Person was discharged post Hospitalisation.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "Day-care count not enumerated; covered per policy definition" + "value": 540, + "source_url": "https://www.tataaig.com/health-insurance/medicare", + "source_note": "Per insurer baseline (Tata AIG product pages state 540+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf" }, "ayush_coverage": { "value": true, @@ -71,9 +87,10 @@ "source_quote": "dings or end of life care. g. AYUSH Benefit: Covers medical Expenses incurred for In-patient/Day care treatment taken in an AYUSH hospital/AYUSH day care centre, including pre and post hospitalization" }, "maternity_coverage": { - "value": false, + "value": true, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "Maternity not explicitly mentioned; presumed excluded in base" + "source_quote": "b. Maternity Care : We will cover Maternity Expenses, Delivery Complications of a New Born Baby and First year Vaccinations of the New Born Baby, subject to a waiting period of 2 years of continuous coverage of the insured person(s) under this cover with Us.", + "_confidence": "high" }, "newborn_coverage": { "value": true, @@ -101,19 +118,22 @@ "source_quote": "Single Private Room" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "No mandatory copay extracted; product may have age-based or zone-based optional copay" + "source_quote": "not stated in tata-aig__medicare-select.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "Aggregate Deductible : Our liability under this Policy shall be subject to Aggregate Deductible as" + "source_quote": "not stated in tata-aig__medicare-select.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric; not extracted in this curation pass" + "value": 12000, + "source_url": "https://www.tataaig.com/", + "source_note": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, @@ -123,12 +143,15 @@ "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric (IRDAI Annual Report); not extracted" + "source_quote": "not stated in tata-aig__medicare-select.pdf", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT not specified in policy wording; governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "source_quote": "not stated in tata-aig__medicare-select.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", diff --git a/40-data/policy_facts/tata-aig__medicare-select__brochure.json b/40-data/policy_facts/tata-aig__medicare-select__brochure.json index 7bee9d0b8cb43ae72d346906f21d1c0519774122..de7c4a35950f23970b541e6ddd31df6a36fb88fb 100644 --- a/40-data/policy_facts/tata-aig__medicare-select__brochure.json +++ b/40-data/policy_facts/tata-aig__medicare-select__brochure.json @@ -7,31 +7,29 @@ "value": "TATHLIP25051V012425", "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "TATA AIG MediCare Select UIN: TATHLIP25051V012425", + "_confidence": "high" }, "min_entry_age": { "value": 18, "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "1. Suitability Entry Age: Minimum Child- 0 days Dependent children between 0 days and 5 years can be insured only when both parents are getting insured. Adult- 18 years", + "_confidence": "high" }, "max_entry_age": { - "value": null, - "unit": "years", - "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, + "value": 25, "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "are getting insured. Adult- 18 years Entry Age: Maximum Child- 25 years Adult- No limit Cover Ceasing age There is no maximum co", + "_confidence": "high" }, "min_child_entry_age": { "value": 0, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "1. Suitability Entry Age: Minimum Child- 0 days Dependent children between 0 days and 5 years can be insured only when both parents are getting insured. Adult- 18 years", + "_confidence": "high" }, "sum_insured_options": { "value": [ @@ -49,102 +47,213 @@ ], "unit": "INR", "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "Suitability 1. Sum Insured options (in ₹) : • 15 Lacs • 20 Lacs • 25 Lacs • 5 Lacs • 7.5 Lacs • 10 Lacs 2. Zone(s)", + "_confidence": "high" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "At the end of the policy period - the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.", + "_confidence": "high" }, "free_look_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "9. Free Look Period: The insured person shall be provided a free look period of thirty days beginning from the date of receipt of the policy document", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "iii. 30 Days Waiting Period (Code- Excl 03): a. Expenses related to the treatment of any Illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 36, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first Policy with Us.", + "_confidence": "high" }, "specific_disease_waiting_months": { - "value": null, + "value": 24, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy with Us.", + "_confidence": "high" }, "maternity_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "subject to a waiting period of 2 years of continuous coverage of the insured person(s) under this cover with Us.", + "_confidence": "high" }, "pre_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "b. Pre-Hospitalization expenses: Covers Medical Expenses incurred upto 90 days prior to the date of admission to the Hospital.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "c. Post-Hospitalization expenses: Covers Medical Expenses incurred upto 90 days immediately after the Insured Person was discharged post Hospitalisation.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.tataaig.com/health-insurance/medicare", + "source_note": "Per insurer baseline (Tata AIG product pages state 540+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12000, + "source_url": "https://www.tataaig.com/", + "source_note": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-select__brochure.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-select__brochure.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "Cover Ceasing age There is no maximum cover ceasing age under this policy. Policy Term 1 Year/ 2 Years/ 3 Years Coverage Options Individual/Family floater Age of Proposer 18 years or above", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-select__brochure.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-select__brochure.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare-select__brochure.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "source_quote": "g. AYUSH Benefit: Covers medical Expenses incurred for In-patient/Day care treatment taken in an AYUSH hospital/AYUSH day care centre, including pre and post hospitalization expenses.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "source_quote": "b. Maternity Care : We will cover Maternity Expenses, Delivery Complications of a New Born Baby and First year Vaccinations of the New Born Baby, subject to a waiting period of 2 years of continuous coverage of the insured person(s) under this cover with Us.", + "_confidence": "high" + }, + "newborn_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "source_quote": "b. Maternity Care : We will cover Maternity Expenses, Delivery Complications of a New Born Baby and First year Vaccinations of the New Born Baby, subject to a waiting period of 2 years of continuous coverage of the insured person(s) under this cover with Us.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "source_quote": "e. Organ Donor: Covers Medical Expenses incurred by or in respect of the organ donor, for an organ transplant Surgery, solely towards the harvesting of the organ donated. The insured person must be the recipient of the organ so donated by the organ donor.", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "source_quote": "d. Restore Infinity Plus: We will provide reinstatement of the base sum insured, if the Sum Insured and Cumulative Bonus (if accrued) is insufficient to pay an admissible Hospitalization claim in the Policy.", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "source_quote": "f. Domiciliary Treatment: Covers Medical Expenses related to Domiciliary Hospitalization of the", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "source_quote": "d. Procedure for availing cashless facility: • For any emergency Hospitalisation, our TPA/We must be informed within 24 hours after hospitalization.", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "source_quote": "1) Cumulative Bonus: If you choose Cumulative Bonus, 50% Cumulative Bonus will be applied on the Sum Insured for every claim free policy year subject to maximum of 100% of the sum insured.", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "source_quote": "not stated in tata-aig__medicare-select__brochure.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "source_quote": "This Policy only covers claims incurred within India, and payments under this Policy shall only be made in Indian Rupees within India.", + "_confidence": "high" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "source_quote": "Policy Term 1 Year/ 2 Years/ 3 Years Coverage Options Individual/Family floater Age of Proposer 18 years or above", + "_confidence": "high" + }, + "room_rent_capping": { + "value": null, + "unit": "text", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "source_quote": "not stated in tata-aig__medicare-select.pdf", + "_confidence": "low" + }, + "no_claim_bonus_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/tata-aig/medicare-select__brochure.pdf", + "source_quote": "1) Cumulative Bonus: If you choose Cumulative Bonus, 50% Cumulative Bonus will be applied on the Sum Insured for every claim free policy year subject to maximum of 100% of the sum insured.", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/tata-aig__medicare.json b/40-data/policy_facts/tata-aig__medicare.json index 69ac9632cee15a25fa0f90e5a9447fcfcef97a26..cc2337691f5107400e4faf7ba9bde33a0ebd1486 100644 --- a/40-data/policy_facts/tata-aig__medicare.json +++ b/40-data/policy_facts/tata-aig__medicare.json @@ -8,32 +8,31 @@ "source_quote": "IRDA of India Registration No.:108 • CIN: U85110MH2000PLC128425 • UIN: TATHLIP21224V022021" }, "min_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Dependent child entry standard 91 days (per Policy Schedule)" + "source_quote": "not stated in tata-aig__medicare.pdf", + "_confidence": "low" }, "max_entry_age": { - "value": 65, - "unit": "years", - "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Adult entry per Policy Schedule (Tata AIG MediCare brochure: 18-65 years)" - }, - "max_renewal_age": { "value": null, + "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Lifelong renewability" + "source_quote": "not stated in tata-aig__medicare.pdf", + "_confidence": "low" }, "sum_insured_options": { "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Sum Insured options per Policy Schedule (MediCare: 3L/5L/7.5L/10L/15L/20L/25L)" + "source_quote": "not stated in tata-aig__medicare.pdf", + "_confidence": "low" }, "initial_waiting_period_days": { "value": 30, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "30-day waiting period for illness (standard IRDAI Excl03)" + "source_quote": "iii. 30 Days Waiting Period(Code- Excl 03): a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, @@ -43,52 +42,63 @@ "specific_disease_waiting_months": { "value": 24, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Specified Disease/Procedure Waiting Period (Code- Excl 02): ... excluded until the expiry of 24 months of continuous coverage" + "source_quote": "shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident.", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Maternity not a base benefit of MediCare (base variant); upgrade to MediCare Premier (TATHLIP21257) for maternity inclusion" + "source_quote": "not stated in tata-aig__medicare.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Pre-Hospitalization expenses ... incurred upto 60 days before the date of admission" + "source_quote": "B2. Pre-Hospitalization expenses We will cover for expenses for Pre- H o s p i t a l i z a t i o n c o n s u l t a t i o n s , investigations and medicines incurred upto 60 days before the date of admission to the hospital. The benefit is payable if We have admitted a claim under B1 or B4 or B6.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Post-Hospitalization expenses ... incurred upto 90 days after discharge from the hospital." + "source_quote": "B3. Post-Hospitalization expenses We will cover for expenses for Post- H o s p i t a l i z a t i o n c o n s u l t a t i o n s , investigations and medicines incurred upto", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Day Care Procedures ... list of such day care procedures covered is available on our website (www.tataaig.com)" + "value": 540, + "source_url": "https://www.tataaig.com/health-insurance/medicare", + "source_note": "Per insurer baseline (Tata AIG product pages state 540+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf" }, "ayush_coverage": { "value": true, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "AYUSH Medical Practitioner referenced (AYUSH treatment covered)" + "source_quote": "B8. AYUSH Benefit We will cover for expenses incurred for treatment as in-patient in AYUSH Hospital.", + "_confidence": "high" }, "maternity_coverage": { "value": false, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Maternity not a base benefit of MediCare (excluded as per standard IRDAI Excl18; MediCare Premier variant includes maternity)" + "source_quote": "xii. Maternity (Code - Excl 18): a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; b. Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.", + "_confidence": "high" }, "newborn_coverage": { "value": false, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Maternity excluded; newborn cover linked to maternity" + "source_quote": "xii. Maternity (Code - Excl 18): a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; b. Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.", + "_confidence": "high" }, "organ_donor_expenses": { "value": true, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Organ Donor expenses covered (standard inclusion)" + "source_quote": "B5. Organ Donor We will cover for Medical and surgical Expenses of the organ donor for harvesting the organ where an Insured Person is the recipient provided that:", + "_confidence": "high" }, "no_claim_bonus_pct": { - "value": null, + "value": 50, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Cumulative Bonus available (rate per claim-free year per Policy Schedule; max 100% of Sum Insured)" + "source_quote": "50% cumulative bonus will be applied on the Sum Insured for next policy year under the Policy after every claim free Policy Year, provided that the Policy is renewed with Us and without a break. The maximum cumulative bonus shall not exceed 100% of the Sum Insured in any Policy Year.", + "_confidence": "high" }, "restoration_benefit": { "value": "Restore Benefit: automatic restoration of Basic Sum Insured upon exhaustion, once per policy period", @@ -96,49 +106,67 @@ "source_quote": "B7. Restore benefits We will automatically restore the Basic Sum Insured upon exhaustion of the Sum Insured and accrued Cumulative Bonus" }, "room_rent_capping": { - "value": "Per Policy Schedule (Single Private Room category typical)", + "value": "Room Rent means the amount charged by a Hospital towards Room and Boarding expenses and shall include the associated medical expenses (per Policy Schedule entitlement)", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Room Rent ... amount charged (per Policy Schedule entitlement)" + "source_quote": "35. Room Rent Room Rent means the amount charged by a Hospital towards Room and Boarding expenses and shall include the associated medical expenses.", + "_confidence": "high" }, "copayment_pct": { - "value": 0, + "value": null, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "No mandatory base copay" + "source_quote": "not stated in tata-aig__medicare.pdf", + "_confidence": "low" }, "deductible_amount": { "value": null, - "source_pdf_path": null, - "source_quote": "No base deductible" + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "not stated in tata-aig__medicare.pdf", + "_confidence": "low" }, "network_hospital_count": { - "value": null, - "source_url": null, - "source_quote": "Insurer-level metric (Tata AIG 7,200+)" + "value": 12000, + "source_url": "https://www.tataaig.com/", + "source_note": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "_confidence": "high" }, "cashless_treatment_supported": { "value": true, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Cashless facility through Network Provider" + "source_quote": "3. Procedure for Cashless Service i. Cashless Service is only available at Network Hospitals.", + "_confidence": "high" }, "claim_settlement_ratio": { "value": null, "source_url": null, - "source_quote": "Insurer-level metric; not extracted" + "source_quote": "not stated in tata-aig__medicare.pdf", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, - "source_pdf_path": null, - "source_quote": "TAT governed by IRDAI Master Circular" + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "not stated in tata-aig__medicare.pdf", + "_confidence": "low" }, "policy_type": { "value": "indemnity", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "Indemnity-based base health plan" + "source_quote": "Preamble While the policy is in force, if the Insured Person contracts any disease or suffers from any illness or sustains bodily injury through accident and if such event requires the insured Person to incur expenses for Medically Necessary Treatment, We will indemnify You for the amount of such Reasonable and Customary Charges", + "_confidence": "high" }, "_meta": { "curated_at": "2026-05-13", "primary_source_pdf": "rag/corpus/tata-aig/medicare__wordings.pdf", "completeness_pct": 78, - "notes": "Tata AIG MediCare (base variant): 36-month PED, no maternity (upgrade to MediCare Premier for maternity)." + "notes": "Tata AIG MediCare (base variant): 36-month PED, no maternity (upgrade to MediCare Premier for maternity). | Batch 3 (2026-05-15): coverage breadth fields backfilled.", + "batch3_added_fields": [ + "domiciliary_treatment" + ] + }, + "domiciliary_treatment": { + "value": true, + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "Domiciliary Hospitalization A day care centre means any institution established for day care treatment of illness Domici", + "extraction_method": "tools/curate_batch3.py — pattern-grep over pdfplumber text" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/tata-aig__medicare__wordings.json b/40-data/policy_facts/tata-aig__medicare__wordings.json index e49fde9a9aae63af872cb4a56d1d7ff2a86ed916..971ee2d4478eae0e874335eabe1f063b7521064f 100644 --- a/40-data/policy_facts/tata-aig__medicare__wordings.json +++ b/40-data/policy_facts/tata-aig__medicare__wordings.json @@ -7,138 +7,248 @@ "value": "TATHLIP21224V022021", "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "IRDA of India Registration No.:108 • CIN: U85110MH2000PLC128425 • UIN: TATHLIP21224V022021", + "_confidence": "high" }, "min_entry_age": { - "value": 18, + "value": null, "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare__wordings.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" - }, - "max_renewal_age": { - "value": 999, - "unit": "years", - "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare__wordings.pdf", + "_confidence": "low" }, "min_child_entry_age": { - "value": 91, + "value": null, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare__wordings.pdf", + "_confidence": "low" }, "sum_insured_options": { - "value": [ - 500000, - 1000000, - 2000000, - 5000000, - 10000000 - ], + "value": null, "unit": "INR", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare__wordings.pdf", + "_confidence": "low" }, "grace_period": { "value": 30, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.", + "_confidence": "high" }, "free_look_period": { - "value": 30, + "value": 15, "unit": "days", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "The insured person shall be allowed free look period of fifteen days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not accep", + "_confidence": "high" }, "initial_waiting_period_days": { "value": 30, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "iii. 30 Days Waiting Period(Code- Excl 03): a. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.", + "_confidence": "high" }, "pre_existing_disease_waiting_months": { "value": 36, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "i. Pre-existing Diseases Waiting Period (Code- Excl 01) a. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverag", + "_confidence": "high" }, "specific_disease_waiting_months": { "value": 24, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "cl 02): a. Expenses related to the treatment of the listed C o n d i t i o n s , s u r g e r i e s / treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising du", + "_confidence": "medium" }, "maternity_waiting_months": { - "value": 36, + "value": null, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "not stated in tata-aig__medicare__wordings.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": 60, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "We will cover for expenses for Pre- H o s p i t a l i z a t i o n c o n s u l t a t i o n s , investigations and medicines incurred upto 60 days before the date of admission to the hospital.", + "_confidence": "high" }, "post_hospitalization_days": { "value": 90, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "extracted from PDF policy document by NIM DeepSeek-V4 (D-019); see source PDF for verbatim" + "source_quote": "90 days after discharge from the hospital. The benefit is payable if We have admitted a claim under B1 or B4 or B6.", + "_confidence": "high" }, "day_care_treatments_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 540, + "source_url": "https://www.tataaig.com/health-insurance/medicare", + "source_note": "Per insurer baseline (Tata AIG product pages state 540+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf" }, "network_hospital_count": { - "value": null, - "unit": null, - "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "value": 12000, + "source_url": "https://www.tataaig.com/", + "source_note": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "_confidence": "high" }, "co_payment_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare__wordings.pdf", + "_confidence": "low" }, "room_rent_capped_at_pct_of_si": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare__wordings.pdf", + "_confidence": "low" }, "policy_term_options_years": { - "value": null, + "value": [ + 1, + 2, + 3 + ], "unit": "years", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "premium for the policy period shall be paid before the policy commencement date with an option of policy tenure 1/2/3 years", + "_confidence": "high" }, "claim_settlement_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare__wordings.pdf", + "_confidence": "low" }, "incurred_claim_ratio_pct": { "value": null, "unit": "percent", "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare__wordings.pdf", + "_confidence": "low" }, "complaint_per_10k_claims": { "value": null, "unit": null, "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", - "source_quote": "not extracted from this PDF (field absent or LLM unable to infer)" + "source_quote": "not stated in tata-aig__medicare__wordings.pdf", + "_confidence": "low" + }, + "ayush_coverage": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "B8. AYUSH Benefit We will cover for expenses incurred for treatment as in-patient in AYUSH Hospital.", + "_confidence": "high" + }, + "maternity_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "xii. Maternity (Code - Excl 18): a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; b. Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.", + "_confidence": "high" + }, + "newborn_coverage": { + "value": false, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "xii. Maternity (Code - Excl 18): a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; b. Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.", + "_confidence": "high" + }, + "organ_donor_expenses": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "B5. Organ Donor We will cover for Medical and surgical Expenses of the organ donor for harvesting the organ where an Insured Person is the recipient provided that:", + "_confidence": "high" + }, + "restoration_benefit": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "B7. Restore benefits We will automatically restore the Basic Sum Insured upon exhaustion of the Sum Insured and accrued Cumulative Bonus, during the policy period. This benefit can be availed once during the policy period", + "_confidence": "high" + }, + "domiciliary_treatment": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "B6. Domiciliary Treatment We will cover for expenses related to Domiciliary Hospitalization of the insured person if the treatment exceeds beyond three days. The treatment must be for management of an illness and not for enteral feedings or end of life care.", + "_confidence": "high" + }, + "worldwide_emergency_cover": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "B13. Global Cover We will cover for Medical Expenses of the Insured Person incurred outside India, upto the sum insured, provided that the diagnosis was made in India and the insured travels abroad for treatment.", + "_confidence": "high" + }, + "preventive_health_checkup": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "B10. Health Checkup We will cover for expenses for a Preventive Health Check-up upto 1% of previous sum insured subject to a maximum of Rs. 10,000/- per policy.", + "_confidence": "high" + }, + "cashless_treatment_supported": { + "value": true, + "unit": "boolean", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "4. Cashless facility Cashless facility means a facility extended by the insurer to the insured where the", + "_confidence": "high" + }, + "no_claim_bonus_cap_pct": { + "value": 100, + "unit": "%", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "The maximum cumulative bonus shall not exceed 100% of the Sum Insured in any Policy Year.", + "_confidence": "high" + }, + "tat_cashless_authorization_hours": { + "value": null, + "unit": "hours", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "not stated in tata-aig__medicare__wordings.pdf", + "_confidence": "low" + }, + "geographic_coverage": { + "value": "pan_india", + "unit": "enum", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "The expenses must be incurred within India and shall not exceed Rs. 20,000 during a policy year.", + "_confidence": "low" + }, + "policy_type_indemnity_or_fixed": { + "value": "family_floater", + "unit": "enum", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "In case of family floater policy, the sum insured for all or any of the benefits shall be on a per policy per year basis unless explicitly stated to the contrary.", + "_confidence": "medium" + }, + "no_claim_bonus_pct": { + "value": 50, + "unit": "%", + "source_pdf_path": "rag/corpus/tata-aig/medicare__wordings.pdf", + "source_quote": "B22. Cumulative Bonus i. 50% cumulative bonus will be applied on the Sum Insured for next policy year under the Policy after every claim free Policy Year, provided that the Policy is renewed with Us and without a break.", + "_confidence": "high" } -} +} \ No newline at end of file diff --git a/40-data/policy_facts/tata-aig__wellsurance-family__cis.json b/40-data/policy_facts/tata-aig__wellsurance-family__cis.json index 9cab03b3f7fee14ad45fd7fffae82bbc533b7aa9..e1ade61a7019480e942dce00887d33e101897678 100644 --- a/40-data/policy_facts/tata-aig__wellsurance-family__cis.json +++ b/40-data/policy_facts/tata-aig__wellsurance-family__cis.json @@ -10,112 +10,132 @@ "min_entry_age": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__wellsurance-family__cis.pdf", + "_confidence": "low" }, "max_entry_age": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" - }, - "max_renewal_age": { - "value": 99, - "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "life-long renewable, subject to application for renew" + "source_quote": "not stated in tata-aig__wellsurance-family__cis.pdf", + "_confidence": "low" }, "pre_existing_disease_waiting_months": { - "value": null, + "value": 48, + "unit": "months", "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "1. Any Pre-existing Condition, any complication arising from it. Except if the insured has taken a similar Wellsurance Policy from Us and is covered without a break, for a period of 4 consecutive years since inception of the first policy with Us.", + "_confidence": "medium" }, "initial_waiting_period_days": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__wellsurance-family__cis.pdf", + "_confidence": "low" }, "maternity_coverage": { - "value": null, + "value": false, + "unit": "boolean", "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "13. pregnancy and all related conditions, including services and supplies related to the diagnosis or treatment of infertility or other problems related to inability to conceive a child;", + "_confidence": "high" }, "maternity_waiting_months": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__wellsurance-family__cis.pdf", + "_confidence": "low" }, "ayush_coverage": { - "value": null, + "value": false, + "unit": "boolean", "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "18. Any Ayurvedic, Homeopath or naturopathy treatments.", + "_confidence": "high" }, "cashless_treatment_supported": { - "value": null, + "value": false, + "unit": "boolean", "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "Critical Illness benefits are available on diagnosis of specified Critical Illnesses without hospitalisation of the insured. This benefit will be paid without any conditions as how the money would be spent by you.", + "_confidence": "medium" }, "copayment_pct": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__wellsurance-family__cis.pdf", + "_confidence": "low" }, "no_claim_bonus_pct": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__wellsurance-family__cis.pdf", + "_confidence": "low" }, "restoration_benefit": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__wellsurance-family__cis.pdf", + "_confidence": "low" }, "room_rent_capping": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__wellsurance-family__cis.pdf", + "_confidence": "low" }, "pre_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__wellsurance-family__cis.pdf", + "_confidence": "low" }, "post_hospitalization_days": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__wellsurance-family__cis.pdf", + "_confidence": "low" }, "day_care_treatments_count": { - "value": null, - "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "value": 540, + "source_url": "https://www.tataaig.com/health-insurance/medicare", + "source_note": "Per insurer baseline (Tata AIG product pages state 540+ day care procedures)", + "_confidence": "medium", + "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf" }, "network_hospital_count": { - "value": null, - "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "value": 12000, + "source_url": "https://www.tataaig.com/", + "source_note": "12,000+ Network Hospitals (homepage 'Why TATA AIG' section, scraped 2026-05-15)", + "_confidence": "high" }, "sum_insured_options": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__wellsurance-family__cis.pdf", + "_confidence": "low" }, "claim_settlement_ratio": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__wellsurance-family__cis.pdf", + "_confidence": "low" }, "tat_cashless_authorization_hours": { "value": null, "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "" + "source_quote": "not stated in tata-aig__wellsurance-family__cis.pdf", + "_confidence": "low" }, "policy_type": { - "value": "hospital_cash", + "value": null, "source_pdf_path": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", - "source_quote": "classified as hospital_cash from PDF heuristics" + "source_quote": "not stated in tata-aig__wellsurance-family.pdf", + "_confidence": "low" }, "_meta": { "curated_at": "2026-05-14", "primary_source_pdf": "rag/corpus/tata-aig/wellsurance-family__cis.pdf", "completeness_pct": 14, - "notes": "Curated by tools/curate_remaining.py \u2014 pattern-based extraction from local PDF" + "notes": "Curated by tools/curate_remaining.py — pattern-based extraction from local PDF" } } \ No newline at end of file diff --git a/40-data/premiums/_pending_scrape.txt b/40-data/premiums/_pending_scrape.txt new file mode 100644 index 0000000000000000000000000000000000000000..3b8452265e057f0284ac8a80859da591684bd864 --- /dev/null +++ b/40-data/premiums/_pending_scrape.txt @@ -0,0 +1,133 @@ +# Policies needing manual PolicyBazaar/InsuranceDekho premium scrape +# Generated: 2026-05-15 Count: 130 + +acko__acko-health-ii +acko__acko-health-iii +acko__acko-health-iii-platinum +acko__acko-health-iii-platinum-lite +acko__acko-health-iii-platinum-super-top-up +acko__acko-personal-health +acko__arogya-sanjeevani +aditya-birla__activ-health-individual +aditya-birla__activ-secure-cancer-secure +aditya-birla__activ-secure-personal-accident-cancer-secure +bajaj-allianz__comprehensive-care-plan +bajaj-allianz__criti-care +bajaj-allianz__extra-care-plus +bajaj-allianz__global-health-care +bajaj-allianz__group-health-guard-silver +bajaj-allianz__group-personal-accident +bajaj-allianz__health-guard-gold-individual +care-health__care-advantage-add-ons-protect-plus-care-shield +care-health__care-heart +care-health__care-supreme-enhance +care-health__supreme-enhance +care-health__ultimate-care +cholamandalam__arogya-sanjeevani +cholamandalam__chola-healthline +cholamandalam__critical-healthline +cholamandalam__flexi-health +cholamandalam__flexi-health-supreme +cholamandalam__super-topup +go-digit__arogya-sanjeevani +go-digit__digit-complete-care +go-digit__digit-health-care-plus +go-digit__digit-health-insurance +go-digit__digit-supreme-care +go-digit__digit-top-up +hdfc-ergo__energy-diabetes-hypertension +hdfc-ergo__group-health-insurance +hdfc-ergo__my-health-medisure-prime +hdfc-ergo__my-health-sampoorna-suraksha +hdfc-ergo__my-health-suraksha +hdfc-ergo__my-health-women-suraksha +hdfc-ergo__my-optima-secure +hdfc-ergo__my-optima-secure-older-variant +hdfc-ergo__optima-enhance +hdfc-ergo__total-health-plan +icici-lombard__arogya-sanjeevani +icici-lombard__complete-health-insurance-health-shield +icici-lombard__complete-health-insurance-umbrella +icici-lombard__health-booster-top-up +icici-lombard__health-elite-plus +icici-lombard__health-shield-360-retail +iffco-tokio__critical-illness-benefit +iffco-tokio__essential-health-plan +iffco-tokio__family-health-protector +iffco-tokio__health-protector-assure +iffco-tokio__health-protector-plus +iffco-tokio__individual-health-protector +indusind-general__group-mediclaim +indusind-general__health-gain +indusind-general__hospi-care +manipalcigna__prohealth-insurance-all-variants +manipalcigna__prohealth-select +manipalcigna__sarvah-param +national-insurance__arogya-sanjeevani +national-insurance__arogya-sanjeevani__prospectus +national-insurance__bob-national-health +national-insurance__bob-national-health__prospectus +national-insurance__national-critical-illness +national-insurance__national-critical-illness__prospectus +national-insurance__national-hospi-cash +national-insurance__national-hospi-cash__prospectus +national-insurance__national-mediclaim +national-insurance__national-mediclaim-plus +national-insurance__national-mediclaim-plus__prospectus +national-insurance__national-mediclaim__prospectus +national-insurance__national-parivar-plus +national-insurance__national-parivar-plus__prospectus +national-insurance__national-senior-citizen +national-insurance__national-senior-citizen__prospectus +national-insurance__national-super-top-up +national-insurance__national-super-top-up__prospectus +national-insurance__national-surrogacy +national-insurance__national-surrogacy__prospectus +national-insurance__national-young-india +national-insurance__national-young-india-plus +national-insurance__national-young-india-plus__prospectus +national-insurance__national-young-india__prospectus +national-insurance__new-national-parivar +national-insurance__new-national-parivar__prospectus +national-insurance__universal-health +national-insurance__universal-health__prospectus +new-india__asha-kiran-policy +new-india__janata-mediclaim-policy +new-india__new-india-floater-mediclaim-policy +new-india__new-india-mediclaim-policy +new-india__universal-health-insurance +new-india__yuva-bharat-health-policy +niva-bupa__health-companion +niva-bupa__health-companion-v2022 +niva-bupa__health-plus-top-up +niva-bupa__reassure-2-0 +niva-bupa__reassure-3-0 +niva-bupa__rise +niva-bupa__saral-suraksha-bima +niva-bupa__senior-first +oriental-insurance__arogya-sanjeevani +oriental-insurance__happy-family-floater +oriental-insurance__oriental-mediclaim-individual +reliance-general__personal-accident +royal-sundaram__arogya-sanjeevani +royal-sundaram__family-plus +royal-sundaram__lifeline +royal-sundaram__multiplier +royal-sundaram__presecure-advantage +royal-sundaram__surrosafe +sbi-general__arogya-top-up +sbi-general__health-alpha +sbi-general__health-edge +sbi-general__super-health-insurance +sbi-general__super-top-up +star-health__health-premier +star-health__star-assure +star-health__star-cancer-care-platinum +star-health__star-cardiac-care +star-health__star-cardiac-care-platinum +star-health__star-comprehensive +star-health__star-hospital-cash +tata-aig__criti-medicare +tata-aig__medicare-lite +tata-aig__medicare-select +tata-aig__wellsurance-family diff --git a/40-data/premiums/illustrative_premiums.json b/40-data/premiums/illustrative_premiums.json index 827d01719cfdf4fcea941fdba8e655085bca6bfd..2a96e118698704d8c795c481374229081a42124f 100644 --- a/40-data/premiums/illustrative_premiums.json +++ b/40-data/premiums/illustrative_premiums.json @@ -1,6 +1,6 @@ { "last_updated": "2026-05-13", - "methodology": "Premium samples pulled from public quote pages on PolicyBazaar, JoinDitto, Beshak, and insurer rate cards (Tata AIG MediCare Premier official rate chart, Star Family Health Optima Annexure-2, Niva Bupa ReAssure 2.0 rate card) on 2026-05-13. Single quotes are illustrative starting premiums for healthy non-smoking lives in Delhi (metro / Zone 1 / Zone A); actual premium varies with underwriting, pin code, family composition, and add-ons. Where a specific (insurer, policy, age, SI) combination did not surface a public number, the closest comparable insurer band was used and the gap was filled with the scaling factors below (derived from the 2-3 anchor points that ARE real). Scaling factors are calibrated against the IRDAI bandings used by most Indian health insurers and are consistent with the visible deltas in the JoinDitto / Beshak premium charts. | PED-specialty plans (HDFC Energy): individual base anchor \u00d7 ~1.35 PED load. Group/B2B plans (Aditya Birla Group Activ Health): individual base \u00d7 ~0.60 group-rate factor.", + "methodology": "Premium samples pulled from public quote pages on PolicyBazaar, JoinDitto, Beshak, and insurer rate cards (Tata AIG MediCare Premier official rate chart, Star Family Health Optima Annexure-2, Niva Bupa ReAssure 2.0 rate card) on 2026-05-13. Single quotes are illustrative starting premiums for healthy non-smoking lives in Delhi (metro / Zone 1 / Zone A); actual premium varies with underwriting, pin code, family composition, and add-ons. Where a specific (insurer, policy, age, SI) combination did not surface a public number, the closest comparable insurer band was used and the gap was filled with the scaling factors below (derived from the 2-3 anchor points that ARE real). Scaling factors are calibrated against the IRDAI bandings used by most Indian health insurers and are consistent with the visible deltas in the JoinDitto / Beshak premium charts. | PED-specialty plans (HDFC Energy): individual base anchor × ~1.35 PED load. Group/B2B plans (Aditya Birla Group Activ Health): individual base × ~0.60 group-rate factor.", "sources_consulted": [ "https://www.policybazaar.com/insurance-companies/hdfc-ergo-health-insurance/optima-secure-plan/", "https://www.policybazaar.com/insurance-companies/religare-health-insurance/care-supreme/", @@ -16,7 +16,7 @@ "https://joinditto.in/articles/health-insurance/niva-bupa-reassure-2-0-premium-chart/", "https://joinditto.in/articles/health-insurance/care-supreme-health-insurance-premium-chart/", "https://joinditto.in/articles/health-insurance/tata-aig-health-insurance-premium-rate-chart/", - "https://www.axisbank.com/70-docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", + "https://www.axisbank.com/docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", "https://transactions.nivabupa.com/pages/doc/premium_chart/Health%20Premia%20-%20Rate%20Card.pdf", "https://www.scribd.com/document/667873826/Annexure-2-Premium-Chart-Family-Health-Optima-Insurance-Plan-Revised", "https://www.scribd.com/document/682628786/ReAssure-2-0-Rate-Card-with-Tax", @@ -164,7 +164,7 @@ "family_size": 1, "annual_premium_inr": 9180, "source_url": "derived_from_anchor", - "derivation_note": "Base = HDFC Optima Secure age 30/5L anchor (\u20b96,800) \u00d7 1.35 PED-specialty load. Energy plan offers Day-1 cover for diabetes/hypertension which carries a documented ~30-40% premium load (Acko + PolicyBazaar comparison articles 2024)." + "derivation_note": "Base = HDFC Optima Secure age 30/5L anchor (₹6,800) × 1.35 PED-specialty load. Energy plan offers Day-1 cover for diabetes/hypertension which carries a documented ~30-40% premium load (Acko + PolicyBazaar comparison articles 2024)." }, { "age": 40, @@ -174,7 +174,7 @@ "family_size": 1, "annual_premium_inr": 21840, "source_url": "derived_from_anchor", - "derivation_note": "Base \u00d7 age 1.4 \u00d7 SI 1.7 \u00d7 PED-load 1.35" + "derivation_note": "Base × age 1.4 × SI 1.7 × PED-load 1.35" }, { "age": 50, @@ -184,10 +184,10 @@ "family_size": 2, "annual_premium_inr": 54100, "source_url": "derived_from_anchor", - "derivation_note": "Base \u00d7 age 2.1 \u00d7 SI 1.7 \u00d7 family 1.65 \u00d7 PED-load 1.35" + "derivation_note": "Base × age 2.1 × SI 1.7 × family 1.65 × PED-load 1.35" } ], - "notes": "PED-specialty plan \u2014 Day-1 diabetes/hypertension cover. Premiums carry ~30-40% load over standard health insurance, derived from HDFC Optima Secure base + documented PED uplift." + "notes": "PED-specialty plan — Day-1 diabetes/hypertension cover. Premiums carry ~30-40% load over standard health insurance, derived from HDFC Optima Secure base + documented PED uplift." }, "care-health__care-supreme": { "policy_id": "care-health-care-supreme", @@ -382,7 +382,7 @@ "family_size": 1, "annual_premium_inr": 4928, "source_url": "derived_from_anchor", - "derivation_note": "Group/B2B product \u2014 individuals cannot buy directly; employers sponsor. Derived from Aditya Birla Activ Assure individual anchor (\u20b98,215 age 30/5L) \u00d7 0.60 group-rate discount factor (per Cafemutual + IRDAI group health filings)." + "derivation_note": "Group/B2B product — individuals cannot buy directly; employers sponsor. Derived from Aditya Birla Activ Assure individual anchor (₹8,215 age 30/5L) × 0.60 group-rate discount factor (per Cafemutual + IRDAI group health filings)." }, { "age": 40, @@ -392,7 +392,7 @@ "family_size": 2, "annual_premium_inr": 11375, "source_url": "derived_from_anchor", - "derivation_note": "Base \u00d7 age 1.4 \u00d7 family 1.65 \u00d7 group 0.60" + "derivation_note": "Base × age 1.4 × family 1.65 × group 0.60" }, { "age": 50, @@ -402,10 +402,10 @@ "family_size": 4, "annual_premium_inr": 49680, "source_url": "derived_from_anchor", - "derivation_note": "Base \u00d7 age 2.1 \u00d7 SI 1.7 \u00d7 family 2.4 \u00d7 group 0.60" + "derivation_note": "Base × age 2.1 × SI 1.7 × family 2.4 × group 0.60" } ], - "notes": "B2B / Group plan \u2014 sold to employers, not retail. Indicative per-employee cost assuming sponsor subsidies; actual rate depends on group size + claim history.", + "notes": "B2B / Group plan — sold to employers, not retail. Indicative per-employee cost assuming sponsor subsidies; actual rate depends on group size + claim history.", "policy_type": "group" }, "bajaj-allianz__health-guard": { @@ -762,7 +762,7 @@ "smoker": false, "family_size": 1, "annual_premium_inr": 7100, - "source_url": "https://www.axisbank.com/70-docs/default-source/default-document-library/medicare-rate-chart-06-12-22.pdf", + "source_url": "https://www.axisbank.com/docs/default-source/default-document-library/medicare-rate-chart-06-12-22.pdf", "source_note": "Tata AIG MediCare base variant rate chart - 19-35 / 5L = Rs 7,108 ex-tax" }, { @@ -772,7 +772,7 @@ "smoker": false, "family_size": 1, "annual_premium_inr": 8800, - "source_url": "https://www.axisbank.com/70-docs/default-source/default-document-library/medicare-rate-chart-06-12-22.pdf" + "source_url": "https://www.axisbank.com/docs/default-source/default-document-library/medicare-rate-chart-06-12-22.pdf" }, { "age": 40, @@ -796,7 +796,7 @@ "smoker": false, "family_size": 1, "annual_premium_inr": 8362, - "source_url": "https://www.axisbank.com/70-docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", + "source_url": "https://www.axisbank.com/docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", "source_note": "Official Tata AIG MediCare Premier rate chart: 19-35 age band, 5L SI = Rs 8,362 ex-tax" }, { @@ -806,7 +806,7 @@ "smoker": false, "family_size": 1, "annual_premium_inr": 10319, - "source_url": "https://www.axisbank.com/70-docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", + "source_url": "https://www.axisbank.com/docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", "source_note": "Official rate chart: 19-35 / 10L = Rs 10,319 ex-tax" }, { @@ -816,7 +816,7 @@ "smoker": false, "family_size": 1, "annual_premium_inr": 9868, - "source_url": "https://www.axisbank.com/70-docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", + "source_url": "https://www.axisbank.com/docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", "source_note": "Official rate chart: 36-45 / 5L = Rs 9,868 ex-tax" }, { @@ -826,7 +826,7 @@ "smoker": false, "family_size": 1, "annual_premium_inr": 12266, - "source_url": "https://www.axisbank.com/70-docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", + "source_url": "https://www.axisbank.com/docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", "source_note": "Official rate chart: 36-45 / 10L = Rs 12,266 ex-tax" }, { @@ -1013,6 +1013,73 @@ "source_url": "derived_from_anchor" } ] + }, + "royal-sundaram__advanced-top-up": { + "policy_id": "royal-sundaram-advanced-top-up", + "policy_name": "Advanced Top Up", + "samples": [ + { + "age": 35, + "sum_insured_inr": 4500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1, + "annual_premium_inr": 2494, + "source_url": "extracted_from_brochure", + "source_note": "Found in royal-sundaram__advanced-top-up__brochure PDF: premium_range_indicative_inr[\"26-45_SI_45L_deductible_5L_1A\"]=2494", + "source_quality": "brochure_extract" + }, + { + "age": 53, + "sum_insured_inr": 4500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1, + "annual_premium_inr": 5542, + "source_url": "extracted_from_brochure", + "source_note": "Found in royal-sundaram__advanced-top-up__brochure PDF: premium_range_indicative_inr[\"46-60_SI_45L_deductible_5L_1A\"]=5542", + "source_quality": "brochure_extract" + }, + { + "age": 63, + "sum_insured_inr": 4500000, + "city_tier": "metro", + "smoker": false, + "family_size": 1, + "annual_premium_inr": 9976, + "source_url": "extracted_from_brochure", + "source_note": "Found in royal-sundaram__advanced-top-up__brochure PDF: premium_range_indicative_inr[\"61-65_SI_45L_deductible_5L_1A\"]=9976", + "source_quality": "brochure_extract" + } + ] + }, + "sbi-general__arogya-supreme": { + "policy_id": "sbi-general-arogya-supreme", + "policy_name": "Arogya Supreme", + "samples": [ + { + "age": 35, + "sum_insured_inr": 500000, + "city_tier": "metro", + "smoker": false, + "family_size": 2, + "annual_premium_inr": 38903, + "source_url": "https://www.sbigeneral.in", + "source_note": "Found in sbi-general__arogya-supreme__brochure PDF: premium_range_indicative_inr[\"35y_SI_5L_floater\"]=38903", + "source_quality": "brochure_extract" + }, + { + "age": 35, + "sum_insured_inr": 1500000, + "city_tier": "metro", + "smoker": false, + "family_size": 2, + "annual_premium_inr": 62424, + "source_url": "https://www.sbigeneral.in", + "source_note": "Found in sbi-general__arogya-supreme__brochure PDF: premium_range_indicative_inr[\"35y_SI_15L_floater\"]=62424", + "source_quality": "brochure_extract" + } + ] } }, "scaling_factors": { @@ -1064,5 +1131,19 @@ "group_b2b": 0.6, "_source": "Cafemutual + IRDAI group health filings; group rates typically 50-70% of individual" } - } -} \ No newline at end of file + }, + "link_rot_repairs": [ + { + "date": "2026-05-16", + "was": "https://www.axisbank.com/70-docs/default-source/default-document-library/medicare-rate-chart-06-12-22.pdf", + "now": "https://www.axisbank.com/docs/default-source/default-document-library/medicare-rate-chart-06-12-22.pdf", + "reason": "axisbank moved /70-docs/ -> /docs/ (404 2026-05-16); replacement verified live, identical 'TATA AIG MediCare - Rate Chart' content" + }, + { + "date": "2026-05-16", + "was": "https://www.axisbank.com/70-docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", + "now": "https://www.axisbank.com/docs/default-source/default-document-library/tata-aig-medicare-premier-rate-chart.pdf", + "reason": "axisbank moved /70-docs/ -> /docs/ (404 2026-05-16); replacement verified live, identical 'Tata AIG MediCare Premier UIN TATHLIP21257V022021' content" + } + ] +} diff --git a/40-data/profiles/7f227bef08d1.json b/40-data/profiles/7f227bef08d1.json new file mode 100644 index 0000000000000000000000000000000000000000..50e5be94ef0490bad0df9f348efc8470bddfe760 --- /dev/null +++ b/40-data/profiles/7f227bef08d1.json @@ -0,0 +1,35 @@ +{ + "name_display": "Rohit", + "name_slug": "rohit", + "persona_id": "7f227bef08d1", + "profile": { + "name": "Rohit", + "age": null, + "dependents": null, + "income_band": null, + "existing_cover_inr": null, + "primary_goal": null, + "location_tier": null, + "parents_to_insure": null, + "parents_age_max": null, + "parents_has_ped": null, + "budget_band": null, + "health_conditions": [], + "asked": [ + "name" + ], + "free_form_session": false, + "shown_policies": [], + "selected_policies": [], + "rejected_policies": [] + }, + "first_seen": "2026-05-14T23:24:52Z", + "last_seen": "2026-05-15T03:36:22Z", + "sessions": [ + "ephem_1", + "4556ffba-ef6c-4035-8c67-ce806e681fa7", + "probe_ki151_t1", + "ki151_smoke_1", + "ki158_walk_001" + ] +} \ No newline at end of file diff --git a/40-data/profiles/9b1da84bb052.json b/40-data/profiles/9b1da84bb052.json new file mode 100644 index 0000000000000000000000000000000000000000..8bfecc534658d930937697f59bdfc88321de0100 --- /dev/null +++ b/40-data/profiles/9b1da84bb052.json @@ -0,0 +1,44 @@ +{ + "name_display": "Rohit", + "name_slug": "rohit", + "persona_id": "9b1da84bb052", + "profile": { + "name": "Rohit", + "age": 29, + "dependents": "self", + "income_band": "under_5L", + "existing_cover_inr": 500000, + "primary_goal": "first_buy", + "location_tier": null, + "parents_to_insure": null, + "parents_age_max": null, + "parents_has_ped": null, + "budget_band": "under_15k", + "health_conditions": [], + "asked": [ + "name", + "location", + "health_conditions" + ], + "free_form_session": false, + "shown_policies": [], + "selected_policies": [], + "rejected_policies": [] + }, + "first_seen": "2026-05-15T03:36:34Z", + "last_seen": "2026-05-15T03:51:17Z", + "sessions": [ + "ki158_walk_001", + "ki155-test-1", + "ki158_verify_001", + "ki155-test-2", + "ki155-test-3", + "ki155-test-4", + "ki155-test-5", + "ki155-final-1", + "ki155-final-2", + "ki155-final-3", + "ki155-final-4", + "ki155-final-5" + ] +} \ No newline at end of file diff --git a/40-data/profiles/9f23a75fc19e.json b/40-data/profiles/9f23a75fc19e.json new file mode 100644 index 0000000000000000000000000000000000000000..696780842ef7782b85829e263a3c11e24a9f110a --- /dev/null +++ b/40-data/profiles/9f23a75fc19e.json @@ -0,0 +1,35 @@ +{ + "name_display": "Rohit", + "name_slug": "rohit", + "persona_id": "9f23a75fc19e", + "profile": { + "name": "Rohit", + "age": 29, + "dependents": "self", + "income_band": "under_5L", + "existing_cover_inr": 500000, + "primary_goal": "first_buy", + "location_tier": "metro", + "parents_to_insure": null, + "parents_age_max": null, + "parents_has_ped": null, + "budget_band": "30k_60k", + "health_conditions": [], + "asked": [ + "name", + "location", + "health_conditions", + "budget" + ], + "free_form_session": false, + "shown_policies": [], + "selected_policies": [], + "rejected_policies": [] + }, + "first_seen": "2026-05-15T03:36:41Z", + "last_seen": "2026-05-15T03:48:34Z", + "sessions": [ + "ki158_walk_001", + "ki158_verify_001" + ] +} \ No newline at end of file diff --git a/40-data/profiles/c7b4ef2af903.json b/40-data/profiles/c7b4ef2af903.json new file mode 100644 index 0000000000000000000000000000000000000000..040920b85f701ad5bfb381f1e74cea3196b7da65 --- /dev/null +++ b/40-data/profiles/c7b4ef2af903.json @@ -0,0 +1,46 @@ +{ + "name_display": "X7 Smoke User", + "name_slug": "x7-smoke-user", + "persona_id": "c7b4ef2af903", + "profile": { + "name": "X7 Smoke User", + "age": null, + "dependents": null, + "income_band": null, + "existing_cover_inr": null, + "primary_goal": null, + "location_tier": null, + "parents_to_insure": null, + "parents_age_max": null, + "parents_has_ped": null, + "budget_band": null, + "health_conditions": [], + "asked": [], + "free_form_session": false, + "shown_policies": [ + { + "policy_slug": "care-supreme", + "insurer": "care_health", + "event_at": "2026-05-15T08:13:05Z", + "session_id": "x7-smoke-25746", + "reason": "shown_in_recommendation", + "turn_idx": 4 + }, + { + "policy_slug": "star-comprehensive", + "insurer": "star_health", + "event_at": "2026-05-15T08:13:05Z", + "session_id": "x7-smoke-25746", + "reason": "shown_in_recommendation", + "turn_idx": 4 + } + ], + "selected_policies": [], + "rejected_policies": [] + }, + "first_seen": "2026-05-15T08:13:05Z", + "last_seen": "2026-05-15T08:13:05Z", + "sessions": [ + "x7-smoke-25746" + ] +} \ No newline at end of file diff --git a/40-data/profiles/dd8cd6c71443.json b/40-data/profiles/dd8cd6c71443.json new file mode 100644 index 0000000000000000000000000000000000000000..98634c92eb9b271768295aea892894e027f2d87d --- /dev/null +++ b/40-data/profiles/dd8cd6c71443.json @@ -0,0 +1,34 @@ +{ + "name_display": "Rohit", + "name_slug": "rohit", + "persona_id": "dd8cd6c71443", + "profile": { + "name": "Rohit", + "age": 29, + "dependents": null, + "income_band": "under_5L", + "existing_cover_inr": null, + "primary_goal": null, + "location_tier": null, + "parents_to_insure": null, + "parents_age_max": null, + "parents_has_ped": null, + "budget_band": "under_15k", + "health_conditions": [], + "asked": [ + "name", + "age", + "income_band", + "budget" + ], + "free_form_session": false, + "shown_policies": [], + "selected_policies": [], + "rejected_policies": [] + }, + "first_seen": "2026-05-15T03:36:28Z", + "last_seen": "2026-05-15T03:36:28Z", + "sessions": [ + "ki158_walk_001" + ] +} \ No newline at end of file diff --git a/40-data/profiles/f31d3896ff05.json b/40-data/profiles/f31d3896ff05.json new file mode 100644 index 0000000000000000000000000000000000000000..82e3cc73f937b3cf8d84cc540ad89dccf421b6cf --- /dev/null +++ b/40-data/profiles/f31d3896ff05.json @@ -0,0 +1,36 @@ +{ + "name_display": "Rohit", + "name_slug": "rohit", + "persona_id": "f31d3896ff05", + "profile": { + "name": "Rohit", + "age": 32, + "dependents": "self+spouse+kids", + "income_band": null, + "existing_cover_inr": 0, + "primary_goal": "first_buy", + "location_tier": null, + "parents_to_insure": null, + "parents_age_max": null, + "parents_has_ped": null, + "budget_band": "15k_30k", + "health_conditions": [], + "asked": [ + "name", + "age", + "dependents", + "primary_goal", + "existing_cover", + "budget" + ], + "free_form_session": false, + "shown_policies": [], + "selected_policies": [], + "rejected_policies": [] + }, + "first_seen": "2026-05-15T01:02:36Z", + "last_seen": "2026-05-15T01:02:36Z", + "sessions": [ + "2e4536ac-41ec-4683-aac4-7a069b10f1f6" + ] +} \ No newline at end of file diff --git a/40-data/reviews/acko.json b/40-data/reviews/acko.json new file mode 100644 index 0000000000000000000000000000000000000000..0b3bdf8329fc3529531323c95812c502d96fd71f --- /dev/null +++ b/40-data/reviews/acko.json @@ -0,0 +1,18 @@ +{ + "insurer_slug": "acko", + "insurer_name": "Acko General Insurance", + "last_updated": "2026-05-15", + "claim_metrics": { + "claim_settlement_ratio_pct": 96.31, + "claim_settlement_ratio_year": "FY 2023-24", + "complaints_per_10k_policies": 16, + "complaints_year": "FY 2024-25", + "incurred_claim_ratio_pct": null, + "three_year_avg_csr_pct": 96.5, + "source_irdai_url": "https://irdai.gov.in/document-detail", + "source_secondary_url": "https://joinditto.in/articles/health-insurance/acko-health-insurance-claim-settlement-ratio/", + "source_complaints_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "source_company_url": "https://www.acko.com/health-insurance/claim-settlement-ratio/", + "notes": "Health-specific CSR from Acko public disclosure (Form NL-37). Complaints metric is 'per 10K claims' from IRDAI FY24-25; comparable proxy for per-10K-policies. Acko also led private GI insurers with 99.91% of claims paid within 3 months in 2023-24." + } +} diff --git a/40-data/reviews/aditya-birla.json b/40-data/reviews/aditya-birla.json index 17671925dce3a25ee93ae8962be2899f1317c23b..14a3018e0d474c152bf56dd1362d848ebb0ac6cf 100644 --- a/40-data/reviews/aditya-birla.json +++ b/40-data/reviews/aditya-birla.json @@ -8,7 +8,7 @@ "complaints_per_10k_policies": 13, "complaints_year": "2023-24", "incurred_claim_ratio_pct": 71.5, - "source_irdai_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_irdai_url": "https://irdai.gov.in/document-detail", "source_secondary_url": "https://www.policyx.com/health-insurance/aditya-birla-health-insurance/claim-settlement-ratio/", "source_company_url": "https://www.angelone.in/news/market-updates/aditya-birla-health-insurance-claims-settlement-ratio-analysis-for-2024-25" }, diff --git a/40-data/reviews/bajaj-allianz.json b/40-data/reviews/bajaj-allianz.json index 6c9efe0be7e47f8afc1fc5db28bd327358c9d96f..7368f8fadde31a2f75d0e4d2087b8115fa9508ff 100644 --- a/40-data/reviews/bajaj-allianz.json +++ b/40-data/reviews/bajaj-allianz.json @@ -9,7 +9,7 @@ "complaints_year": "2023-24", "incurred_claim_ratio_pct": 76.0, "three_year_avg_csr_pct": 96.78, - "source_irdai_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_irdai_url": "https://irdai.gov.in/document-detail", "source_secondary_url": "https://www.policyx.com/health-insurance/bajaj-general-health-insurance/claim-settlement-ratio/", "source_company_url": "https://www.bajajgeneralinsurance.com/about-us/financial-information.html", "source_annual_report": "https://www.bajajgeneralinsurance.com/download-documents/annual-report/Annual-Report-2023-2024.pdf" diff --git a/40-data/reviews/care-health.json b/40-data/reviews/care-health.json index 6c650c46881d41fc3d633e7122e08484178af65e..4f13ad55e9339ae4a45fa893bbce39788096e7f1 100644 --- a/40-data/reviews/care-health.json +++ b/40-data/reviews/care-health.json @@ -9,7 +9,7 @@ "complaints_year": "2023-24", "claims_rejected_fy24": 76903, "incurred_claim_ratio_pct": 57.69, - "source_irdai_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_irdai_url": "https://irdai.gov.in/document-detail", "source_secondary_url": "https://www.policyx.com/health-insurance/religare-health-insurance/claim-settlement-ratio/", "source_company_url": "https://www.careinsurance.com/health-insurance/health-insurance-claim-settlement-ratio" }, diff --git a/40-data/reviews/cholamandalam.json b/40-data/reviews/cholamandalam.json new file mode 100644 index 0000000000000000000000000000000000000000..a98b6a640065cc98adc7b6f60bee124d018c0d0b --- /dev/null +++ b/40-data/reviews/cholamandalam.json @@ -0,0 +1,18 @@ +{ + "insurer_slug": "cholamandalam", + "insurer_name": "Cholamandalam MS General Insurance", + "last_updated": "2026-05-15", + "claim_metrics": { + "claim_settlement_ratio_pct": 94.5, + "claim_settlement_ratio_year": "FY 2023-24", + "complaints_per_10k_policies": 13, + "complaints_year": "FY 2024-25", + "incurred_claim_ratio_pct": 73.04, + "three_year_avg_csr_pct": null, + "source_irdai_url": "https://irdai.gov.in/document-detail", + "source_secondary_url": "https://www.policyx.com/health-insurance/cholamandalam-ms-health-insurance/claim-settlement-ratio/", + "source_complaints_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "source_company_url": "https://www.cholainsurance.com/", + "notes": "Cholamandalam settled 96.52% of claims in <30 days in FY24. ICR 73.04% per IRDAI 2023-24. CSR 94.5% from PolicyX aggregator (sourced from public disclosure)." + } +} diff --git a/40-data/reviews/go-digit.json b/40-data/reviews/go-digit.json new file mode 100644 index 0000000000000000000000000000000000000000..c65b299ed029df475207b8aa77de333fd0c269d7 --- /dev/null +++ b/40-data/reviews/go-digit.json @@ -0,0 +1,18 @@ +{ + "insurer_slug": "go-digit", + "insurer_name": "Go Digit General Insurance", + "last_updated": "2026-05-15", + "claim_metrics": { + "claim_settlement_ratio_pct": 90.69, + "claim_settlement_ratio_year": "FY 2023-24", + "complaints_per_10k_policies": 19, + "complaints_year": "FY 2024-25", + "incurred_claim_ratio_pct": 93.87, + "three_year_avg_csr_pct": null, + "source_irdai_url": "https://irdai.gov.in/document-detail", + "source_secondary_url": "http://web.archive.org/web/20260122094704/https://www.policybazaar.com/insurance-companies/digit-health-insurance/claim-settlement-ratio/", + "source_complaints_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "source_company_url": "https://www.godigit.com/digest/reports/transparency-report-10", + "notes": "Go Digit was the highest payer among private GI insurers with ICR 93.87% (Rs 4.69 of every Rs 5 claimed) in FY 2023-24. CSR 90.69% per IRDAI public disclosure March 2024." + } +} diff --git a/40-data/reviews/hdfc-ergo.json b/40-data/reviews/hdfc-ergo.json index 74e005671c5e38e2e3c0a3fc688702f0e7edca16..31e0af60ad8c4ad5d1f965bcb269a1dca439d5e8 100644 --- a/40-data/reviews/hdfc-ergo.json +++ b/40-data/reviews/hdfc-ergo.json @@ -9,7 +9,7 @@ "complaints_year": "2023-24", "incurred_claim_ratio_pct": 88.0, "three_year_avg_csr_pct": 96.71, - "source_irdai_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_irdai_url": "https://irdai.gov.in/document-detail", "source_secondary_url": "http://web.archive.org/web/20260211155805/https://www.policybazaar.com/insurance-companies/hdfc-ergo-health-insurance/claim-settlement-ratio/", "source_company_url": "https://www.hdfcergo.com/blogs/health-insurance/hdfc-ergo-claim-settlement-ratio" }, diff --git a/40-data/reviews/icici-lombard.json b/40-data/reviews/icici-lombard.json index d6a8f9f8779959eac029496c572d8c8cdaa29afd..801eacaf5e95fa2034c5738cf967a2d22ea7fd2b 100644 --- a/40-data/reviews/icici-lombard.json +++ b/40-data/reviews/icici-lombard.json @@ -9,7 +9,7 @@ "complaints_year": "2023-24 (3-year avg ~9-10)", "incurred_claim_ratio_pct": 78.67, "three_year_avg_csr_pct": 84.5, - "source_irdai_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_irdai_url": "https://irdai.gov.in/document-detail", "source_secondary_url": "https://www.policyx.com/health-insurance/icici-lombard-health-insurance/claim-settlement-ratio/", "source_company_url": "https://www.icicilombard.com/health-insurance/blogs/icici-lombard-health-insurance-claim-settlement-ratio" }, diff --git a/40-data/reviews/iffco-tokio.json b/40-data/reviews/iffco-tokio.json new file mode 100644 index 0000000000000000000000000000000000000000..c267847b4525da7807104dbdcf094edb794fbadc --- /dev/null +++ b/40-data/reviews/iffco-tokio.json @@ -0,0 +1,18 @@ +{ + "insurer_slug": "iffco-tokio", + "insurer_name": "IFFCO Tokio General Insurance", + "last_updated": "2026-05-15", + "claim_metrics": { + "claim_settlement_ratio_pct": 96.33, + "claim_settlement_ratio_year": "FY 2023-24", + "complaints_per_10k_policies": 41, + "complaints_year": "FY 2024-25", + "incurred_claim_ratio_pct": 86.33, + "three_year_avg_csr_pct": null, + "source_irdai_url": "https://irdai.gov.in/document-detail", + "source_secondary_url": "https://www.policyx.com/health-insurance/iffco-tokio-health-insurance/claim-settlement-ratio/", + "source_complaints_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "source_company_url": "https://www.iffcotokio.co.in/content/dam/iffcotokio/iffco-pdf/public-disclosure-march-2024.pdf", + "notes": "IFFCO Tokio CSR 96.33% per IRDAI 2023-24 (PolicyX). Complaints per 10K claims at 41 places IFFCO Tokio above the 20-per-10K industry benchmark." + } +} diff --git a/40-data/reviews/indusind-general.json b/40-data/reviews/indusind-general.json new file mode 100644 index 0000000000000000000000000000000000000000..4359aba213d6b09f596a26b4ddf1b083351441f1 --- /dev/null +++ b/40-data/reviews/indusind-general.json @@ -0,0 +1,19 @@ +{ + "insurer_slug": "indusind-general", + "insurer_name": "IndusInd General Insurance (formerly Reliance General)", + "last_updated": "2026-05-15", + "claim_metrics": { + "claim_settlement_ratio_pct": 86.38, + "claim_settlement_ratio_year": "FY 2024-25", + "complaints_per_10k_policies": 5, + "complaints_year": "FY 2024-25", + "complaints_metric_unit": "per 10,000 claims (Reliance General predecessor reporting)", + "incurred_claim_ratio_pct": null, + "three_year_avg_csr_pct": null, + "source_irdai_url": "https://irdai.gov.in/document-detail", + "source_secondary_url": "https://www.beshak.org/insurance/insurance-companies/indus-ind-general-insurance-company-limited/claim-settlement-ratio/", + "source_complaints_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "source_company_url": "https://www.indusindinsurance.com/insurance/press-release/news-and-coverage/reliance-general-insurance-has-one-of-the-highest-claim-settlement-ratios-in-the-country.aspx", + "notes": "IndusInd General Insurance is the rebrand of Reliance General Insurance (rebrand October 2025). Predecessor Reliance General had CSR 98.75% (claims settled in <3 months) in FY 2023-24 and 99.32% in FY 2024-25. Standalone post-rebrand health-only CSR is 86.38% per Beshak/public disclosure FY24-25. Complaints metric of 5 per 10,000 claims (FY24-25) is from the Reliance General reporting line in the IRDAI grievance digest (Algates aggregator) — same entity continuing post-rebrand. Backfilled 2026-05-15 in targeted scrape pass." + } +} diff --git a/40-data/reviews/manipalcigna.json b/40-data/reviews/manipalcigna.json index 48064d86e3327cdaee8056f20e2d92e3e90c93c1..48e35bf4643580b9ace9fc84a31efa923ee96a95 100644 --- a/40-data/reviews/manipalcigna.json +++ b/40-data/reviews/manipalcigna.json @@ -8,7 +8,7 @@ "complaints_per_10k_policies": 24, "complaints_year": "2023-24", "incurred_claim_ratio_pct": 74.81, - "source_irdai_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_irdai_url": "https://irdai.gov.in/document-detail", "source_secondary_url": "https://www.policyx.com/health-insurance/manipalcigna-health-insurance/claim-settlement-ratio/", "source_company_url": "https://www.manipalcigna.com/blog/claim-settlement-ratio" }, diff --git a/40-data/reviews/national-insurance.json b/40-data/reviews/national-insurance.json new file mode 100644 index 0000000000000000000000000000000000000000..a6022cfef064403b96978f0dcc7cae1e665e32d0 --- /dev/null +++ b/40-data/reviews/national-insurance.json @@ -0,0 +1,18 @@ +{ + "insurer_slug": "national-insurance", + "insurer_name": "National Insurance Company", + "last_updated": "2026-05-15", + "claim_metrics": { + "claim_settlement_ratio_pct": 91.18, + "claim_settlement_ratio_year": "FY 2023-24", + "complaints_per_10k_policies": 29, + "complaints_year": "FY 2024-25", + "incurred_claim_ratio_pct": 95.9, + "three_year_avg_csr_pct": null, + "source_irdai_url": "https://irdai.gov.in/document-detail", + "source_secondary_url": "https://www.policyx.com/health-insurance/national-health-insurance/claim-settlement-ratio/", + "source_complaints_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "source_company_url": "https://nationalinsurance.nic.co.in/", + "notes": "National Insurance is a public-sector general insurer. Ranked 4th by absolute complaint volume in FY24 (2,196 complaints per Business Standard). FY24-25 CSR rose to 91.79% per IRDAI 2026 release. Complaints per 10K claims = 29 (above 20-benchmark)." + } +} diff --git a/40-data/reviews/new-india.json b/40-data/reviews/new-india.json index 47cd6e93bc3a72faf50571841be932079936c778..62961edd948f495303c49aa2cf60c297e75324a9 100644 --- a/40-data/reviews/new-india.json +++ b/40-data/reviews/new-india.json @@ -9,7 +9,7 @@ "complaints_year": "2023-24", "incurred_claim_ratio_pct": 103.38, "claim_amount_settlement_pct": 98.74, - "source_irdai_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_irdai_url": "https://irdai.gov.in/document-detail", "source_secondary_url": "https://www.policybazaar.com/insurance-companies/new-india-assurance-health-insurance/claim-settlement-ratio/", "source_company_url": "https://www.newindia.co.in/public-disclosure", "note": "Highest payer among general insurers; IBAI 2023-24 General Insurance Claim Insights ranks NIA #1 on settlement" diff --git a/40-data/reviews/niva-bupa.json b/40-data/reviews/niva-bupa.json index 262d51325252094430131d59f554dca292904d5d..5d6c60dff5795afd2ac3f6e50cba15f0cfb355f7 100644 --- a/40-data/reviews/niva-bupa.json +++ b/40-data/reviews/niva-bupa.json @@ -8,7 +8,7 @@ "complaints_per_10k_policies": 43, "complaints_year": "2023-24", "incurred_claim_ratio_pct": 59.0, - "source_irdai_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_irdai_url": "https://irdai.gov.in/document-detail", "source_secondary_url": "https://joinditto.in/articles/health-insurance/niva-bupa-health-insurance-claim-settlement-ratio/", "source_annual_report": "https://transactions.nivabupa.com/pages/doc/pub-dis/annual-reports/Annual-Report-FY-2023-24.pdf" }, diff --git a/40-data/reviews/oriental-insurance.json b/40-data/reviews/oriental-insurance.json new file mode 100644 index 0000000000000000000000000000000000000000..e2a5ae3bc2f85c8bff64fff0d25a4d4373784e0c --- /dev/null +++ b/40-data/reviews/oriental-insurance.json @@ -0,0 +1,21 @@ +{ + "insurer_slug": "oriental-insurance", + "insurer_name": "The Oriental Insurance Company", + "last_updated": "2026-05-15", + "claim_metrics": { + "claim_settlement_ratio_pct": 93.96, + "claim_settlement_ratio_year": "FY 2023-24", + "complaints_per_10k_policies": 1, + "complaints_year": "FY 2024-25", + "complaints_metric_unit": "per 10,000 policyholders (derived: 1,456 complaints / 14.79M lives covered ≈ 1 per 10K)", + "complaints_raw_count": 1456, + "complaints_lives_covered_millions": 14.79, + "incurred_claim_ratio_pct": 98.89, + "three_year_avg_csr_pct": null, + "source_irdai_url": "https://irdai.gov.in/document-detail?documentId=8375620", + "source_secondary_url": "https://www.policyx.com/health-insurance/oriental-health-insurance/claim-settlement-ratio/", + "source_complaints_url": "https://irdai.gov.in/documents/37343/366637/%E0%A4%86%E0%A4%88%E0%A4%86%E0%A4%B0%E0%A4%A1%E0%A5%80%E0%A4%8F%E0%A4%88+%E0%A4%B5%E0%A4%BE%E0%A4%B0%E0%A5%8D%E0%A4%B7%E0%A4%BF%E0%A4%95+%E0%A4%B0%E0%A4%BF%E0%A4%AA%E0%A5%8B%E0%A4%B0%E0%A5%8D%E0%A4%9F+_+IRDAI+Annual+Report+2024-25.pdf/06f02832-66a3-6308-a16f-f46a6640fc93?version=1.0&t=1767160078418", + "source_company_url": "https://orientalinsurance.org.in/", + "notes": "Oriental Insurance is a public-sector general insurer. CSR 93.96% per IRDAI 2023-24 aggregated by PolicyX. ICR 98.89% (near break-even on premium-vs-claims). FY24-25 CSR per IRDAI 2026 release = 90.17%. Complaints: Oriental Insurance grievance/complaint tables for FY 2024-25 (1,456 complaints against 14.79M lives covered, ≈10 per 100K policyholders or ~1 per 10K) sourced from the IRDAI Annual Report 2024-25 (official irdai.gov.in PDF, 416 pp; grievance tables ~p.382). Backfilled 2026-05-15 in targeted scrape pass; complaints source URL repaired 2026-05-16 — was: https://www.insurancebusinessmag.com/asia/news/life-insurance/latest-india-data-finds-complaints-clustered-in-insurance-segment-565197.aspx (403 Cloudflare-blocked 2026-05-16; that page was a secondary aggregation of this same IRDAI report)." + } +} diff --git a/40-data/reviews/reliance-general.json b/40-data/reviews/reliance-general.json new file mode 100644 index 0000000000000000000000000000000000000000..01b2332ed8838246e0a6b2e7dc7c6e75912a16e9 --- /dev/null +++ b/40-data/reviews/reliance-general.json @@ -0,0 +1,18 @@ +{ + "insurer_slug": "reliance-general", + "insurer_name": "Reliance General Insurance (legacy; now IndusInd General)", + "last_updated": "2026-05-15", + "claim_metrics": { + "claim_settlement_ratio_pct": 98.75, + "claim_settlement_ratio_year": "FY 2023-24", + "complaints_per_10k_policies": 5, + "complaints_year": "FY 2024-25", + "incurred_claim_ratio_pct": 81.06, + "three_year_avg_csr_pct": null, + "source_irdai_url": "https://irdai.gov.in/document-detail", + "source_secondary_url": "http://web.archive.org/web/20260212185521/https://www.policybazaar.com/insurance-companies/reliance-health-insurance/claim-settlement-ratio/", + "source_complaints_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "source_company_url": "https://www.indusindinsurance.com/insurance/press-release/news-and-coverage/reliance-general-insurance-has-one-of-the-highest-claim-settlement-ratios-in-the-country.aspx", + "notes": "Reliance General Insurance topped private GI insurers with 98.75% claims paid within 3 months in FY 2023-24. Complaints per 10K claims = 5 (well below industry benchmark of 20). Insurer rebranded to IndusInd General Insurance in October 2025." + } +} diff --git a/40-data/reviews/royal-sundaram.json b/40-data/reviews/royal-sundaram.json new file mode 100644 index 0000000000000000000000000000000000000000..81bdb3953a4a76a36afd4886071b4d2d2c772701 --- /dev/null +++ b/40-data/reviews/royal-sundaram.json @@ -0,0 +1,18 @@ +{ + "insurer_slug": "royal-sundaram", + "insurer_name": "Royal Sundaram General Insurance", + "last_updated": "2026-05-15", + "claim_metrics": { + "claim_settlement_ratio_pct": 95.95, + "claim_settlement_ratio_year": "FY 2023-24", + "complaints_per_10k_policies": 18, + "complaints_year": "FY 2024-25", + "incurred_claim_ratio_pct": 77.62, + "three_year_avg_csr_pct": null, + "source_irdai_url": "https://irdai.gov.in/document-detail", + "source_secondary_url": "https://www.policyx.com/health-insurance/royal-sundaram-health-insurance/claim-settlement-ratio/", + "source_complaints_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "source_company_url": "http://web.archive.org/web/20260504142913/https://www.royalsundaram.in/", + "notes": "Royal Sundaram CSR 95.95% (industry avg 94.21%). Complaints per 10K claims = 18 (just below 20-benchmark). ICR 77.62% per PolicyX FY24." + } +} diff --git a/40-data/reviews/sbi-general.json b/40-data/reviews/sbi-general.json new file mode 100644 index 0000000000000000000000000000000000000000..ed591c31e8a5c37003081132b57b99281c58758b --- /dev/null +++ b/40-data/reviews/sbi-general.json @@ -0,0 +1,18 @@ +{ + "insurer_slug": "sbi-general", + "insurer_name": "SBI General Insurance", + "last_updated": "2026-05-15", + "claim_metrics": { + "claim_settlement_ratio_pct": 96.14, + "claim_settlement_ratio_year": "FY 2022-25 (3-yr avg)", + "complaints_per_10k_policies": 15, + "complaints_year": "FY 2024-25", + "incurred_claim_ratio_pct": 82.19, + "three_year_avg_csr_pct": 96.14, + "source_irdai_url": "https://irdai.gov.in/document-detail", + "source_secondary_url": "https://joinditto.in/articles/health-insurance/sbi-health-insurance-claim-settlement-ratio/", + "source_complaints_url": "https://algatesinsurance.in/insurance-infographic/health-insurance-claims-complaints-volume/", + "source_company_url": "https://www.sbigeneral.in/", + "notes": "SBI General 3-yr avg CSR (FY22-25) = 96.14% per Ditto (industry avg 91.22%). ICR 82.19% per FY24-25 IRDAI. Complaints per 10K claims = 15 (well below 20-benchmark). PolicyX shows SBI General CSR as 0% in their data-lab listing which is a confirmed PolicyX data error (excluded)." + } +} diff --git a/40-data/reviews/star-health.json b/40-data/reviews/star-health.json index cb329d34b17576c2c91cf39dc2db94a89c79259b..484ed3a6c20b1cd2c993ef3de0406c97e6489a56 100644 --- a/40-data/reviews/star-health.json +++ b/40-data/reviews/star-health.json @@ -10,7 +10,7 @@ "total_complaints_fy24": 13308, "claims_rejected_fy24": 296356, "incurred_claim_ratio_pct": 66.47, - "source_irdai_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_irdai_url": "https://irdai.gov.in/document-detail", "source_secondary_url": "https://www.business-standard.com/finance/personal-finance/star-health-care-niva-bupa-record-most-policyholder-complaints-in-fy24-125090100487_1.html" }, "aggregator_ratings": { diff --git a/40-data/reviews/tata-aig.json b/40-data/reviews/tata-aig.json index 81c4bb7482703be88d05d2a15fb984915c3da362..2d0cac9166059c40b748ab817e7f50200483dc5a 100644 --- a/40-data/reviews/tata-aig.json +++ b/40-data/reviews/tata-aig.json @@ -8,7 +8,7 @@ "complaints_per_10k_policies": 11, "complaints_year": "2023-24 (3-year avg ~10.65)", "incurred_claim_ratio_pct": 76.24, - "source_irdai_url": "https://irdai.gov.in/document-detail?documentId=6436847", + "source_irdai_url": "https://irdai.gov.in/document-detail", "source_secondary_url": "https://www.policyx.com/health-insurance/tata-aig-health-insurance/claim-settlement-ratio/", "source_tertiary_url": "https://joinditto.in/articles/health-insurance/tata-aig-health-insurance-claim-settlement-ratio/" }, diff --git a/70-docs/10-architecture/scoring-knowledge-graph.md b/70-docs/10-architecture/scoring-knowledge-graph.md index a435c06e8d7b9a733b477a9f0966b7e6b951bb31..284db843f29ba299f6478c131315635d62ea7ec5 100644 --- a/70-docs/10-architecture/scoring-knowledge-graph.md +++ b/70-docs/10-architecture/scoring-knowledge-graph.md @@ -69,15 +69,17 @@ Each row: "if the policy has this value, the listed sub-score moves by this delt | `tat_cashless_authorization_hours` | ≤2 | +4 | | `tat_cashless_authorization_hours` | ≥24 | −4 | -### Renewal Protection (base 65, weight 12%) +### Renewal Protection (base 50, weight 12%) + +> Renewal Protection now = `max_entry_age` only. Lifelong renewability is the IRDAI universal norm for every health-indemnity product (mandated since 2020), so it is constant across the market and is **not scored** — `max_renewal_age` was removed entirely as a scored field. | Attribute | Value condition | Sub-score delta | |---|---|---| -| `max_renewal_age` | "Lifelong" or ≥99 | +12 | -| `max_renewal_age` | 80 | +6 | -| `max_renewal_age` | ≤70 | −5 | -| `max_entry_age` | ≥65 | +4 | -| `guaranteed_renewability` | true (stated) | +4 | +| `max_entry_age` | ≥65 | +25 | +| `max_entry_age` | ≥55 | +12 | +| `max_entry_age` | ≥50 | +0 | +| `max_entry_age` | <50 | −20 | +| (lifelong renewability) | IRDAI-universal | not scored — shown for transparency only | ### Bonus & Loyalty (base 60, weight 8%) diff --git a/70-docs/10-architecture/scoring-methodology.md b/70-docs/10-architecture/scoring-methodology.md index 123486b0d9852a2b6d37556a773dc59619bed091..9146b7fbf8c6494931ae1e23587c65acd22b27fb 100644 --- a/70-docs/10-architecture/scoring-methodology.md +++ b/70-docs/10-architecture/scoring-methodology.md @@ -130,10 +130,11 @@ The 62 fields are aggregated into **6 sub-scores**, each 0-100. The aggregation | Schema field | Effect on score | | --- | --- | -| `max_renewal_age` (int) | +25 if lifelong (≥99), +15 if ≥80, −15 if <65 | -| `max_entry_age` (int) | +10 if ≥65, −6 if <50 | +| `max_entry_age` (int) | +25 if ≥65, +12 if ≥55, +0 if ≥50, −20 if <50 | -**Base score: 60.** +> **Renewal Protection now = `max_entry_age` only.** Lifelong renewability is the IRDAI universal norm for every health-indemnity product (mandated since 2020), so it is constant across the market and is **not scored** — `max_renewal_age` was removed entirely as a scored field. What still genuinely varies between products is the maximum *entry* age (how late a first-time buyer can take the policy), so it is the sole driver of this sub-score. + +**Base score: 50.** ### 2.6 Bonus & Loyalty — *sweeteners for sticking around* @@ -175,7 +176,7 @@ overall_score = 0.22 × Coverage Breadth | Field group | In scorecard? | Why / why not | | --- | --- | --- | | Identity (5 fields) | No | Doesn't affect quality, only display | -| Eligibility (5 fields) | Partial — `max_renewal_age`, `max_entry_age` only | Renewal age matters for buyer; family composition is a filter, not a quality signal | +| Eligibility (5 fields) | Partial — `max_entry_age` only | Max entry age matters for a late first-time buyer; lifelong renewability is the IRDAI universal norm (not scored); family composition is a filter, not a quality signal | | Sum insured & premium (5 fields) | No | We don't score absolute price (Doc 01 D-007: pricing is illustrative); buyers compare per-rupee value separately | | Waiting periods (6 fields) | All 3 used | Direct buyer impact | | Coverage scope (~10 fields) | 8 used | Most relevant | diff --git a/70-docs/10-architecture/system-overview.md b/70-docs/10-architecture/system-overview.md index 0d4e322d8c80737b4ecba1a4dbb110dc2daa288c..03045e1174f882fa3bb9076d97874b60a8b85112 100644 --- a/70-docs/10-architecture/system-overview.md +++ b/70-docs/10-architecture/system-overview.md @@ -174,7 +174,7 @@ Full Pydantic model lives in `rag/schema.py` (designed in parallel by a sub-agen **Field groupings:** 1. **Identity** — `policy_id`, `insurer_name`, `insurer_slug`, `policy_name`, `policy_type` (enum), `uin_code` -2. **Eligibility** — `min_entry_age`, `max_entry_age`, `max_renewal_age`, `family_composition` +2. **Eligibility** — `min_entry_age`, `max_entry_age`, `family_composition` *(lifelong renewability is the IRDAI universal norm — not a scored field)* 3. **Sum insured & premium** — `sum_insured_options[]`, `premium_payment_modes[]`, `premium_band_illustrative`, `grace_period_days` 4. **Waiting periods** *(comparison-critical)* — `initial_waiting_period_days`, `pre_existing_disease_waiting_months`, `specific_disease_waiting_months`, `maternity_waiting_months`, `specific_diseases_listed[]` 5. **Coverage scope** *(comparison-critical)* — `pre_hospitalization_days`, `post_hospitalization_days`, `day_care_treatments_count`, `domiciliary_treatment`, `ayush_coverage`, `maternity_coverage`, `newborn_coverage`, `organ_donor_expenses`, `ambulance_cover`, `critical_illness_cover`, `restoration_benefit`, `no_claim_bonus_pct`, `preventive_health_checkup` diff --git a/backend/brain_tools.py b/backend/brain_tools.py index d8ace4d0292baf4dbdb183b8b5876a535238ffe8..3863ced9f7bc23acc6144df3b07e0852be3cc628 100644 --- a/backend/brain_tools.py +++ b/backend/brain_tools.py @@ -60,12 +60,134 @@ SLOT_UNION because no consumer reads it. from __future__ import annotations +import json as _json import logging +from pathlib import Path from typing import Any, Optional _log = logging.getLogger(__name__) +# ─────────────────────────────────────────────────────────────────────────── +# KI-278 (2026-05-16) — policy-fact enrichment for the eligibility/ranking +# filter. The Chroma chunk only carries citation metadata; the structural +# facts the eligibility filter needs (top-up signal, sum-insured options, +# mandatory co-pay) live in 40-data/policy_facts/*.json. +# +# IMPORTANT: this code only READS those JSON files and only reads STABLE +# SCHEMA KEYS (policy_type_indemnity_or_fixed / deductible_amount / +# co_payment_pct / sum_insured_options). The concurrent scorecard-repair +# process rewrites the *values*; the *field names* are the contract and do +# not change. We never write to policy_facts/*.json. +# +# A short in-process cache keeps this off the hot path (the catalog is ~250 +# files; we only ever touch the ≤8 retrieved per turn, and memoise stems). +# ─────────────────────────────────────────────────────────────────────────── + +_FACTS_DIR = Path(__file__).resolve().parent.parent / "40-data" / "policy_facts" +_DOCTYPE_SUFFIXES = ("__wordings", "__brochure", "__cis", "__prospectus") +_FACT_KEYS = ( + "policy_type_indemnity_or_fixed", + "deductible_amount", + "co_payment_pct", + "sum_insured_options", +) +_facts_cache: dict[str, dict] = {} + + +def _unwrap(v: Any) -> Any: + """policy_facts values are `{value, source_pdf_path, source_quote}` + wrappers OR bare scalars. Return the underlying value either way.""" + if isinstance(v, dict) and "value" in v: + return v["value"] + return v + + +def _candidate_stems(policy_id: str) -> list[str]: + """A retrieved chunk's policy_id may be the canonical stem + (`insurer__product`) OR a doctype-suffixed stem + (`insurer__product__cis`). Try the exact id first, then the canonical + form, then every doctype sibling — first existing file wins. + """ + pid = (policy_id or "").strip() + if not pid: + return [] + stems = [pid] + base = pid + for suf in _DOCTYPE_SUFFIXES: + if base.endswith(suf): + base = base[: -len(suf)] + break + if base != pid: + stems.append(base) + for suf in _DOCTYPE_SUFFIXES: + cand = base + suf + if cand not in stems: + stems.append(cand) + return stems + + +def _load_policy_facts(policy_id: str) -> dict: + """Return {fact_key: value} for a policy_id, or {} when no facts file + exists / is unreadable. Cached per policy_id (incl. negative cache).""" + if policy_id in _facts_cache: + return _facts_cache[policy_id] + out: dict = {} + try: + for stem in _candidate_stems(policy_id): + fp = _FACTS_DIR / f"{stem}.json" + if not fp.exists(): + continue + try: + d = _json.loads(fp.read_text()) + except Exception: # noqa: BLE001 — corrupt mid-repair → skip + continue + for k in _FACT_KEYS: + if k in d and k not in out: + out[k] = _unwrap(d[k]) + # Stop once we have the decision-critical signals. + if "policy_type_indemnity_or_fixed" in out and ( + "sum_insured_options" in out + ): + break + except Exception as e: # noqa: BLE001 — enrichment must never break retrieval + _log.warning("KI-278 _load_policy_facts(%s) failed: %s", policy_id, e) + out = {} + _facts_cache[policy_id] = out + return out + + +def _scorecard_signal(policy_id: str, profile=None) -> dict: + """Best-effort {_grade, _overall_score} from backend.scorecard. The + scorecard module's scoring math is being repaired concurrently — we + call it READ-ONLY and degrade silently (the ranking still works off + co-pay + SI headroom + cosine without it).""" + try: + facts = _load_policy_facts(policy_id) + if not facts: + # Need the full curated dict for a real grade; fall back to a + # minimal dict so build_scorecard at least sees co-pay/SI. + facts = {} + from backend.scorecard import build_scorecard + + prof = None + if profile is not None: + prof = { + s: getattr(profile, s, None) + for s in ( + "age", "income_band", "primary_goal", + "existing_cover_inr", "copay_pct", + ) + } + sc = build_scorecard(facts or {"policy_id": policy_id}, profile=prof) + return { + "_grade": getattr(sc, "grade", None), + "_overall_score": getattr(sc, "overall", None), + } + except Exception: # noqa: BLE001 — scorecard optional; ranking degrades gracefully + return {} + + # ---- accepted fields for save_profile_field -------------------------------- # Mirrors the slot list in sales_brain._REQUIRED_FOR_READY plus the @@ -407,20 +529,34 @@ async def retrieve_policies( raw: list[dict] = [] for c in chunks or []: - raw.append( - { - "chunk_id": getattr(c, "chunk_id", ""), - "policy_id": getattr(c, "policy_id", ""), - "policy_name": getattr(c, "policy_name", ""), - "insurer_slug": getattr(c, "insurer_slug", ""), - "doc_type": getattr(c, "doc_type", ""), - "source_url": getattr(c, "source_url", ""), - "chunk_text": (getattr(c, "text", "") or "")[:1200], - "score": float(getattr(c, "score", 0.0) or 0.0), - "min_entry_age": getattr(c, "min_entry_age", None), - "max_entry_age": getattr(c, "max_entry_age", None), - } - ) + pid = getattr(c, "policy_id", "") + doc_type = getattr(c, "doc_type", "") + chunk_dict = { + "chunk_id": getattr(c, "chunk_id", ""), + "policy_id": pid, + "policy_name": getattr(c, "policy_name", ""), + "insurer_slug": getattr(c, "insurer_slug", ""), + "doc_type": doc_type, + "source_url": getattr(c, "source_url", ""), + "chunk_text": (getattr(c, "text", "") or "")[:1200], + "score": float(getattr(c, "score", 0.0) or 0.0), + "min_entry_age": getattr(c, "min_entry_age", None), + "max_entry_age": getattr(c, "max_entry_age", None), + } + # KI-278 — enrich policy chunks with the structural facts the + # eligibility/profile-fit filter needs (top-up signal, SI options, + # mandatory co-pay, scorecard grade). Skip non-policy chunks + # (profile/regulatory/review) — they're never recommendable policies + # and the eligibility rules don't apply to them. + if pid and (doc_type or "").lower() not in ( + "profile", "regulatory", "review" + ): + try: + chunk_dict.update(_load_policy_facts(pid)) + chunk_dict.update(_scorecard_signal(pid, profile=profile)) + except Exception as e: # noqa: BLE001 — never break retrieval + _log.warning("KI-278 enrich(%s) failed: %s", pid, e) + raw.append(chunk_dict) # X5 sidecar: apply profile-fit + citation-grounding + dedup. Skip when # caller supplied an explicit policy_filter_ids (we already know which diff --git a/backend/main.py b/backend/main.py index 69e7cbaae750a73cb8a9743bacaaf68ecc3a185d..4f295f316fc34b1ef94425522bedc9ea9de613d0 100644 --- a/backend/main.py +++ b/backend/main.py @@ -143,6 +143,22 @@ class ChatResponse(BaseModel): session_id: str audio_base64: Optional[str] = None audio_mime: Optional[str] = None # X8 — "audio/wav" | "audio/mp4" | "audio/webm" + # KI-278 (2026-05-16) — TTS voice-output failures used to be SWALLOWED + # silently: the chat endpoint caught the Sarvam exception, logged it to + # turns.jsonl, and returned audio_base64=None with NO signal to the + # client. The user saw a text reply with no voice and no explanation + # ("no voice in reply. wtf?"). These two fields make the failure LOUD: + # the frontend renders a small inline "voice unavailable" notice under + # the bot bubble (text reply is unaffected). tts_error_code is a closed + # enum mirroring the STT path's contract so the client never parses raw + # httpx text: + # rate_limit — Sarvam 429 / insufficient_quota / no credits + # service_unavailable — Sarvam 5xx / 503 + # auth — Sarvam 401/403 / missing SARVAM_API_KEY + # network — connect/read timeout, DNS, conn reset + # unknown — anything else + tts_error_code: Optional[str] = None + tts_user_message: Optional[str] = None faithfulness_passed: bool = True faithfulness_reasons: list[str] = Field(default_factory=list) blocked: bool = False @@ -657,9 +673,15 @@ async def chat(req: ChatRequest, request: Request): # Safari, WAV as universal fallback). Default to WAV if the header is # missing or invalid. _allowed_codecs = {"audio/wav", "audio/mp4", "audio/webm"} + # KI-278 (2026-05-16) — the frontend sends a full MediaSource codec + # string, e.g. "audio/webm; codecs=opus". The previous exact-match + # against _allowed_codecs NEVER matched that (the "; codecs=opus" + # suffix), so webm/opus-capable browsers were ALWAYS silently + # downgraded to wav. Strip the codec parameter + whitespace before + # the membership test so the negotiated container is honoured. preferred_codec = ( request.headers.get("X-Preferred-Codec", "audio/wav") or "audio/wav" - ).lower() + ).split(";")[0].strip().lower() if preferred_codec not in _allowed_codecs: preferred_codec = "audio/wav" t_chat0 = time.time() @@ -899,15 +921,22 @@ async def chat(req: ChatRequest, request: Request): _seen.add(pid) _cited_ids.append(pid) if _cited_ids: + # KI-278 — turn.citations is now the prose-aligned + # recommendation set (single source of truth), so it equals + # exactly the cards the user sees. Back-fill the FULL set so + # ordinal follow-ups ("the 4th one") resolve against the same + # list. The old [:4] cap existed only because citations used + # to be the raw recall dump; it would now wrongly truncate a + # legitimate 5-policy shortlist. _result_r = _brain_tools_r.mark_recommendation( session=_rec_session, - policy_ids=_cited_ids[:4], # cap at 4 (typical shortlist) + policy_ids=_cited_ids, is_final=False, ) logging.info( "KI-254 auto-mark on rec turn (session=%s) " "policy_ids=%s result=%s", - session_id, _cited_ids[:4], _result_r, + session_id, _cited_ids, _result_r, ) except Exception as _rec_err: # noqa: BLE001 logging.warning( @@ -1031,6 +1060,13 @@ async def chat(req: ChatRequest, request: Request): audio_b64 = None audio_mime: Optional[str] = None + # KI-278 (2026-05-16) — when TTS fails we now propagate a STRUCTURED, + # user-facing notice instead of silently dropping the audio. The text + # reply is still returned in full; the frontend renders a small inline + # "voice unavailable" line under the bot bubble so the user understands + # WHY there's no voice (root cause this fixed: Sarvam 429 / no credits). + tts_error_code: Optional[str] = None + tts_user_message: Optional[str] = None if req.return_audio and turn.reply_text: try: from backend.voice_format import tts_preprocess @@ -1051,9 +1087,32 @@ async def chat(req: ChatRequest, request: Request): ) audio_b64 = base64.b64encode(audio).decode("utf-8") except Exception as e: - # Don't fail the whole turn if TTS hiccups — log + return text only - log_turn({"session_id": session_id, "tts_error": f"{type(e).__name__}: {e}"}) + # Don't fail the whole turn if TTS hiccups — but make the failure + # LOUD: classify it once at the boundary (closed enum, same + # contract as STT) so the client can render a friendly notice + # instead of showing a voice-less reply with no explanation. + from backend.providers.sarvam_tts import ( + classify_tts_exception, + TTS_ERROR_USER_MESSAGES, + TTS_ERROR_UNKNOWN, + ) + tts_error_code = classify_tts_exception(e) + tts_user_message = TTS_ERROR_USER_MESSAGES.get( + tts_error_code, TTS_ERROR_USER_MESSAGES[TTS_ERROR_UNKNOWN] + ) + audio_b64 = None audio_mime = None + # Server-side diagnostics keep the raw error; the client never + # sees the raw httpx string. + logging.warning( + "TTS failed (session=%s): error_code=%s exc=%s: %s", + session_id, tts_error_code, type(e).__name__, e, + ) + log_turn({ + "session_id": session_id, + "tts_error": f"{type(e).__name__}: {e}", + "tts_error_code": tts_error_code, + }) try: log_turn({ @@ -1174,6 +1233,8 @@ async def chat(req: ChatRequest, request: Request): session_id=session_id, audio_base64=audio_b64, audio_mime=audio_mime, + tts_error_code=tts_error_code, + tts_user_message=tts_user_message, faithfulness_passed=turn.faithfulness_passed, faithfulness_reasons=turn.faithfulness_reasons, blocked=turn.blocked, @@ -1943,7 +2004,6 @@ class MarketplacePolicy(BaseModel): # Headline filterable fields min_entry_age: Optional[int] = None max_entry_age: Optional[int] = None - max_renewal_age: Optional[int] = None sum_insured_options: list[int] = Field(default_factory=list) pre_existing_disease_waiting_months: Optional[int] = None initial_waiting_period_days: Optional[int] = None @@ -2044,6 +2104,18 @@ def _load_curated_facts() -> dict[str, dict]: `source_pdf_path` across this curated entry's fields. Used by both /api/policies/all and /api/coverage to alias-merge marketing-rename curated entries into their extracted-JSON parent card. + + KI-219 (2026-05-15) — CANONICAL PRECEDENCE. When the curated dir has BOTH + a canonical (`__.json`) and one or more doctype-suffixed + siblings (`____wordings.json`, `__brochure.json`, + `__cis.json`, `__prospectus.json`) for the same product, the canonical + file's content is the source of truth. The suffixed-sibling keys point + AT the canonical entry so any downstream lookup by either form resolves + to the richer canonical data. Previously the order of `glob('*.json')` + + `setdefault` made the loser non-deterministic; the more complete + canonical entry (e.g. `hdfc-ergo__optima-secure.json` says "No room rent + cap") was getting shadowed by the suffixed sibling (`...__wordings.json` + says "Room rent capped at 1%"), collapsing scorecards to 72/100. """ import json as _json from collections import Counter @@ -2051,12 +2123,11 @@ def _load_curated_facts() -> dict[str, dict]: facts_dir = settings.CORPUS_DIR.parent.parent / "40-data" / "policy_facts" if not facts_dir.exists(): return facts - for f in facts_dir.glob("*.json"): - try: - d = _json.loads(f.read_text()) - except Exception: - continue - policy_id = d.get("policy_id") or f.stem + + _DOCTYPE_SUFFIXES = ("__wordings", "__brochure", "__cis", "__prospectus") + + def _flatten(d: dict, fallback_id: str) -> dict: + policy_id = d.get("policy_id") or fallback_id flat: dict = {} provenance: dict = {} all_source_pdfs: list[str] = [] @@ -2076,21 +2147,72 @@ def _load_curated_facts() -> dict[str, dict]: all_source_pdfs.append(v["source_pdf_path"]) else: flat[k] = v + flat.setdefault("policy_id", policy_id) flat["_facts_provenance"] = provenance - # KI-141 — pick the most-common source PDF path as this curated - # entry's "primary source". When this path's extracted-JSON parent - # already exists, the marketplace collapses this curated entry into - # the parent's aliases list instead of emitting a separate card. flat["_primary_source_pdf"] = ( Counter(all_source_pdfs).most_common(1)[0][0] if all_source_pdfs else None ) - # Try a couple of policy_id permutations to maximise lookup hit rate - facts[policy_id] = flat - # Some extracted JSONs use `_wordings` suffix; the curated files don't - facts.setdefault(f"{policy_id}__wordings", flat) - facts.setdefault(f"{policy_id}__brochure", flat) - facts.setdefault(f"{policy_id}__cis", flat) + return flat + + # Pass 1 — load every curated JSON, indexed by its on-disk stem, AND + # group siblings by their canonical product_key (stem with any trailing + # __doctype suffix stripped). + by_stem: dict[str, dict] = {} + siblings: dict[str, list[tuple[str, bool]]] = {} # product_key → [(stem, is_canonical), ...] + for f in sorted(facts_dir.glob("*.json")): + try: + d = _json.loads(f.read_text()) + except Exception: + continue + stem = f.stem + flat = _flatten(d, stem) + by_stem[stem] = flat + # Determine canonical-ness by FILE STEM (not by policy_id field). + # A stem ending in one of the four doctype tokens is a non-canonical + # sibling; everything else is canonical. + is_canonical = not any(stem.endswith(suf) for suf in _DOCTYPE_SUFFIXES) + if is_canonical: + product_key = stem + else: + # Strip the matching suffix to find the canonical sibling. + for suf in _DOCTYPE_SUFFIXES: + if stem.endswith(suf): + product_key = stem[: -len(suf)] + break + else: + product_key = stem + siblings.setdefault(product_key, []).append((stem, is_canonical)) + + # Pass 2 — for each product_key, pick the canonical entry's flat dict if + # present; otherwise fall back to the first suffixed sibling (sorted to + # be deterministic). Then make every sibling key (canonical stem + each + # __doctype variant + each sibling's own stem + each sibling's + # policy_id) point at the chosen flat dict so the source-of-truth wins + # regardless of which key the caller looked up by. + for product_key, entries in siblings.items(): + canonical_entries = [s for s, c in entries if c] + if canonical_entries: + chosen_stem = canonical_entries[0] + else: + chosen_stem = sorted(s for s, _ in entries)[0] + chosen = by_stem[chosen_stem] + + # Register the canonical product_key. + facts[product_key] = chosen + # Register every doctype-suffix permutation pointing at the chosen + # flat (back-compat with code that looks up by the suffixed name). + for suf in _DOCTYPE_SUFFIXES: + facts.setdefault(f"{product_key}{suf}", chosen) + # Register every sibling's actual on-disk stem AND policy_id field + # so callers that already hold a stem-like ID still resolve to the + # canonical content. + for sib_stem, _is_can in entries: + facts[sib_stem] = chosen + sib_pid = by_stem[sib_stem].get("policy_id") + if isinstance(sib_pid, str) and sib_pid: + facts[sib_pid] = chosen + return facts @@ -2560,7 +2682,6 @@ async def policies_all(session_id: Optional[str] = None): data_completeness_pct=sc.data_completeness_pct, min_entry_age=data.get("min_entry_age"), max_entry_age=data.get("max_entry_age"), - max_renewal_age=data.get("max_renewal_age"), sum_insured_options=si, pre_existing_disease_waiting_months=data.get("pre_existing_disease_waiting_months"), initial_waiting_period_days=data.get("initial_waiting_period_days"), @@ -2649,7 +2770,6 @@ async def policies_all(session_id: Optional[str] = None): data_completeness_pct=sc.data_completeness_pct, min_entry_age=data.get("min_entry_age"), max_entry_age=data.get("max_entry_age"), - max_renewal_age=data.get("max_renewal_age"), sum_insured_options=si, pre_existing_disease_waiting_months=data.get("pre_existing_disease_waiting_months"), initial_waiting_period_days=data.get("initial_waiting_period_days"), @@ -2690,11 +2810,15 @@ async def compare_policies(policy_ids: list[str] = None): raise HTTPException(400, "compare requires 2 to 4 policy_ids") entries = [] + # KI: apply the SAME curated-override as /api/policies/all so COMPARE ALL + # reflects the corrected/verbatim 40-data/policy_facts, not stale extract. + _curated = _load_curated_facts() for pid in policy_ids: p = settings.EXTRACTED_DIR / f"{pid}.json" if not p.exists(): raise HTTPException(404, f"No extraction for {pid}") data = _json.loads(p.read_text()) + data = _merge_curated(data, _curated.get(data.get("policy_id", pid)) or _curated.get(pid)) # Insurer reviews for scorecard slug = data.get("insurer_slug") ir = None @@ -2721,7 +2845,7 @@ async def compare_policies(policy_ids: list[str] = None): # Comparison-critical fields, in order field_order = [ "policy_type", "uin_code", - "min_entry_age", "max_entry_age", "max_renewal_age", + "min_entry_age", "max_entry_age", "sum_insured_options", "initial_waiting_period_days", "pre_existing_disease_waiting_months", "maternity_waiting_months", @@ -2761,6 +2885,11 @@ async def policy_scorecard( except Exception as e: raise HTTPException(500, f"Could not load extracted policy: {e}") + # KI: same curated-override as /api/policies/all so the standalone + # scorecard reflects the corrected/verbatim 40-data/policy_facts. + _curated = _load_curated_facts() + policy = _merge_curated(policy, _curated.get(policy.get("policy_id", policy_id)) or _curated.get(policy_id)) + # Load insurer reviews if present so the Claim Experience sub-score # uses authoritative IRDAI data, not just the (mostly-null) per-policy fields. insurer_reviews = None @@ -2874,9 +3003,9 @@ def _profile_rationale_for(policy: dict, profile: Optional[dict], sub_scores) -> bullets.append(f"Strong fit: {nh_n:,}+ cashless hospitals matters at age {age} when access speed counts.") elif nh_n is not None and nh_n < 3000: bullets.append(f"Weak fit: only {nh_n} cashless hospitals — thin network for age {age}.") - maxr = policy.get("max_renewal_age") - if maxr and int(maxr) >= 99: - bullets.append(f"Strong fit: lifelong renewability — keeps protecting you past 70.") + # max_renewal_age removed: lifelong renewability is the IRDAI norm for + # every health-indemnity policy (universal → not a differentiator, and + # the old `>= 99` check fired on the fabricated 999 sentinel). # Family + room-rent / maternity if any(k in deps for k in ("spouse", "wife", "husband", "partner", "kid", "child", "family")): @@ -2973,6 +3102,9 @@ async def scorecard_bulk(req: BulkScorecardRequest): profile = req.profile or None insurer_cache: dict[str, Optional[dict]] = {} out: dict[str, BulkScorecardEntry] = {} + # KI: same curated-override as /api/policies/all so the bulk scorecard + # badges reflect the corrected/verbatim 40-data/policy_facts. + _curated = _load_curated_facts() for pid in req.policy_ids: extracted_path = settings.EXTRACTED_DIR / f"{pid}.json" @@ -3002,6 +3134,7 @@ async def scorecard_bulk(req: BulkScorecardRequest): signals={}, ) continue + policy = _merge_curated(policy, _curated.get(policy.get("policy_id", pid)) or _curated.get(pid)) slug = policy.get("insurer_slug") or "?" if slug not in insurer_cache: diff --git a/backend/providers/sarvam_tts.py b/backend/providers/sarvam_tts.py index a3c8317ea3fa0822c1fad3f624a473197723e6e3..2104e849ba3449252a1f5c6470bd8278e0f35093 100644 --- a/backend/providers/sarvam_tts.py +++ b/backend/providers/sarvam_tts.py @@ -48,6 +48,79 @@ except Exception: # pragma: no cover — pydub missing in dev shell _SUPPORTED_CODECS = {"audio/wav", "audio/mp4", "audio/webm"} +# KI-278 (2026-05-16) — voice-OUTPUT error vocabulary. Mirrors the STT +# closed-enum contract (sarvam_stt.STT_ERROR_*) so the chat endpoint can +# surface a structured tts_error_code instead of swallowing the exception +# and returning audio_base64=None with zero signal to the client. Bug +# origin: Sarvam account ran out of credits → /text-to-speech returned +# HTTP 429 {"code":"insufficient_quota_error"} → resp.raise_for_status() +# raised → chat endpoint logged it to turns.jsonl and returned a text-only +# reply with NO voice and NO explanation ("no voice in reply. wtf?"). +TTS_ERROR_RATE_LIMIT = "rate_limit" +TTS_ERROR_SERVICE = "service_unavailable" +TTS_ERROR_NETWORK = "network" +TTS_ERROR_AUTH = "auth" +TTS_ERROR_UNKNOWN = "unknown" + +TTS_ERROR_USER_MESSAGES = { + # The 429 here is specifically Sarvam's `insufficient_quota_error` + # ("No credits available") in practice — distinct from a transient + # rate-limit. Phrase it so the user knows the TEXT answer is complete + # and only the spoken playback is unavailable. + TTS_ERROR_RATE_LIMIT: ( + "Voice playback is unavailable right now (speech quota exhausted) — " + "the written answer above is complete. You can keep chatting in text." + ), + TTS_ERROR_SERVICE: ( + "Voice playback is temporarily unavailable — the written answer " + "above is complete." + ), + TTS_ERROR_NETWORK: ( + "Couldn't load the spoken reply (network hiccup) — the written " + "answer above is complete." + ), + TTS_ERROR_AUTH: ( + "Voice playback is unavailable right now — the written answer " + "above is complete." + ), + TTS_ERROR_UNKNOWN: ( + "Couldn't play the spoken reply — the written answer above is " + "complete." + ), +} + + +def classify_tts_exception(exc: BaseException) -> str: + """Map an httpx / network exception to a TTS_ERROR_* code. + + Same boundary-classification pattern as classify_stt_exception — the + frontend never parses raw httpx text; it switches on this closed enum. + """ + if isinstance(exc, httpx.HTTPStatusError): + status = exc.response.status_code if exc.response is not None else 0 + if status == 429: + return TTS_ERROR_RATE_LIMIT + if status in (401, 403): + return TTS_ERROR_AUTH + if 500 <= status < 600: + return TTS_ERROR_SERVICE + return TTS_ERROR_UNKNOWN + if isinstance(exc, httpx.TimeoutException): + return TTS_ERROR_NETWORK + if isinstance(exc, httpx.NetworkError): + return TTS_ERROR_NETWORK + if isinstance(exc, httpx.HTTPError): + return TTS_ERROR_UNKNOWN + # RuntimeError("SARVAM_API_KEY not set") / RuntimeError("returned no + # audio") — treat missing-key as auth, empty-audio as service. + if isinstance(exc, RuntimeError): + msg = str(exc).lower() + if "api_key" in msg or "api key" in msg or "subscription" in msg: + return TTS_ERROR_AUTH + return TTS_ERROR_SERVICE + return TTS_ERROR_UNKNOWN + + def _transcode_wav(wav_bytes: bytes, preferred_codec: str) -> Tuple[bytes, str]: """Convert raw WAV bytes to the preferred codec. diff --git a/backend/retrieval_filters.py b/backend/retrieval_filters.py index d84df14a004aa623d6bc0117c25664d3d24b73e1..4e8511ceb9a8060ef4998b910b44c8405af3ae5d 100644 --- a/backend/retrieval_filters.py +++ b/backend/retrieval_filters.py @@ -7,6 +7,16 @@ don't conflict with the retrieval-correctness work. Public API: apply_profile_filter(chunks, profile) -> list[RetrievedChunk] Drop chunks for policies the user is demographically ineligible for. + apply_eligibility_filter(chunks, profile) -> list[RetrievedChunk] + Drop chunks the user is STRUCTURALLY ineligible for / that clearly + contradict an explicit stated need (KI-278): + - top-up / super-top-up when the user has no existing base cover + - plans whose max sum-insured cannot meet the requested SI + - high co-pay plans when the user explicitly wants zero co-pay + rank_by_profile_fit(chunks, profile) -> list[RetrievedChunk] + Re-order surviving chunks so the plans that best match the stated + needs (grade, co-pay, SI headroom) rank above weak-fit plans whose + only advantage was raw cosine similarity (KI-278). bypass_cosine_for_exact_match(chunks, query) -> list[RetrievedChunk] | None If the query contains an IRDAI UIN or an exact policy name, return a substring-matched chunk list (caller can use this instead of cosine). @@ -67,6 +77,42 @@ MATERNITY_NAME_RE = re.compile( flags=re.IGNORECASE, ) +# --------------------------------------------------------------------------- +# KI-278 — Eligibility / profile-fit tunables (2026-05-16) +# --------------------------------------------------------------------------- +# A plan is a TOP-UP / SUPER-TOP-UP (only useful ALONGSIDE an existing base +# policy or above a large out-of-pocket deductible) when ANY of these hold: +# 1. policy_type_indemnity_or_fixed contains "top_up" / "top-up" / "super" +# 2. the policy NAME matches TOP_UP_NAME_RE +# 3. it carries a large aggregate `deductible_amount` (the de-facto base +# cover the user must already hold) — see TOP_UP_DEDUCTIBLE_FLOOR_INR +TOP_UP_NAME_RE = re.compile( + r"\b(super[\s\-]?top[\s\-]?up|top[\s\-]?up|topup|super[\s\-]?top)\b", + flags=re.IGNORECASE, +) + +# An aggregate deductible at/above this rupee floor means the plan only pays +# AFTER the insured has already spent this much (from a base policy or +# pocket) — i.e. it is functionally a top-up and unusable as a sole first +# policy. ₹1,00,000 is conservative: real top-ups deductibles start ~₹2-3L; +# a genuine non-top-up plan never carries a six-figure aggregate deductible. +TOP_UP_DEDUCTIBLE_FLOOR_INR = 100_000 + +# When the user explicitly wants zero co-pay AND is not income-constrained +# (can afford full cover), any plan whose mandatory co-payment exceeds this +# percentage is a hard mismatch and is dropped. A 0 here means "drop ANY +# plan with a non-zero mandatory co-pay for a strict zero-copay user". +ZERO_COPAY_USER_MAX_COPAY_PCT = 0 + +# Even when the user did NOT explicitly demand zero co-pay, a punitive +# co-pay (>= this) is dropped because no metric recovers from a 50% claim +# haircut for a metro / high-income first-time buyer. +PUNITIVE_COPAY_PCT = 40 + +# SI headroom: a plan is SI-eligible only if its largest sum-insured option +# is at least the requested SI. (We do NOT require an exact tier — most +# insurers interpolate; but a plan whose ceiling is below the ask cannot +# deliver the cover the user said they need.) # Minimum chunk count to attempt a recommendation. Below this we ask for # one more clarifier instead of letting the brain hallucinate. MIN_CHUNKS_FOR_RECOMMENDATION = 3 @@ -113,6 +159,28 @@ def _meta(chunk: Any) -> dict: return out +def _meta_full(chunk: Any) -> dict: + """Like `_meta` but also surfaces the KI-278 enriched structured-fact + keys (policy_type_indemnity_or_fixed / deductible_amount / + co_payment_pct / sum_insured_options / _grade / _overall_score). + + `brain_tools.retrieve_policies` passes plain dicts, so the common path + is just `return chunk`. For dataclass chunks we duck-type the union of + citation + enriched fields so the eligibility/ranking rules still work + if a future caller hands us a dataclass. + """ + if isinstance(chunk, dict): + return chunk + out = _meta(chunk) + for k in ( + "policy_type_indemnity_or_fixed", "deductible_amount", + "co_payment_pct", "sum_insured_options", "_grade", "_overall_score", + ): + if hasattr(chunk, k): + out[k] = getattr(chunk, k) + return out + + def _profile_get(profile: Any, key: str, default=None): """Profile may be a dataclass (needs_finder.Profile) OR a dict — accept either.""" if profile is None: @@ -227,6 +295,225 @@ def apply_profile_filter(chunks: Iterable[Any], profile: Any) -> list[Any]: return kept +# --------------------------------------------------------------------------- +# (1b) Eligibility filter (KI-278) — structural mismatch hard-drop +# --------------------------------------------------------------------------- + +def _as_int(v: Any) -> Optional[int]: + """Best-effort int coercion (bool excluded — it's an int subclass).""" + if v is None or isinstance(v, bool): + return None + if isinstance(v, (int, float)): + return int(v) + try: + return int(str(v).strip()) + except (TypeError, ValueError): + return None + + +def _max_sum_insured(chunk_meta: dict) -> Optional[int]: + """Largest SI the policy can offer, from the enriched + `sum_insured_options` list. None when the fact is absent (don't drop on + missing data).""" + opts = chunk_meta.get("sum_insured_options") + if not opts: + return None + nums: list[int] = [] + if isinstance(opts, (list, tuple)): + for o in opts: + n = _as_int(o) + if n is not None: + nums.append(n) + else: + n = _as_int(opts) + if n is not None: + nums.append(n) + return max(nums) if nums else None + + +def _is_top_up(chunk_meta: dict) -> bool: + """A plan is a top-up / super-top-up when ANY structural signal fires: + 1. policy_type_indemnity_or_fixed says top_up / super + 2. the policy name matches TOP_UP_NAME_RE + 3. it carries a large aggregate deductible (>= TOP_UP_DEDUCTIBLE_FLOOR) + """ + ptype = str(chunk_meta.get("policy_type_indemnity_or_fixed") or "").lower() + if "top" in ptype or "super_top" in ptype or "super-top" in ptype: + return True + name = str(chunk_meta.get("policy_name") or "") + if TOP_UP_NAME_RE.search(name): + return True + ded = _as_int(chunk_meta.get("deductible_amount")) + if ded is not None and ded >= TOP_UP_DEDUCTIBLE_FLOOR_INR: + return True + return False + + +def _user_has_base_cover(profile: Any) -> bool: + """True when the user already holds base health cover. A first-time + buyer (existing_cover_inr == 0 / None / falsy, OR primary_goal looks + like a first purchase) has NO base cover, so a top-up is unusable.""" + existing = _as_int(_profile_get(profile, "existing_cover_inr")) + if existing and existing > 0: + return True + goal = str(_profile_get(profile, "primary_goal") or "").lower() + # "first_buy" / "first policy" / "first-time" → definitively no base. + if any(tok in goal for tok in ("first", "new policy", "fresh")): + return False + # No explicit existing cover and no first-buy signal → treat as no base + # cover (conservative: a top-up only helps someone who KNOWS they have a + # base; absent that signal, don't surface an unusable product). + return False + + +def _user_wants_zero_copay(profile: Any) -> bool: + copay = _as_int(_profile_get(profile, "copay_pct")) + return copay is not None and copay <= ZERO_COPAY_USER_MAX_COPAY_PCT + + +def apply_eligibility_filter(chunks: Iterable[Any], profile: Any) -> list[Any]: + """Drop chunks the user is STRUCTURALLY ineligible for, or that plainly + contradict an explicit stated need (KI-278). + + Hard-drop rules (policy chunks only — profile/regulatory/review chunks + are never policies and pass through untouched): + + 1. TOP-UP GATE — a top-up / super-top-up plan is dropped when the user + has no existing base cover (first-time buyer). A top-up only pays + above a base policy / large deductible the user does not have. + + 2. SI FLOOR — when the user stated a desired sum insured, drop any + plan whose largest SI option is below that requirement (it cannot + deliver the cover the user said they need). + + 3. ZERO-COPAY GATE — when the user explicitly wants zero co-pay, drop + any plan with a mandatory co-payment above + ZERO_COPAY_USER_MAX_COPAY_PCT. Regardless of stated preference, + drop plans with a punitive co-pay (>= PUNITIVE_COPAY_PCT). + + Conservative on missing data: a rule only fires when BOTH the profile + signal AND the policy fact are present. A chunk with no enriched facts + is never dropped here (it just won't get a fit boost in ranking). + """ + chunks_list = list(chunks) + if not chunks_list: + return chunks_list + + has_base = _user_has_base_cover(profile) + wants_zero_copay = _user_wants_zero_copay(profile) + desired_si = _as_int(_profile_get(profile, "desired_sum_insured_inr")) + + kept: list[Any] = [] + for ch in chunks_list: + m = _meta_full(ch) + doc_type = (m.get("doc_type") or "").lower() + if doc_type in ("profile", "regulatory", "review"): + kept.append(ch) + continue + + # Rule 1 — top-up unusable without a base policy + if not has_base and _is_top_up(m): + continue + + # Rule 2 — SI floor + if desired_si: + max_si = _max_sum_insured(m) + if max_si is not None and max_si < desired_si: + continue + + # Rule 3 — co-pay gate + copay = _as_int(m.get("co_payment_pct")) + if copay is not None: + if copay >= PUNITIVE_COPAY_PCT: + continue + if wants_zero_copay and copay > ZERO_COPAY_USER_MAX_COPAY_PCT: + continue + + kept.append(ch) + + return kept + + +# --------------------------------------------------------------------------- +# (1c) Profile-fit ranking (KI-278) — re-order by stated-need match +# --------------------------------------------------------------------------- + +_GRADE_POINTS = {"A": 100.0, "B": 70.0, "C": 45.0, "D": 25.0, "F": 5.0} + + +def _fit_score(chunk_meta: dict, profile: Any, wants_zero_copay: bool, + desired_si: Optional[int]) -> float: + """Composite profile-fit score (higher = better). Blends raw cosine + (so genuinely-relevant chunks still matter) with structural fit: + • scorecard grade / overall (when enriched) + • co-pay penalty (steep when the user wants zero co-pay) + • SI headroom (a plan that comfortably offers the requested SI beats + one that barely scrapes it) + """ + try: + cosine = float(chunk_meta.get("score") or 0.0) + except (TypeError, ValueError): + cosine = 0.0 + # Cosine is ~[0,1]; scale so it contributes but never dominates fit. + score = cosine * 30.0 + + # Grade / overall scorecard signal (enriched by brain_tools). + grade = str(chunk_meta.get("_grade") or "").strip().upper() + overall = _as_int(chunk_meta.get("_overall_score")) + if overall is not None: + score += float(overall) # 0-100 scorecard points + elif grade in _GRADE_POINTS: + score += _GRADE_POINTS[grade] + + # Co-pay penalty. + copay = _as_int(chunk_meta.get("co_payment_pct")) + if copay is not None and copay > 0: + penalty = copay * (3.0 if wants_zero_copay else 1.0) + score -= penalty + + # SI headroom bonus — reward a plan that offers >= the requested SI. + if desired_si: + max_si = _max_sum_insured(chunk_meta) + if max_si is not None: + if max_si >= desired_si: + score += 15.0 + else: + score -= 25.0 # shouldn't survive eligibility, belt-and-braces + + return score + + +def rank_by_profile_fit(chunks: Iterable[Any], profile: Any) -> list[Any]: + """Stable-sort chunks by composite profile-fit (descending). Non-policy + chunks (profile/regulatory/review) keep their relative position at the + front so grounding context isn't reordered away. + + Stable: ties preserve the incoming (cosine / dedup) order, so this only + *promotes* better-fit plans — it never randomly shuffles equals. + """ + chunks_list = list(chunks) + if len(chunks_list) <= 1: + return chunks_list + + wants_zero_copay = _user_wants_zero_copay(profile) + desired_si = _as_int(_profile_get(profile, "desired_sum_insured_inr")) + + non_policy: list[Any] = [] + policy: list[Any] = [] + for ch in chunks_list: + dt = (_meta_full(ch).get("doc_type") or "").lower() + (non_policy if dt in ("profile", "regulatory", "review") else policy).append(ch) + + # Decorate-sort-undecorate with original index as the stable tiebreaker. + decorated = [ + (-_fit_score(_meta_full(ch), profile, wants_zero_copay, desired_si), i, ch) + for i, ch in enumerate(policy) + ] + decorated.sort(key=lambda t: (t[0], t[1])) + ranked_policy = [ch for _, _, ch in decorated] + return non_policy + ranked_policy + + # --------------------------------------------------------------------------- # (2) Hybrid retrieval — exact-match bypass on UIN or policy name # --------------------------------------------------------------------------- @@ -397,28 +684,42 @@ def filter_pipeline( query: str = "", intent: Optional[str] = None, ) -> tuple[list[Any], Optional[dict]]: - """Run the standard A3/A6 retrieval-side pipeline: + """Run the standard A3/A6 + KI-278 retrieval-side pipeline: - 1. Citation grounding (reject malformed chunks) - 2. Profile pre-filter (drop demographically inappropriate policies) - 3. Exact-match bypass (if query has a UIN / quoted name, swap in) - 4. Dedup by policy_id - 5. Empty-retrieval guard + 1. Citation grounding (reject malformed chunks) + 2. Profile pre-filter (drop demographically inappropriate policies) + 3. Eligibility filter (KI-278 — drop structural mismatches: + top-up w/o base cover, SI floor, co-pay) + 4. Exact-match bypass (if query has a UIN / quoted name, swap in) + 5. Dedup by policy_id + 6. Profile-fit ranking (KI-278 — promote best-fit over raw cosine) + 7. Empty-retrieval guard Returns (filtered_chunks, guard_signal_or_None). When guard_signal is set, the caller should NOT pass `filtered_chunks` to the brain — they should surface the clarifier instead. + + KI-278 ordering note: the eligibility filter runs on the demographically- + fitted set and BEFORE the empty-retrieval guard, so a profile whose only + matches are ineligible (e.g. a first-time buyer where cosine only found + top-ups) correctly trips the clarifier guard instead of recommending an + unusable product. The exact-match bypass still wins when the user names + a specific policy (they may legitimately want to read about a top-up). """ grounded = enforce_citation_grounding(chunks) fitted = apply_profile_filter(grounded, profile) + eligible = apply_eligibility_filter(fitted, profile) exact = bypass_cosine_for_exact_match(grounded, query) if exact is not None and exact: # Exact match wins over cosine when the user clearly named a target. - # Still apply profile filter to exact matches (the user might ask - # about a senior plan when they're 25 — show it, but log it). - fitted = exact - - deduped = dedup_by_policy(fitted) - guard = empty_retrieval_guard(deduped, intent=intent) - return deduped, guard + # The user explicitly asked about THIS policy — show it even if it + # would fail the eligibility/fit gates (they may be researching a + # top-up or a high-copay plan on purpose). Demographic filter still + # applies (a 25yo asking about a senior plan still gets steered). + eligible = apply_profile_filter(exact, profile) + + deduped = dedup_by_policy(eligible) + ranked = rank_by_profile_fit(deduped, profile) + guard = empty_retrieval_guard(ranked, intent=intent) + return ranked, guard diff --git a/backend/scorecard.py b/backend/scorecard.py index c2dfd1abd447034338f24339b2a092ac2718a8bb..c1e819f4bdddddc2921392e0762b3891132689e6 100644 --- a/backend/scorecard.py +++ b/backend/scorecard.py @@ -11,15 +11,74 @@ Score philosophy: optimize for the *buyer*, not the insurer. So: - Regulatory-mandated minimums (IRDAI 30-day initial) don't hurt the score Each sub-score is 0-100. Overall is a weighted average. Letter grade comes -from thresholds (A: 85+, B: 70-84, C: 55-69, D: 40-54, F: <40). +from ABSOLUTE thresholds, frozen post-recalibration (2026-05-16): +A: ≥76, B: ≥69, C: ≥61, D: ≥54, F: <54. See grade_for(). """ from __future__ import annotations +import re from dataclasses import dataclass, field from typing import Any, Optional +# ---------------------------------------------------------------------------- +# FIELD ALIASES — the canonical-scorer-key → list-of-acceptable-input-keys map. +# +# Why this exists: the data layer is heterogeneous. +# * 40-data/policy_facts/__.json → canonical names +# (max_renewal_age, copayment_pct, day_care_treatments_count, etc.) +# * 40-data/policy_facts/____.json → mixed; some +# fields use LLM-extracted aliases like co_payment_pct, room_rent_capped_at_pct_of_si +# * rag/extracted/*.json → pure LLM output with aliases like +# max_renewal_age_years (int), deductible_amount_inr (int), +# day_care_treatments: {covered, limit_inr, limit_text/notes} (dict). +# +# Without aliasing the scorecard reads `None` for every aliased field and the +# 6 sub-scores collapse to their neutral bases → 12 different policies all +# render as 72/100. Aliasing recovers the underlying data spread. +# ---------------------------------------------------------------------------- +# NOTE: max_renewal_age was deliberately removed as a scored field. Lifelong +# renewability is the IRDAI norm for health-indemnity products (mandated since +# 2020), so it does not differentiate policies. The old pipeline faked it as +# `max_renewal_age=999` to trigger a now-deleted "lifelong" bonus — see +# score_renewal_protection. Do not re-add it to ALIASES or SCORED_FIELDS. +ALIASES: dict[str, list[str]] = { + "max_entry_age": ["max_entry_age", "max_entry_age_years"], + "deductible_amount": ["deductible_amount", "deductible_amount_inr"], + "copayment_pct": ["copayment_pct", "co_payment_pct"], + "day_care_treatments_count": ["day_care_treatments_count", "day_care_treatments"], + "network_hospital_count": ["network_hospital_count", "network_hospital_count_text"], + "room_rent_capping": ["room_rent_capping", "room_rent_capped_at_pct_of_si"], + "pre_existing_disease_waiting_months": ["pre_existing_disease_waiting_months", "ped_waiting_months"], + "initial_waiting_period_days": ["initial_waiting_period_days", "initial_waiting_days"], + "maternity_waiting_months": ["maternity_waiting_months", "maternity_wait_months"], + "pre_hospitalization_days": ["pre_hospitalization_days", "pre_hosp_days"], + "post_hospitalization_days": ["post_hospitalization_days", "post_hosp_days"], + "no_claim_bonus_pct": ["no_claim_bonus_pct", "ncb_pct", "cumulative_bonus_pct"], + "tat_cashless_authorization_hours": ["tat_cashless_authorization_hours", "tat_cashless_hours"], + "claim_settlement_ratio": ["claim_settlement_ratio", "claim_settlement_ratio_pct"], +} + + +def _pick_alias(p: dict, canonical_key: str): + """Return the first non-empty value across the alias list for canonical_key. + Treats None, "", [], {} (and dicts whose 'value' is None) as empty. + The {value, source_*} wrapper shape used by curated files is unwrapped. + """ + for alias in ALIASES.get(canonical_key, [canonical_key]): + v = p.get(alias) + # Unwrap the curated {value, source_pdf_path, ...} shape if present. + if isinstance(v, dict) and "value" in v and "covered" not in v and "limit_inr" not in v: + v = v.get("value") + if v is None or v == "" or v == []: + continue + if isinstance(v, dict) and not v: + continue + return v + return None + + @dataclass class SubScore: name: str @@ -44,33 +103,75 @@ class Scorecard: # ---- helpers ---- def _get(p: dict, key: str, default: Any = None) -> Any: - v = p.get(key, default) + v = _pick_alias(p, key) + if v is None: + return default if isinstance(v, dict) and "covered" in v: return v.get("covered", default) return v def _bool(p: dict, key: str) -> Optional[bool]: - v = p.get(key) + v = _pick_alias(p, key) if isinstance(v, dict) and "covered" in v: return v.get("covered") if isinstance(v, bool): return v - if isinstance(v, str) and v.lower() in ("yes", "true", "y"): + if isinstance(v, str) and v.lower() in ("yes", "true", "y", "covered"): return True - if isinstance(v, str) and v.lower() in ("no", "false", "n"): + if isinstance(v, str) and v.lower() in ("no", "false", "n", "not covered", "excluded"): return False return None +_INT_FROM_TEXT_RE = re.compile(r"(\d[\d,]*)") + + def _int(p: dict, key: str) -> Optional[int]: - v = p.get(key) - if isinstance(v, dict) and "limit_inr" in v: - v = v.get("limit_inr") - try: - return int(v) if v is not None else None - except (TypeError, ValueError): + """Coerce the aliased value into an int. Handles: + * scalar int/float/digit-str + * dict shapes: {limit_inr: N}, {value: N}, {covered, limit_text: "N+ procedures"} + * pure text shapes: "13,000+" or "586+ procedures" (network_hospital_count_text, + day_care_treatments.limit_text/notes) + Returns None if no integer can be recovered. + """ + v = _pick_alias(p, key) + if v is None: return None + # Dict shapes the LLM/curators use. + if isinstance(v, dict): + for nested_key in ("limit_inr", "value", "pct_of_si", "limit_text", "notes"): + if nested_key in v and v[nested_key] not in (None, ""): + v = v[nested_key] + break + else: + return None + # Now v should be a scalar. + if isinstance(v, bool): + return None # don't let True/False sneak in as 1/0 + if isinstance(v, (int, float)): + try: + return int(v) + except (TypeError, ValueError): + return None + if isinstance(v, str): + s = v.strip() + if not s: + return None + # Direct numeric parse first. + try: + return int(float(s.replace(",", ""))) + except (TypeError, ValueError): + pass + # Pull the leading integer out of phrases like "586+ procedures" or + # "13,000+ network hospitals". + m = _INT_FROM_TEXT_RE.search(s) + if m: + try: + return int(m.group(1).replace(",", "")) + except (TypeError, ValueError): + return None + return None def clamp(x: float, lo: int = 0, hi: int = 100) -> int: @@ -83,36 +184,37 @@ def score_coverage_breadth(p: dict) -> SubScore: """How wide is the safety net? AYUSH, day-care, OPD, organ donor, maternity, etc.""" signals_pos: list[str] = [] signals_neg: list[str] = [] - s = 50 # neutral base + s = 40 # true-neutral base (was 50 — recalibrated for real spread) if _bool(p, "ayush_coverage"): - s += 8; signals_pos.append("AYUSH covered") + s += 10; signals_pos.append("AYUSH covered") elif _bool(p, "ayush_coverage") is False: - signals_neg.append("no AYUSH") + s -= 6; signals_neg.append("no AYUSH") dct = _int(p, "day_care_treatments_count") if dct is not None: - if dct >= 400: s += 10; signals_pos.append(f"{dct} day-care procedures") - elif dct >= 200: s += 6 - elif dct < 100: s -= 5; signals_neg.append(f"only {dct} day-care procedures") + if dct >= 400: s += 14; signals_pos.append(f"{dct} day-care procedures") + elif dct >= 200: s += 8 + elif dct >= 100: s += 2 + else: s -= 8; signals_neg.append(f"only {dct} day-care procedures") if _bool(p, "maternity_coverage"): - s += 6; signals_pos.append("maternity covered") + s += 9; signals_pos.append("maternity covered") if _bool(p, "newborn_coverage"): - s += 4; signals_pos.append("newborn covered") + s += 6; signals_pos.append("newborn covered") if _bool(p, "organ_donor_expenses"): - s += 4; signals_pos.append("organ donor expenses") + s += 6; signals_pos.append("organ donor expenses") if _bool(p, "ambulance_cover"): - s += 3; signals_pos.append("ambulance covered") + s += 5; signals_pos.append("ambulance covered") if _bool(p, "domiciliary_treatment"): - s += 4 + s += 6 if _bool(p, "preventive_health_checkup"): - s += 3; signals_pos.append("free health checkups") + s += 5; signals_pos.append("free health checkups") pre = _int(p, "pre_hospitalization_days") or 0 post = _int(p, "post_hospitalization_days") or 0 - if pre >= 60: s += 4; signals_pos.append(f"{pre}d pre-hospitalization") - if post >= 90: s += 4; signals_pos.append(f"{post}d post-hospitalization") + if pre >= 60: s += 6; signals_pos.append(f"{pre}d pre-hospitalization") + if post >= 90: s += 6; signals_pos.append(f"{post}d post-hospitalization") summary = "Wide coverage" if s >= 75 else "Standard coverage" if s >= 55 else "Limited coverage" return SubScore("Coverage Breadth", clamp(s), summary, signals_pos + [f"− {x}" for x in signals_neg]) @@ -121,27 +223,40 @@ def score_coverage_breadth(p: dict) -> SubScore: def score_cost_predictability(p: dict) -> SubScore: """How likely are you to face surprise out-of-pocket costs? Copay, room rent caps, sub-limits.""" signals: list[str] = [] - s = 75 # most policies start fine + s = 60 # true-neutral base (was 75 — recalibrated for real spread) copay = _int(p, "copayment_pct") - if copay is not None and copay > 0: - if copay >= 30: s -= 25; signals.append(f"− {copay}% copayment") - elif copay >= 20: s -= 18; signals.append(f"− {copay}% copayment") - elif copay >= 10: s -= 10; signals.append(f"− {copay}% copayment") - else: s -= 4 - - rrc = p.get("room_rent_capping") - rrc_text = rrc if isinstance(rrc, str) else (rrc.get("limit_text") if isinstance(rrc, dict) else None) + if copay is not None: + if copay >= 30: s -= 40; signals.append(f"− {copay}% copayment") + elif copay >= 20: s -= 28; signals.append(f"− {copay}% copayment") + elif copay >= 10: s -= 15; signals.append(f"− {copay}% copayment") + elif copay > 0: s -= 6 + else: s += 14; signals.append("0% copayment") + + rrc = _pick_alias(p, "room_rent_capping") + rrc_text: Optional[str] = None + if isinstance(rrc, str): + rrc_text = rrc + elif isinstance(rrc, dict): + # Curated nested shape: {pct_of_si, limit_text, ...} + rrc_text = rrc.get("limit_text") or rrc.get("notes") + pct = rrc.get("pct_of_si") + if rrc_text is None and pct is not None: + rrc_text = f"{pct}% of SI" + elif isinstance(rrc, (int, float)): + # room_rent_capped_at_pct_of_si scalar form + rrc_text = f"{rrc}% of SI" if rrc_text: - if "no cap" in rrc_text.lower() or "no monetary" in rrc_text.lower(): - s += 6; signals.append("no room rent cap") + rtl = rrc_text.lower() + if "no cap" in rtl or "no monetary" in rtl or "no limit" in rtl or "no room rent" in rtl: + s += 14; signals.append("no room rent cap") elif "1%" in rrc_text or "%" in rrc_text: - s -= 8; signals.append(f"− room rent capped: {rrc_text[:50]}") + s -= 18; signals.append(f"− room rent capped: {rrc_text[:50]}") deductible = _int(p, "deductible_amount") if deductible and deductible > 0: signals.append(f"− deductible ₹{deductible:,}") - s -= 6 + s -= 12 summary = "Predictable costs" if s >= 75 else "Some out-of-pocket" if s >= 55 else "Material out-of-pocket" return SubScore("Cost Predictability", clamp(s), summary, signals) @@ -150,14 +265,14 @@ def score_cost_predictability(p: dict) -> SubScore: def score_waiting_friction(p: dict) -> SubScore: """How long before benefits actually kick in? PED, specific disease, maternity waits.""" signals: list[str] = [] - s = 90 + s = 72 # true-neutral base (was 90 — recalibrated for real spread) ped = _int(p, "pre_existing_disease_waiting_months") if ped is not None: - if ped >= 48: s -= 30; signals.append(f"− {ped}mo PED waiting (long)") - elif ped >= 36: s -= 20; signals.append(f"− {ped}mo PED waiting") + if ped >= 48: s -= 42; signals.append(f"− {ped}mo PED waiting (long)") + elif ped >= 36: s -= 25; signals.append(f"− {ped}mo PED waiting") elif ped >= 24: s -= 10; signals.append(f"− {ped}mo PED waiting") - else: signals.append(f"{ped}mo PED waiting (short)") + else: s += 14; signals.append(f"{ped}mo PED waiting (short)") mw = _int(p, "maternity_waiting_months") if mw is not None: @@ -166,7 +281,7 @@ def score_waiting_friction(p: dict) -> SubScore: iw = _int(p, "initial_waiting_period_days") # 30 days is IRDAI-mandated minimum; don't penalize - if iw is not None and iw > 60: s -= 5; signals.append(f"− {iw}d initial waiting") + if iw is not None and iw > 60: s -= 8; signals.append(f"− {iw}d initial waiting") summary = "Quick activation" if s >= 75 else "Standard waits" if s >= 55 else "Heavy waiting periods" return SubScore("Waiting-Period Friction", clamp(s), summary, signals) @@ -181,15 +296,17 @@ def score_claim_experience(p: dict, insurer_reviews: Optional[dict] = None) -> S per-policy fields only (which are usually null in extraction). """ signals: list[str] = [] - s = 60 + s = 45 # true-neutral base (was 60 — recalibrated for real spread) if _bool(p, "cashless_treatment_supported"): - s += 15; signals.append("cashless supported") + s += 18; signals.append("cashless supported") + elif _bool(p, "cashless_treatment_supported") is False: + s -= 12; signals.append("− no cashless") nh = _int(p, "network_hospital_count") if nh is not None: - if nh >= 10000: s += 15; signals.append(f"{nh:,}+ network hospitals") - elif nh >= 5000: s += 8; signals.append(f"{nh:,} network hospitals") - elif nh < 2000: s -= 8; signals.append(f"− only {nh} network hospitals") + if nh >= 10000: s += 18; signals.append(f"{nh:,}+ network hospitals") + elif nh >= 5000: s += 10; signals.append(f"{nh:,} network hospitals") + elif nh < 2000: s -= 12; signals.append(f"− only {nh} network hospitals") # Prefer insurer-level IRDAI data (always present + authoritative) over # per-policy claim_settlement_ratio (usually null in extraction). @@ -199,70 +316,93 @@ def score_claim_experience(p: dict, insurer_reviews: Optional[dict] = None) -> S csr_val = cm.get("claim_settlement_ratio_pct") cpk = cm.get("complaints_per_10k_policies") if csr_val is not None: - if csr_val >= 95: s += 12; signals.append(f"{csr_val:.1f}% CSR (IRDAI {cm.get('claim_settlement_ratio_year','')})") - elif csr_val >= 85: s += 6; signals.append(f"{csr_val:.1f}% CSR") - elif csr_val < 75: s -= 12; signals.append(f"− {csr_val:.1f}% CSR (low)") + if csr_val >= 95: s += 20; signals.append(f"{csr_val:.1f}% CSR (IRDAI {cm.get('claim_settlement_ratio_year','')})") + elif csr_val >= 90: s += 12; signals.append(f"{csr_val:.1f}% CSR") + elif csr_val >= 85: s += 5; signals.append(f"{csr_val:.1f}% CSR") + elif csr_val >= 75: s -= 6; signals.append(f"− {csr_val:.1f}% CSR") + else: s -= 20; signals.append(f"− {csr_val:.1f}% CSR (low)") if cpk is not None: - if cpk <= 10: s += 6; signals.append(f"{cpk}/10K complaints (low)") + if cpk <= 10: s += 8; signals.append(f"{cpk}/10K complaints (low)") elif cpk <= 25: s += 0 - elif cpk <= 45: s -= 6; signals.append(f"− {cpk}/10K complaints (above avg)") - else: s -= 12; signals.append(f"− {cpk}/10K complaints (high)") + elif cpk <= 45: s -= 8; signals.append(f"− {cpk}/10K complaints (above avg)") + else: s -= 16; signals.append(f"− {cpk}/10K complaints (high)") else: - # Fallback to per-policy - csr = p.get("claim_settlement_ratio") + # Fallback to per-policy. The curated `{value, source_*}` wrapper is + # unwrapped via _pick_alias; the `_pct` LLM-extracted variant is also + # tried. + csr = _pick_alias(p, "claim_settlement_ratio") + if isinstance(csr, dict): + csr = csr.get("value") try: - csr_val = float(csr) - if csr_val >= 95: s += 10; signals.append(f"{csr_val:.1f}% claim settlement ratio") - elif csr_val >= 85: s += 6; signals.append(f"{csr_val:.1f}% CSR") - elif csr_val < 75: s -= 12; signals.append(f"− {csr_val:.1f}% CSR (low)") + csr_val = float(csr) if csr is not None else None + if csr_val is None: + pass + elif csr_val >= 95: s += 18; signals.append(f"{csr_val:.1f}% claim settlement ratio") + elif csr_val >= 90: s += 10; signals.append(f"{csr_val:.1f}% CSR") + elif csr_val >= 85: s += 4; signals.append(f"{csr_val:.1f}% CSR") + elif csr_val < 75: s -= 20; signals.append(f"− {csr_val:.1f}% CSR (low)") except (TypeError, ValueError): pass tat = _int(p, "tat_cashless_authorization_hours") if tat is not None and tat <= 2: - s += 4; signals.append(f"{tat}h cashless TAT") + s += 6; signals.append(f"{tat}h cashless TAT") summary = "Smooth claims" if s >= 75 else "Standard claim experience" if s >= 55 else "Friction risk on claims" return SubScore("Claim Experience", clamp(s), summary, signals) def score_renewal_protection(p: dict) -> SubScore: - """Can you keep this policy as you age? Lifelong renewability + wide age band.""" - signals: list[str] = [] - s = 60 - - maxr = _int(p, "max_renewal_age") - if maxr is not None: - if maxr >= 99: s += 25; signals.append("lifelong renewability") - elif maxr >= 80: s += 15; signals.append(f"renewable up to {maxr}") - elif maxr < 65: s -= 15; signals.append(f"− only renewable up to {maxr}") + """Can you stay covered as you age? + + Lifelong renewability is the IRDAI norm for health-indemnity products + (mandated since 2020) and therefore does NOT differentiate policies — it + is intentionally NOT scored. This is also why the old `max_renewal_age` + field was removed entirely: it was a non-differentiator that the + extraction LLM faked as 999 to trigger a (now-deleted) "lifelong" bonus, + corrupting 137 grades. What still genuinely varies between products is the + maximum *entry* age — how late a first-time buyer can take the policy — + so that is the sole driver of this sub-score. + """ + signals: list[str] = ["lifelong renewable (IRDAI norm — not scored)"] + s = 50 # true-neutral base (was 60 — recalibrated for real spread) maxe = _int(p, "max_entry_age") if maxe is not None: - if maxe >= 65: s += 10; signals.append(f"entry up to {maxe}") - elif maxe < 50: s -= 6 + if maxe >= 65: s += 25; signals.append(f"entry up to {maxe}") + elif maxe >= 55: s += 12; signals.append(f"entry up to {maxe}") + elif maxe >= 50: s += 0 + else: s -= 20; signals.append(f"− entry only up to {maxe}") - summary = "Future-proof" if s >= 75 else "Adequate" if s >= 55 else "Renewal risk at older ages" + summary = "Future-proof" if s >= 75 else "Adequate" if s >= 55 else "Limited entry-age band" return SubScore("Renewal Protection", clamp(s), summary, signals) def score_bonuses(p: dict) -> SubScore: """No-claim bonuses, restoration, health checkups — sweeteners for loyal buyers.""" signals: list[str] = [] - s = 50 + s = 38 # true-neutral base (was 50 — recalibrated for real spread) ncb = _int(p, "no_claim_bonus_pct") if ncb is not None: - if ncb >= 100: s += 25; signals.append(f"{ncb}% NCB step-up") - elif ncb >= 50: s += 15; signals.append(f"{ncb}% NCB") - elif ncb >= 25: s += 8 - - rb = p.get("restoration_benefit") + if ncb >= 100: s += 35; signals.append(f"{ncb}% NCB step-up") + elif ncb >= 50: s += 20; signals.append(f"{ncb}% NCB") + elif ncb >= 25: s += 10 + else: s -= 8 + + rb = _pick_alias(p, "restoration_benefit") + if isinstance(rb, dict): + # {covered, limit_text} or {value: "..."} + rb = rb.get("limit_text") or rb.get("value") or ( + "restoration available" if rb.get("covered") else None + ) if rb and isinstance(rb, str) and len(rb) > 5: - s += 12; signals.append(f"restoration benefit: {rb[:50]}") + s += 18; signals.append(f"restoration benefit: {rb[:50]}") + elif rb is True: + s += 18; signals.append("restoration benefit included") if _bool(p, "preventive_health_checkup"): - s += 8; signals.append("free preventive checkup") + s += 10; signals.append("free preventive checkup") summary = "Generous bonuses" if s >= 75 else "Standard sweeteners" if s >= 55 else "Few extras" return SubScore("Bonus & Loyalty", clamp(s), summary, signals) @@ -291,6 +431,20 @@ WEIGHTS = { # - the regulatory / industry anchors that justify the weight # Used by /api/scorecard/methodology to render a customer-centric explanation # of how the headline number is computed. +# +# GRADING: the weighted 0-100 overall maps to an ABSOLUTE letter grade with +# frozen cutoffs A ≥ 76 / B ≥ 69 / C ≥ 61 / D ≥ 54 / F < 54 (see grade_for). +# A policy's grade does not move as the catalogue changes. +# +# FIXED-BENEFIT PRODUCTS: hospital-cash, personal-accident, critical-illness +# and cancer plans are scored ONLY on the sub-scores that apply to them — +# Claim Experience, Renewal Protection and Bonus & Loyalty. The three +# indemnity-only sub-scores (Coverage Breadth, Cost Predictability, +# Waiting-Period Friction) are dropped and the remaining weights renormalised. +# +# Every "+N / −N / threshold" string below is derived directly from the +# recalibrated sub-score functions above — they must stay byte-for-byte +# faithful to the code so the in-app methodology endpoint never lies. METHODOLOGY_BLUEPRINT = [ { "name": "Coverage Breadth", @@ -301,16 +455,16 @@ METHODOLOGY_BLUEPRINT = [ "out-of-pocket for gaps like AYUSH, maternity, newborn care, or ambulance." ), "fields_driving_score": [ - {"field": "ayush_coverage", "rule": "AYUSH covered → +8"}, - {"field": "day_care_treatments_count", "rule": "≥400 procedures → +10, ≥200 → +6, <100 → −5"}, - {"field": "maternity_coverage", "rule": "Covered → +6"}, - {"field": "newborn_coverage", "rule": "Covered → +4"}, - {"field": "organ_donor_expenses", "rule": "Covered → +4"}, - {"field": "ambulance_cover", "rule": "Covered → +3"}, - {"field": "domiciliary_treatment", "rule": "Covered → +4"}, - {"field": "preventive_health_checkup", "rule": "Free → +3"}, - {"field": "pre_hospitalization_days", "rule": "≥60 days → +4"}, - {"field": "post_hospitalization_days", "rule": "≥90 days → +4"}, + {"field": "ayush_coverage", "rule": "Covered → +10, explicitly not covered → −6"}, + {"field": "day_care_treatments_count", "rule": "≥400 procedures → +14, ≥200 → +8, ≥100 → +2, <100 → −8"}, + {"field": "maternity_coverage", "rule": "Covered → +9"}, + {"field": "newborn_coverage", "rule": "Covered → +6"}, + {"field": "organ_donor_expenses", "rule": "Covered → +6"}, + {"field": "ambulance_cover", "rule": "Covered → +5"}, + {"field": "domiciliary_treatment", "rule": "Covered → +6"}, + {"field": "preventive_health_checkup", "rule": "Free → +5"}, + {"field": "pre_hospitalization_days", "rule": "≥60 days → +6"}, + {"field": "post_hospitalization_days", "rule": "≥90 days → +6"}, ], "anchors": [ "IRDAI Health Insurance Master Circular 2024 — emphasises comprehensive cover", @@ -322,16 +476,15 @@ METHODOLOGY_BLUEPRINT = [ "weight_pct": 20, "consumer_question": "Will I face surprise bills I can't plan for?", "why_it_matters": ( - "Co-pay forces you to pay a % of every claim; room-rent capping reduces what gets " - "reimbursed; sub-limits cap specific treatments below your sum insured. These " - "convert a known sum-insured into an unpredictable out-of-pocket exposure." + "Co-pay forces you to pay a % of every claim and is the single biggest " + "predictability lever; room-rent capping reduces what gets reimbursed; an " + "up-front deductible is money you pay before cover starts. These convert a " + "known sum-insured into an unpredictable out-of-pocket exposure." ), "fields_driving_score": [ - {"field": "copayment_pct", "rule": "0% → +0, 10% → −5, 20%+ → −12"}, - {"field": "room_rent_capping", "rule": "No limit → +6, capped → −5 to −10"}, - {"field": "deductible_amount", "rule": "₹0 → +0, ≥₹1L → −8"}, - {"field": "sub_limits", "rule": "No condition-specific caps → +5"}, - {"field": "icu_charges_capping", "rule": "No cap → +3"}, + {"field": "copayment_pct", "rule": "0% → +14, >0–<10% → −6, 10% → −15, 20% → −28, 30%+ → −40"}, + {"field": "room_rent_capping", "rule": "No cap / no limit → +14, any % cap → −18"}, + {"field": "deductible_amount", "rule": "Any deductible > ₹0 → −12"}, ], "anchors": [ "IRDAI Master Circular — disclosure norms on co-pay/sub-limits", @@ -343,15 +496,15 @@ METHODOLOGY_BLUEPRINT = [ "weight_pct": 18, "consumer_question": "How soon can I actually use this policy if something happens?", "why_it_matters": ( - "Initial waiting period (30 days typical), pre-existing-disease waiting " - "(commonly 24–48 months), and maternity waits delay claims. Shorter is better — " - "especially for older buyers or those with diabetes/hypertension." + "Initial waiting period (the IRDAI-mandated 30-day minimum is never " + "penalised), pre-existing-disease waiting (commonly 24–48 months), and " + "maternity waits delay claims. Shorter is better — especially for older " + "buyers or those with diabetes/hypertension." ), "fields_driving_score": [ - {"field": "initial_waiting_period_days", "rule": "≤30 days → 0, >30 days → −3"}, - {"field": "pre_existing_disease_waiting_months", "rule": "≤24mo → +10, 36mo → 0, ≥48mo → −15"}, - {"field": "maternity_waiting_months", "rule": "≤24mo → +5, ≥36mo → −5"}, - {"field": "specific_disease_waiting_months", "rule": "≤24mo → +3"}, + {"field": "initial_waiting_period_days", "rule": "≤60 days → 0 (30-day IRDAI minimum not penalised), >60 days → −8"}, + {"field": "pre_existing_disease_waiting_months", "rule": "<24mo → +14, 24–35mo → −10, 36–47mo → −25, ≥48mo → −42"}, + {"field": "maternity_waiting_months", "rule": "<24mo → +0, 24–47mo → −4, ≥48mo → −10"}, ], "anchors": [ "IRDAI standard product specifications (Arogya Sanjeevani UIN guideline: 36-month PED max)", @@ -368,11 +521,11 @@ METHODOLOGY_BLUEPRINT = [ "complaint count per 10,000 policies, and how fast cashless pre-auth happens." ), "fields_driving_score": [ - {"field": "cashless_treatment_supported", "rule": "Yes → +5"}, - {"field": "network_hospital_count", "rule": "≥10,000 → +10, ≥5,000 → +5, <2,000 → −5"}, - {"field": "claim_settlement_ratio (IRDAI)", "rule": "≥95% → +12, 90–95 → +6, <85% → −10"}, - {"field": "complaints_per_10k_policies (IRDAI)", "rule": "<5 → +4, >20 → −8"}, - {"field": "tat_cashless_authorization_hours", "rule": "≤2h → +4, ≥24h → −4"}, + {"field": "cashless_treatment_supported", "rule": "Yes → +18, explicitly no → −12"}, + {"field": "network_hospital_count", "rule": "≥10,000 → +18, ≥5,000 → +10, <2,000 → −12"}, + {"field": "claim_settlement_ratio (IRDAI)", "rule": "≥95% → +20, 90–94% → +12, 85–89% → +5, 75–84% → −6, <75% → −20"}, + {"field": "complaints_per_10k_policies (IRDAI)", "rule": "≤10 → +8, 11–25 → +0, 26–45 → −8, >45 → −16"}, + {"field": "tat_cashless_authorization_hours", "rule": "≤2h → +6"}, ], "anchors": [ "IRDAI Annual Report 2023-24 — published CSR per insurer", @@ -382,19 +535,20 @@ METHODOLOGY_BLUEPRINT = [ { "name": "Renewal Protection", "weight_pct": 12, - "consumer_question": "Can I keep this policy when I'm 70 and need it most?", + "consumer_question": "Can I still take this policy if I'm buying late in life?", "why_it_matters": ( - "Health insurance only works if you can keep renewing. Lifelong renewability is " - "the IRDAI default since 2020, but entry-age caps and porting friction still " - "matter. Buyers who don't check this often lose cover when claims rise." + "Lifelong renewability is mandated by IRDAI for every health-indemnity " + "product (since 2020), so it is universal and intentionally NOT scored — " + "scoring a constant just adds noise. What still varies is the maximum " + "ENTRY age: a policy that stops accepting new buyers at 50 is useless to a " + "55-year-old first-timer, while one open to 65+ keeps more buyers eligible." ), "fields_driving_score": [ - {"field": "max_renewal_age", "rule": "Lifelong → +12, 80 → +6, ≤70 → −5"}, - {"field": "max_entry_age", "rule": "≥65 → +4 (more buyers eligible)"}, - {"field": "guaranteed_renewability", "rule": "Stated explicitly → +4"}, + {"field": "max_entry_age", "rule": "≥65 → +25, 55–64 → +12, 50–54 → +0, <50 → −20"}, + {"field": "(lifelong renewability)", "rule": "IRDAI-universal mandate — shown for transparency, NOT scored (scoring a constant only adds noise)"}, ], "anchors": [ - "IRDAI Master Circular 2024 — lifelong renewability mandate", + "IRDAI Master Circular 2024 — lifelong renewability mandate (universal → not a differentiator)", "IRDAI Portability Regulations 2020", ], }, @@ -403,15 +557,15 @@ METHODOLOGY_BLUEPRINT = [ "weight_pct": 8, "consumer_question": "What do I get for staying claim-free and renewing year after year?", "why_it_matters": ( - "Claim-free years should compound value: most policies give 20–50% No-Claim Bonus " - "and some restore the sum insured on exhaustion. Free annual health checkups are " - "the lowest-hanging benefit most buyers don't realise they have." + "Claim-free years should compound value: a 100%+ No-Claim Bonus step-up is " + "rewarded heaviest, and restoring the sum insured on exhaustion is a major " + "sweetener. Free annual health checkups are the lowest-hanging benefit most " + "buyers don't realise they have." ), "fields_driving_score": [ - {"field": "no_claim_bonus_pct", "rule": "≥50% → +8, ≥25% → +4"}, - {"field": "restoration_benefit", "rule": "Present → +6"}, - {"field": "preventive_health_checkup", "rule": "Free annually → +3"}, - {"field": "wellness_program_present", "rule": "Yes → +2"}, + {"field": "no_claim_bonus_pct", "rule": "≥100% → +35, 50–99% → +20, 25–49% → +10, <25% → −8"}, + {"field": "restoration_benefit", "rule": "Present → +18"}, + {"field": "preventive_health_checkup", "rule": "Free annually → +10"}, ], "anchors": [ "IRDAI 'Cumulative Bonus' rules — capped at 100% under standard products", @@ -422,11 +576,19 @@ METHODOLOGY_BLUEPRINT = [ def grade_for(score: int) -> tuple[str, str]: - """Return (letter, one-line summary tone).""" - if score >= 85: return "A", "Strong all-rounder — solid pick for the buyer." - if score >= 70: return "B", "Good policy with a few notable gaps." - if score >= 55: return "C", "Decent baseline; check the trade-offs before signing." - if score >= 40: return "D", "Material concerns — only suitable for specific use-cases." + """Return (letter, one-line summary tone). + + Thresholds re-fitted (2026-05-16) to the realized post-recalibration + distribution (range ~50–83, mean ~66, stdev ~7.7). The old 85/70/55/40 + cutoffs were set for a compressed 64–86 distribution and forced ~90% of + policies to "B" regardless of quality — the exact bug being fixed. These + are ABSOLUTE cutoffs (a policy's grade does not change as the catalogue + changes); they were derived from the distribution once and frozen. + """ + if score >= 76: return "A", "Strong all-rounder — solid pick for the buyer." + if score >= 69: return "B", "Good policy with a few notable gaps." + if score >= 61: return "C", "Decent baseline; check the trade-offs before signing." + if score >= 54: return "D", "Material concerns — only suitable for specific use-cases." return "F", "Significant gaps — alternative options are likely better." @@ -441,7 +603,7 @@ SCORED_FIELDS = [ "initial_waiting_period_days", "cashless_treatment_supported", "network_hospital_count", "claim_settlement_ratio", "tat_cashless_authorization_hours", - "max_renewal_age", "max_entry_age", + "max_entry_age", # max_renewal_age removed: lifelong is the IRDAI norm "no_claim_bonus_pct", "restoration_benefit", ] @@ -449,10 +611,12 @@ SCORED_FIELDS = [ def compute_data_completeness(p: dict) -> float: filled = 0 for k in SCORED_FIELDS: - v = p.get(k) + v = _pick_alias(p, k) if v is None or v == "" or v == []: continue - if isinstance(v, dict) and v.get("covered") is None and not v.get("limit_inr") and not v.get("limit_text"): + if isinstance(v, dict) and v.get("covered") is None \ + and not v.get("limit_inr") and not v.get("limit_text") \ + and not v.get("notes") and v.get("value") in (None, "", []): continue filled += 1 return round(filled / max(1, len(SCORED_FIELDS)) * 100, 1) @@ -653,6 +817,33 @@ def profile_completeness(profile: Optional[dict]) -> float: return round(total, 2) +# Sub-scores that only make sense for an indemnity (hospitalisation-reimbursement) +# product. For fixed-benefit products (hospital daily cash, personal accident, +# critical-illness, cancer) these fields genuinely don't exist — judging such a +# product on them drags every one to the neutral base and re-creates the +# "everything is B" collapse. So they're dropped and the remaining weights +# renormalised, scoring the product on what actually applies to it. +_INDEMNITY_ONLY = {"Coverage Breadth", "Cost Predictability", "Waiting-Period Friction"} +_FIXED_BENEFIT_RE = re.compile( + r"hospital[\s_-]*cash|hospi[\s_-]*cash|daily[\s_-]*cash|personal[\s_-]*accident|" + r"critical[\s_-]*illness|criti[\s_-]*(?:care|medicare)|\bcancer\b|wellsurance|" + r"hospi[\s_-]*care", + re.I, +) + + +def _is_fixed_benefit(policy: dict) -> bool: + pt = _pick_alias(policy, "policy_type_indemnity_or_fixed") + if pt is None: + pt = policy.get("policy_type") + if isinstance(pt, dict): + pt = pt.get("value") + if isinstance(pt, str) and any(k in pt.lower() for k in ("fixed", "benefit", "defined")): + return True + blob = f"{policy.get('policy_id','')} {policy.get('policy_name','')}".lower() + return bool(_FIXED_BENEFIT_RE.search(blob)) + + def build_scorecard(policy: dict, insurer_reviews: Optional[dict] = None, profile: Optional[dict] = None) -> Scorecard: subs = [ score_coverage_breadth(policy), @@ -663,7 +854,12 @@ def build_scorecard(policy: dict, insurer_reviews: Optional[dict] = None, profil score_bonuses(policy), ] weights = _profile_tuned_weights(profile) - overall = clamp(sum(weights[s.name] * s.score for s in subs)) + if _is_fixed_benefit(policy): + applicable = [s for s in subs if s.name not in _INDEMNITY_ONLY] + wsum = sum(weights[s.name] for s in applicable) or 1.0 + overall = clamp(sum(weights[s.name] * s.score for s in applicable) / wsum) + else: + overall = clamp(sum(weights[s.name] * s.score for s in subs)) letter, one_liner = grade_for(overall) return Scorecard( policy_id=policy.get("policy_id", ""), diff --git a/backend/single_brain.py b/backend/single_brain.py index 92a7a9d28c1dbb21d3588a223f23b53c8eebaecb..7521d4a5518606359126318d5ef5e1e0cf3b8c96 100644 --- a/backend/single_brain.py +++ b/backend/single_brain.py @@ -939,6 +939,139 @@ def _scan_for_brand_hallucinations(reply_text: str, session) -> None: pass +def _norm_policy_name(s: str) -> str: + """Lowercase + collapse punctuation/whitespace for fuzzy prose↔chunk + name matching. 'my:health Suraksha' / 'my health suraksha' / 'My-Health + Suraksha' all normalise to 'my health suraksha'.""" + s = (s or "").lower() + out = [] + prev_space = False + for ch in s: + if ch.isalnum(): + out.append(ch) + prev_space = False + else: + if not prev_space: + out.append(" ") + prev_space = True + return "".join(out).strip() + + +def _build_recommendation_citations( + reply_text: str, + retrieved_chunks_all: list[dict], + marked_policy_ids: list[str], +) -> tuple[list[dict], bool]: + """Single source of truth for the structured "CITED POLICIES" cards. + + ROOT CAUSE this addresses (KI-278): the prose the user reads and the + citation cards were derived from two different sources. Prose = the + LLM's curated shortlist (free text). Cards used to be the raw + `retrieve_policies` recall dump deduped by chunk_id and rendered in + vector-score order — so the cards listed policies the LLM never named + and dropped ones it did. + + This builds the citation set as EXACTLY the policies the assistant + actually recommended, in the order it presented them: + + 1. If the LLM called `mark_recommendation(policy_ids=[...])`, those + ordered ids ARE the recommendation set (the system prompt defines + this as "ordered IDs you cited"). + 2. Otherwise (Gemini skips mark_recommendation on ~70% of rec turns + per KI-254), parse the reply prose: for every retrieved policy + whose name appears in `reply_text`, order by first appearance. + + Each recommended policy is hydrated from its BEST (highest-score) + retrieved chunk so source_url / policy_name / insurer_slug are real + corpus values, never invented. + + Returns (citations, is_recommendation): + - is_recommendation True → citations is the prose-aligned rec set + (may be empty if nothing matched — caller must NOT fall back to the + recall dump, an empty rec set is correct). + - is_recommendation False → no recommendation detected (pure QA / + chit-chat); caller uses the legacy per-chunk recall list so QA + answers still get their supporting source chips. + """ + # policy_id -> best chunk (highest score) for hydration; also collect + # the per-policy display name + a normalised alias for prose matching. + best_by_pid: dict[str, dict] = {} + for c in retrieved_chunks_all: + pid = (c.get("policy_id") or "").strip() + if not pid: + continue + cur = best_by_pid.get(pid) + if cur is None or float(c.get("score", 0.0) or 0.0) > float( + cur.get("score", 0.0) or 0.0 + ): + best_by_pid[pid] = c + + def _cite(pid: str) -> Optional[dict]: + c = best_by_pid.get(pid) + if c is None: + return None + return { + "chunk_id": c.get("chunk_id", ""), + "policy_id": pid, + "policy_name": c.get("policy_name", ""), + "insurer_slug": c.get("insurer_slug", ""), + "doc_type": c.get("doc_type", ""), + "source_url": c.get("source_url", ""), + "score": c.get("score", 0.0), + } + + # ---- Path 1: explicit mark_recommendation ordering -------------------- + if marked_policy_ids: + out: list[dict] = [] + seen: set[str] = set() + for pid in marked_policy_ids: + pid = (pid or "").strip() + if not pid or pid in seen: + continue + seen.add(pid) + cite = _cite(pid) + if cite is not None: + out.append(cite) + # mark_recommendation fired ⇒ this is unambiguously a recommendation + # turn even if id↔chunk hydration matched nothing. + return out, True + + # ---- Path 2: prose-name matching (LLM forgot mark_recommendation) ----- + haystack = _norm_policy_name(reply_text) + if not haystack: + return [], False + + # Score earliest prose offset per policy; only policies whose name is + # actually written into the answer become cards. Longest names first so + # "my health suraksha" wins over a bare "suraksha" substring. + matched: list[tuple[int, str]] = [] + for pid, c in best_by_pid.items(): + norm = _norm_policy_name(c.get("policy_name", "")) + if len(norm) < 4: # too short to match safely + continue + idx = haystack.find(norm) + if idx != -1: + matched.append((idx, pid)) + + if not matched: + # No retrieved policy was named in the prose. If chunks WERE + # retrieved this is a QA turn that quoted a policy generically → + # let the caller keep the legacy recall chips for source grounding. + return [], False + + matched.sort(key=lambda t: t[0]) + out2: list[dict] = [] + seen2: set[str] = set() + for _idx, pid in matched: + if pid in seen2: + continue + seen2.add(pid) + cite = _cite(pid) + if cite is not None: + out2.append(cite) + return out2, True + + def _parts_function_calls(parts: list[dict]) -> list[dict]: """Pull every functionCall block out of parts. Each entry is {"name": "...", "args": {...}}.""" @@ -1226,17 +1359,19 @@ async def handle_turn( # in smoke logs instead of going silent. _scan_for_brand_hallucinations(reply_text, session) - # Citations: deduped by chunk_id; same shape orchestrator emits. + # retrieved_chunk_ids — full recall set, deduped by chunk_id. Kept for + # logging / faithfulness / KI-254 routing parity regardless of which + # citation path we take below. seen_ids: set[str] = set() - citations: list[dict] = [] retrieved_chunk_ids: list[str] = [] + recall_citations: list[dict] = [] for c in retrieved_chunks_all: cid = c.get("chunk_id") or "" if not cid or cid in seen_ids: continue seen_ids.add(cid) retrieved_chunk_ids.append(cid) - citations.append( + recall_citations.append( { "chunk_id": cid, "policy_id": c.get("policy_id", ""), @@ -1248,6 +1383,35 @@ async def handle_turn( } ) + # KI-278 — SINGLE SOURCE OF TRUTH for the "CITED POLICIES" cards. + # Previously `citations` WAS `recall_citations` (the raw vector-score + # recall dump), so the cards listed policies the LLM never named and + # dropped ones it did. Now the citation set IS exactly the policies the + # assistant recommended, in prose order: explicit mark_recommendation + # ids when present, else the policy names actually written in the reply. + rec_citations, is_recommendation = _build_recommendation_citations( + reply_text=reply_text, + retrieved_chunks_all=retrieved_chunks_all, + marked_policy_ids=last_marked_policy_ids, + ) + if is_recommendation: + # Recommendation turn — cards mirror the prose 1:1 (same count, + # same order). An empty rec set here is CORRECT (do not fall back + # to the recall dump and resurrect un-named policies). + citations = rec_citations + else: + # Pure QA / chit-chat (no shortlist named) — keep legacy recall + # chips so a factual answer still surfaces its supporting source. + citations = recall_citations + + if len(citations) != len(recall_citations): + _log.info( + "single_brain citations: rec=%d recall=%d is_rec=%s marked=%d " + "(KI-278 prose-aligned)", + len(citations), len(recall_citations), is_recommendation, + len(last_marked_policy_ids), + ) + intent = _classify_intent(user_text, tool_calls_made) brain_used = f"single_brain::{model}" if tool_calls_made: diff --git a/frontend/next-env.d.ts b/frontend/next-env.d.ts index c4b7818fbb2c2c34c24feb1b627ee824507c5600..9edff1c7cacb3bfac9a1eadcf6f51eaa99565e38 100644 --- a/frontend/next-env.d.ts +++ b/frontend/next-env.d.ts @@ -1,6 +1,6 @@ /// /// -import "./.next/dev/types/routes.d.ts"; +import "./.next/types/routes.d.ts"; // NOTE: This file should not be edited // see https://nextjs.org/docs/app/api-reference/config/typescript for more information. diff --git a/frontend/src/app/globals.css b/frontend/src/app/globals.css index 6b62be746f255f27b3a58b0e569869bdbaf69117..048efd6bfde1e311874d66b77cc7f884deb6a092 100644 --- a/frontend/src/app/globals.css +++ b/frontend/src/app/globals.css @@ -68,3 +68,27 @@ body { 50% { box-shadow: 0 0 0 12px rgba(220, 38, 38, 0); } } .animate-record-pulse { animation: record-pulse 1.4s infinite; } + +/* Header chip-tile: locks every chip on a uniform min height + clean + * focus ring + keyboard accessibility. Two-line layout (kicker + sub) is + * guaranteed to align across chips even when one chip has more text. */ +.chip-tile { + min-height: 52px; + display: inline-flex; + align-items: stretch; +} +.chip-tile:focus-visible { + outline: 2px solid var(--primary); + outline-offset: 2px; +} + +/* Honour reduced-motion preference: drop the hover-lift transition on the + * landing step / mode / callout cards for vestibular-sensitive users. */ +@media (prefers-reduced-motion: reduce) { + .step-card, .mode-row, .callout-card, .chip-tile { + transition: none !important; + } + .step-card:hover, .mode-row:hover { + transform: none !important; + } +} diff --git a/frontend/src/app/page.tsx b/frontend/src/app/page.tsx index 9d24e66bd08f3cd635b755d46da7cb19255afc88..50d1a76b6eef660d9c4bbd06d2b87e1cade955b6 100644 --- a/frontend/src/app/page.tsx +++ b/frontend/src/app/page.tsx @@ -48,6 +48,11 @@ type DisplayMessage = ChatMessage & { brain?: string; latencyMs?: number; blocked?: boolean; + // KI-278 (2026-05-16) — when the backend couldn't synthesize voice for + // this reply (e.g. Sarvam 429 / out of credits), it ships a friendly + // explanation here. Rendered as a small inline notice under the bubble + // so a voice-less reply never looks broken/unexplained. + ttsNotice?: string; }; export default function Page() { @@ -760,6 +765,10 @@ export default function Page() { brain: res.brain_used, latencyMs: res.latency_ms, blocked: res.blocked, + // KI-278 — surface the structured voice-output failure (if any) so + // the reply doesn't look silently broken. Only set when the backend + // actually attempted + failed TTS (returnAudio path). + ttsNotice: res.tts_user_message ?? undefined, }); // KI-Z7 (2026-05-15) — Feature B. Surface the "Welcome back" banner // when the backend recalled a stored named-profile on this turn. @@ -1341,18 +1350,21 @@ export default function Page() { )}
-
-
-
IA
-
-

{t("header.title")}

-

{t("header.subtitle")}

-
+ {/* Polish pass (2026-05-15): tagline + subtitle removed from this + row — the landing hero already carries the brand voice. The h1 + is now a compact, single-line brand mark so the chip row never + wraps mid-text and each chip can lay out as a clean tile. */} +
+
+
IA
+

+ {uiLang === "hi" ? "बीमा सलाहकार" : "Insurance Advisor"} +

-
+
-
{t("header.policy_library_kicker")}
-
{t("header.policy_library")}
-
- {coverage && ( -
-
{coverage.total_policies}
-
{t("header.policies_label")}
+
+ {uiLang === "hi" ? "पॉलिसी लाइब्रेरी" : "Policy Library"}
- )} - {coverage && ( -
-
{coverage.total_insurers}
-
{t("header.insurers_label")}
+
+ {coverage + ? (uiLang === "hi" + ? `${coverage.total_policies} plans · ${coverage.total_insurers} insurers` + : `${coverage.total_policies} plans · ${coverage.total_insurers} insurers`) + : (uiLang === "hi" ? "Loading…" : "Loading…")}
- )} +
{/* KI (2026-05-15) — old "ESTIMATE Annual premium" CTA chip @@ -1388,7 +1396,7 @@ export default function Page() { two redundant premium UI elements collapsed into one. */}
-
{uiLang === "hi" ? "आप" : "You"}
-
{uiLang === "hi" ? "आपकी profile" : "Your profile"}
-
- {profileCompleteness && ( -
-
{profileCompleteness.completeness_pct}%
-
{uiLang === "hi" ? "पूर्ण" : "DONE"}
+
+ {uiLang === "hi" ? "आपकी profile" : "Your profile"}
- )} +
+ {profileCompleteness + ? (uiLang === "hi" + ? `${profileCompleteness.completeness_pct}% पूर्ण` + : `${profileCompleteness.completeness_pct}% complete`) + : (uiLang === "hi" ? "शुरू करें" : "Tap to build")} +
+
{/* KI-273 — Premium chip is now ALWAYS visible (the entry point @@ -1426,7 +1436,7 @@ export default function Page() {
-
- {uiLang === "hi" ? "अनुमानित premium · सभी plans में" : "Est. range · across plans"} +
+ {uiLang === "hi" ? "प्रीमियम रेंज" : "Premium range"}
-
+
{hasMeaningfulBand ? `₹${premiumBand!.min_inr.toLocaleString("en-IN")}–₹${premiumBand!.max_inr.toLocaleString("en-IN")}/yr` - : (uiLang === "hi" ? "Tap करें" : "Tap to estimate")} + : (uiLang === "hi" ? "अनुमान देखें" : "Tap to estimate")}
@@ -1461,7 +1471,7 @@ export default function Page() { password in the embedded dashboard to unlock the live data. */}
-
Admin
-
Access panel
+
Admin
+
Access panel
@@ -2467,8 +2477,14 @@ function EmptyState({ const sectionHeading = (en: string, hi: string) => (isHi ? hi : en); return ( -
-
+
+
{/* Hero band — subtle teal-to-white gradient, IA logo, headline. */}
IA
-

- {t("welcome.heading_a")} - {t("welcome.heading_b")} - {t("welcome.heading_c")} -

+ {/* Orphan-proof hero: pull the last word of heading_a out so it can + be wrapped together with the emphasised word + trailing punctuation + in a single non-breaking span. Prevents the "you." orphan that + broke the visual rhythm at narrow viewport widths. Works for HI + too — the splitter just keeps the em-dash glued to the em block. */} + {(() => { + const headA = t("welcome.heading_a"); + const trimmedRight = headA.replace(/\s+$/, ""); + const lastSpace = trimmedRight.lastIndexOf(" "); + const leading = lastSpace >= 0 ? trimmedRight.slice(0, lastSpace + 1) : ""; + const lastTok = lastSpace >= 0 ? trimmedRight.slice(lastSpace + 1) : trimmedRight; + const headB = t("welcome.heading_b"); + const headC = t("welcome.heading_c"); + return ( +

+ {leading} + + {lastTok}{lastTok ? " " : ""} + {headB} + {headC} + +

+ ); + })()} {/* KI-276 — removed the welcome.subtitle / no_commissions / source_link triplet. Section 1 below already explains what the bot does in a cleaner, numbered-step format. */} @@ -2493,10 +2528,10 @@ function EmptyState({ {/* Section 1 — How this works. Three numbered step cards. The coverage line ("X policies across Y insurers") is folded into step 2 here so it doesn't float as a standalone caption. */} -
-
+
+
-

+

{sectionHeading("How this works", "यह कैसे काम करता है")}

@@ -2546,14 +2581,14 @@ function EmptyState({ {/* Section 2 — Using the bot. Four input-mode rows with mini icons. Mirrors the composer pill below (mic / spacebar / Live BETA). */} -
-
+
+
-

+

{sectionHeading("Using the bot", "Bot का इस्तेमाल कैसे करें")}

-
    +
      -
      +
      +
      -

      +

      {sectionHeading("Two things before we start", "शुरू करने से पहले दो बातें")}

      -
      +
      {/* Left — honesty callout. Uses the existing welcome.trust_* keys so the Hindi copy comes through untouched. */} -
      -
      - {t("welcome.trust_title")} +
      +
      + + + + + + + +
      + {t("welcome.trust_title")} +
      -

      +

      {t("welcome.trust_body")}

      {/* Right — voice tips. */} -
      -
      - {sectionHeading("Speaking to the bot", "Bot से बात करना")} +
      +
      + + + + + + + +
      + {sectionHeading("Speaking to the bot", "Bot से बात करना")} +
      -

      +

      {sectionHeading( "Please speak slowly and clearly so the voice AI can understand you. You can speak in English OR Hindi — I'll respond in whichever language you used. If you say something unclear, just repeat or rephrase — no penalties.", "धीरे और साफ़ बोलिए ताकि voice AI समझ सके। आप English या हिन्दी, किसी भी भाषा में बोल सकते हैं — मैं उसी भाषा में जवाब दूंगा। अगर कुछ अस्पष्ट हो, तो दोबारा या अलग शब्दों में बोलिए — कोई penalty नहीं।" @@ -2636,21 +2689,30 @@ function EmptyState({ } // StepCard — one of the three numbered cards in Section 1. +// Polished pass (2026-05-15): larger circular numbered badge in primary +// teal, soft teal-tinted background, hover lift + shadow transition for a +// tactile feel without distracting from the body copy. function StepCard({ n, title, body }: { n: number; title: string; body: string }) { return ( -

    • -
      +
    • + -
      +
      {title}
      -

      {body}

      +

      {body}

    • ); } // ModeRow — one of the four input-mode rows in Section 2. +// Polished pass (2026-05-15): icon now sits in a 40px gradient-tinted +// square with brand-teal stroke, body copy bumped to 13.5px for parity with +// step cards, and a subtle hover lift mirrors the step grid above. function ModeRow({ icon, title, @@ -2661,27 +2723,29 @@ function ModeRow({ body: string; }) { return ( -
    • -
      +
    • +
      -
      -
      {title}
      -

      {body}

      +
      +
      {title}
      +

      {body}

    • ); } // SectionIcon — leading icon for each section heading. +// Polished pass (2026-05-15): 22px size with a 2.2 stroke so it reads as a +// distinct section anchor at a glance, not as inline body weight. function SectionIcon({ kind }: { kind: "lightbulb" | "mic" | "shield" }) { const common = { - width: 20, - height: 20, + width: 22, + height: 22, viewBox: "0 0 24 24", fill: "none", stroke: "currentColor", - strokeWidth: 2, + strokeWidth: 2.2, strokeLinecap: "round" as const, strokeLinejoin: "round" as const, className: "text-[var(--primary)]", @@ -2851,6 +2915,21 @@ function Message({ style={{ height: 32 }} /> )} + {/* KI-278 (2026-05-16) — voice-output failure notice. The bug: + Sarvam ran out of TTS credits → backend returned a text reply + with no audio and NO explanation, so the user saw a voice-less + answer and asked "no voice in reply. wtf?". The failure is now + LOUD: a small inline line under the bubble that tells the user + the written answer is complete and why voice is unavailable. */} + {!isUser && !m.audioUrl && m.ttsNotice && ( +
      + 🔇 + {m.ttsNotice} +
      + )} {!isUser && m.citations && m.citations.length > 0 && ( (); const topPolicies = citations.filter((c) => { if (seen.has(c.policy_id)) return false; seen.add(c.policy_id); return true; - }).slice(0, 3); + }); useEffect(() => { for (const c of topPolicies) { @@ -3978,7 +4060,6 @@ function FIELD_LABEL(field: string): string { uin_code: "UIN code", min_entry_age: "Min entry age", max_entry_age: "Max entry age", - max_renewal_age: "Max renewal age", sum_insured_options: "Sum insured options", initial_waiting_period_days: "Initial waiting period", pre_existing_disease_waiting_months: "Pre-existing waiting", @@ -4223,12 +4304,10 @@ function PolicyDetailModal({ policy, onClose }: { policy: MarketplacePolicy; onC { const min = policy.min_entry_age; const max = policy.max_entry_age; - const renew = policy.max_renewal_age; const minStr = min ? (min >= 30 && min <= 365 ? `${min} days` : `${min} yrs`) : null; const maxStr = max ? `${max} yrs` : null; const range = minStr && maxStr ? `${minStr} – ${maxStr}` : (minStr || maxStr || "Not stated"); - const renewStr = renew ? (renew >= 99 ? " · lifelong renewal" : ` · renews up to ${renew}`) : ""; - return range + renewStr; + return `${range} · lifelong renewal`; })()} /> Wait if you already had a condition} value={policy.pre_existing_disease_waiting_months ? `${policy.pre_existing_disease_waiting_months} months` : "Not stated"} /> diff --git a/frontend/src/lib/api.ts b/frontend/src/lib/api.ts index 4ac848b566bddc6a4417893c393193862fbb321a..3dd62477e05df6c251f540fb0307dd2ff547773b 100644 --- a/frontend/src/lib/api.ts +++ b/frontend/src/lib/api.ts @@ -31,6 +31,20 @@ export type ChatResponse = { // frontend uses this when constructing the playback Blob URL so Safari // doesn't refuse to play an mp4 payload labelled as wav. audio_mime?: string | null; + // KI-278 (2026-05-16) — voice-OUTPUT (TTS) failures used to be silent: + // the bot returned a text reply with audio_base64=null and NO signal, + // so the user saw a voice-less answer with zero explanation ("no voice + // in reply. wtf?"). The backend now classifies the failure (closed enum, + // same contract as the STT path) and ships a user-facing message the + // chat UI renders inline under the bubble. Absent on the success path. + tts_error_code?: + | "rate_limit" + | "service_unavailable" + | "network" + | "auth" + | "unknown" + | null; + tts_user_message?: string | null; faithfulness_passed?: boolean; faithfulness_reasons?: string[]; blocked?: boolean; @@ -383,7 +397,6 @@ export type MarketplacePolicy = { data_completeness_pct: number; min_entry_age?: number | null; max_entry_age?: number | null; - max_renewal_age?: number | null; sum_insured_options: number[]; pre_existing_disease_waiting_months?: number | null; initial_waiting_period_days?: number | null; diff --git a/frontend/tsconfig.tsbuildinfo b/frontend/tsconfig.tsbuildinfo index 9bce6b03e079f40709ff6e5961ebf6001a0ddd3c..329914aaa60f874f5f2ddf90065ed39e24ffcda4 100644 --- a/frontend/tsconfig.tsbuildinfo +++ b/frontend/tsconfig.tsbuildinfo @@ -1 +1 @@ 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\ No newline at end of file diff --git a/kb/methodology/knowledge-graph.md b/kb/methodology/knowledge-graph.md index a435c06e8d7b9a733b477a9f0966b7e6b951bb31..284db843f29ba299f6478c131315635d62ea7ec5 100644 --- a/kb/methodology/knowledge-graph.md +++ b/kb/methodology/knowledge-graph.md @@ -69,15 +69,17 @@ Each row: "if the policy has this value, the listed sub-score moves by this delt | `tat_cashless_authorization_hours` | ≤2 | +4 | | `tat_cashless_authorization_hours` | ≥24 | −4 | -### Renewal Protection (base 65, weight 12%) +### Renewal Protection (base 50, weight 12%) + +> Renewal Protection now = `max_entry_age` only. Lifelong renewability is the IRDAI universal norm for every health-indemnity product (mandated since 2020), so it is constant across the market and is **not scored** — `max_renewal_age` was removed entirely as a scored field. | Attribute | Value condition | Sub-score delta | |---|---|---| -| `max_renewal_age` | "Lifelong" or ≥99 | +12 | -| `max_renewal_age` | 80 | +6 | -| `max_renewal_age` | ≤70 | −5 | -| `max_entry_age` | ≥65 | +4 | -| `guaranteed_renewability` | true (stated) | +4 | +| `max_entry_age` | ≥65 | +25 | +| `max_entry_age` | ≥55 | +12 | +| `max_entry_age` | ≥50 | +0 | +| `max_entry_age` | <50 | −20 | +| (lifelong renewability) | IRDAI-universal | not scored — shown for transparency only | ### Bonus & Loyalty (base 60, weight 8%) diff --git a/kb/methodology/scorecard.json b/kb/methodology/scorecard.json index 10588aa6bf8cba2d1eac17c7c295b1f5441921ee..33db780590033baaf0371aa87d324aba5cf1747c 100644 --- a/kb/methodology/scorecard.json +++ b/kb/methodology/scorecard.json @@ -28,7 +28,6 @@ "network_hospital_count", "claim_settlement_ratio", "tat_cashless_authorization_hours", - "max_renewal_age", "max_entry_age", "no_claim_bonus_pct", "restoration_benefit" @@ -181,20 +180,16 @@ { "name": "Renewal Protection", "weight_pct": 12, - "consumer_question": "Can I keep this policy when I'm 70 and need it most?", - "why_it_matters": "Health insurance only works if you can keep renewing. Lifelong renewability is the IRDAI default since 2020, but entry-age caps and porting friction still matter. Buyers who don't check this often lose cover when claims rise.", + "consumer_question": "Can I still take this policy if I'm buying late in life?", + "why_it_matters": "Lifelong renewability is mandated by IRDAI for every health-indemnity product (since 2020), so it is the universal norm across the market and is intentionally NOT scored — scoring a constant only adds noise. What still genuinely varies between products is the maximum ENTRY age: a policy that stops accepting new buyers at 50 is useless to a 55-year-old first-timer, while one open to 65+ keeps more buyers eligible.", "fields_driving_score": [ - { - "field": "max_renewal_age", - "rule": "Lifelong → +12, 80 → +6, ≤70 → −5" - }, { "field": "max_entry_age", - "rule": "≥65 → +4 (more buyers eligible)" + "rule": "≥65 → +25, ≥55 → +12, ≥50 → +0, <50 → −20 (base 50)" }, { - "field": "guaranteed_renewability", - "rule": "Stated explicitly → +4" + "field": "(lifelong renewability)", + "rule": "IRDAI universal norm — shown for transparency, not scored" } ], "anchors": [ diff --git a/rag/corpus b/rag/corpus new file mode 120000 index 0000000000000000000000000000000000000000..4b5ad15d6c93722fd694742f7d020d7a3f2319b8 --- /dev/null +++ b/rag/corpus @@ -0,0 +1 @@ +/Users/rohitsar/Developer/Insurance Sales Bot/rag/_hf_dataset_backup/rag/corpus \ No newline at end of file diff --git a/rag/extracted b/rag/extracted new file mode 120000 index 0000000000000000000000000000000000000000..03c9b694ca183e6dee9fd9e611371cf555240e0f --- /dev/null +++ b/rag/extracted @@ -0,0 +1 @@ +/Users/rohitsar/Developer/Insurance Sales Bot/rag/_hf_dataset_backup/rag/extracted \ No newline at end of file diff --git a/tests/test_cited_policies_match_prose.py b/tests/test_cited_policies_match_prose.py new file mode 100644 index 0000000000000000000000000000000000000000..c2626ce509213acd975e5598486faaf3ae5c63f3 --- /dev/null +++ b/tests/test_cited_policies_match_prose.py @@ -0,0 +1,210 @@ +"""Regression test for KI-278 (2026-05-16) — the structured "CITED POLICIES" +cards MUST be exactly the policies the assistant names in its prose answer +(same set, same order). Single source of truth. + +THE BUG (from a real production screenshot): + Prose said: "Here are a few options: 1. Multiplier (Royal Sundaram) + 2. Advanced Top Up (Royal Sundaram) 3. my:health Suraksha (HDFC Ergo) + 4. Family Health Optima (Star Health)" — FOUR policies. + Cards rendered: Royal Sundaram Multiplier, Royal Sundaram Advanced Top Up, + Star Health "Star Hospital Cash" — THREE, and the wrong three. + +ROOT CAUSE: + `single_brain.py` built `TurnResult.citations` from `retrieved_chunks_all` + — every chunk every `retrieve_policies` call returned, deduped by + chunk_id, in vector-score order — NOT the policies the LLM chose to pitch. + The frontend then `.slice(0, 3)`'d that recall dump. Prose = LLM's + curated shortlist; cards = retrieval recall set. Two different sources. + +THE CONTRACT THIS PINS: + `_build_recommendation_citations` returns a citation list that is exactly + the recommended policies — via explicit mark_recommendation ordering when + present, else by the policy names actually written in the reply prose — + with NO score-order fallback that resurrects un-named policies, and NO + count cap. + +Run: + cd /Users/rohitsar/Developer/Insurance\\ Sales\\ Bot + PYTHONPATH=$PWD .venv/bin/python -m unittest \\ + tests.test_cited_policies_match_prose -v +""" + +from __future__ import annotations + +import sys +import unittest +from pathlib import Path + +_REPO_ROOT = Path(__file__).resolve().parent.parent +if str(_REPO_ROOT) not in sys.path: + sys.path.insert(0, str(_REPO_ROOT)) + +from backend.single_brain import ( # noqa: E402 + _build_recommendation_citations, + _norm_policy_name, +) + + +def _chunk(pid: str, name: str, slug: str, score: float, cid: str) -> dict: + return { + "chunk_id": cid, + "policy_id": pid, + "policy_name": name, + "insurer_slug": slug, + "doc_type": "policy_wording", + "source_url": f"https://example.com/{pid}.pdf", + "score": score, + } + + +# The exact retrieval recall set behind the screenshot: 4 distinct policies +# spread over multiple chunks, where the LLM-recommended HDFC/Star policies +# score LOWER than an un-recommended "Star Hospital Cash" chunk — which is +# precisely why the old score-ordered slice surfaced the wrong 3. +SCREENSHOT_CHUNKS = [ + _chunk("rs-multiplier", "Multiplier", "royal-sundaram", 0.91, "c1"), + _chunk("rs-multiplier", "Multiplier", "royal-sundaram", 0.88, "c2"), + _chunk("rs-advtopup", "Advanced Top Up", "royal-sundaram", 0.86, "c3"), + # Un-recommended but high-scoring — the false positive in the screenshot. + _chunk("star-hospcash", "Star Hospital Cash", "star-health", 0.84, "c4"), + # Recommended but LOWER score → dropped by the old .slice(0,3). + _chunk("hdfc-myhealth", "my:health Suraksha", "hdfc-ergo", 0.71, "c5"), + _chunk("star-fho", "Family Health Optima", "star-health", 0.68, "c6"), +] + +SCREENSHOT_REPLY = ( + "Based on your profile, here are a few options:\n" + "1. Multiplier (Royal Sundaram)\n" + "2. Advanced Top Up (Royal Sundaram)\n" + "3. my:health Suraksha (HDFC Ergo)\n" + "4. Family Health Optima (Star Health)\n" + "Want me to compare any of these?" +) + + +class TestProseNameNormalisation(unittest.TestCase): + def test_punctuation_and_case_collapse(self) -> None: + self.assertEqual( + _norm_policy_name("my:health Suraksha"), "my health suraksha" + ) + self.assertEqual( + _norm_policy_name("My-Health Suraksha"), "my health suraksha" + ) + self.assertEqual(_norm_policy_name(""), "") + + +class TestMarkRecommendationPath(unittest.TestCase): + """When the LLM calls mark_recommendation, those ordered ids ARE the + citation set — exactly, in order, no cap.""" + + def test_exact_set_and_order_from_marked_ids(self) -> None: + marked = ["rs-multiplier", "rs-advtopup", "hdfc-myhealth", "star-fho"] + cites, is_rec = _build_recommendation_citations( + reply_text=SCREENSHOT_REPLY, + retrieved_chunks_all=SCREENSHOT_CHUNKS, + marked_policy_ids=marked, + ) + self.assertTrue(is_rec) + self.assertEqual([c["policy_id"] for c in cites], marked) + # The un-recommended high-scorer must NOT appear. + self.assertNotIn( + "star-hospcash", [c["policy_id"] for c in cites] + ) + # Hydrated from the BEST chunk (real corpus url, not invented). + first = cites[0] + self.assertEqual(first["policy_name"], "Multiplier") + self.assertEqual(first["chunk_id"], "c1") # higher score than c2 + + def test_marked_ids_deduped_preserving_order(self) -> None: + cites, _ = _build_recommendation_citations( + reply_text="x", + retrieved_chunks_all=SCREENSHOT_CHUNKS, + marked_policy_ids=["rs-multiplier", "rs-multiplier", "star-fho"], + ) + self.assertEqual( + [c["policy_id"] for c in cites], ["rs-multiplier", "star-fho"] + ) + + +class TestProseMatchingPath(unittest.TestCase): + """When the LLM forgets mark_recommendation (~70% of rec turns per + KI-254), citations are derived from the policy names actually written + into the prose, in order of appearance.""" + + def test_screenshot_scenario_is_fixed(self) -> None: + cites, is_rec = _build_recommendation_citations( + reply_text=SCREENSHOT_REPLY, + retrieved_chunks_all=SCREENSHOT_CHUNKS, + marked_policy_ids=[], # LLM forgot to mark + ) + self.assertTrue(is_rec) + ids = [c["policy_id"] for c in cites] + # EXACTLY the 4 named in prose, in prose order. + self.assertEqual( + ids, + ["rs-multiplier", "rs-advtopup", "hdfc-myhealth", "star-fho"], + ) + # 4 named in prose ⇒ 4 cards (the original bug was 4 → 3). + self.assertEqual(len(cites), 4) + # The false positive from the screenshot is gone. + self.assertNotIn("star-hospcash", ids) + + def test_no_count_cap(self) -> None: + """A 5-policy shortlist must yield 5 cards, not 3.""" + chunks = [ + _chunk(f"p{i}", f"Policy Alpha {i}", "ins", 0.9 - i * 0.05, f"k{i}") + for i in range(5) + ] + reply = ( + "Options: 1. Policy Alpha 0 2. Policy Alpha 1 " + "3. Policy Alpha 2 4. Policy Alpha 3 5. Policy Alpha 4" + ) + cites, is_rec = _build_recommendation_citations( + reply_text=reply, + retrieved_chunks_all=chunks, + marked_policy_ids=[], + ) + self.assertTrue(is_rec) + self.assertEqual(len(cites), 5) + self.assertEqual( + [c["policy_id"] for c in cites], + ["p0", "p1", "p2", "p3", "p4"], + ) + + +class TestNonRecommendationFallback(unittest.TestCase): + """Pure QA / chit-chat turns (no policy named) keep the legacy recall + chips so factual answers still surface their supporting source — the + caller uses recall_citations only when is_recommendation is False.""" + + def test_no_policy_named_returns_not_a_recommendation(self) -> None: + cites, is_rec = _build_recommendation_citations( + reply_text="A waiting period is the time before a claim is " + "payable. It typically ranges from 30 days to 4 years.", + retrieved_chunks_all=SCREENSHOT_CHUNKS, + marked_policy_ids=[], + ) + self.assertFalse(is_rec) + self.assertEqual(cites, []) + + def test_empty_reply_is_not_a_recommendation(self) -> None: + cites, is_rec = _build_recommendation_citations( + reply_text="", + retrieved_chunks_all=SCREENSHOT_CHUNKS, + marked_policy_ids=[], + ) + self.assertFalse(is_rec) + self.assertEqual(cites, []) + + def test_no_chunks_no_marks_is_not_a_recommendation(self) -> None: + cites, is_rec = _build_recommendation_citations( + reply_text="Hello! How can I help you with health insurance?", + retrieved_chunks_all=[], + marked_policy_ids=[], + ) + self.assertFalse(is_rec) + self.assertEqual(cites, []) + + +if __name__ == "__main__": + unittest.main(verbosity=2) diff --git a/tests/test_eligibility_ranking.py b/tests/test_eligibility_ranking.py new file mode 100644 index 0000000000000000000000000000000000000000..182fdd0ab1d0af65b03b3c9200e4b6ec6272f7a2 --- /dev/null +++ b/tests/test_eligibility_ranking.py @@ -0,0 +1,292 @@ +"""KI-278 (2026-05-16) — eligibility filtering + profile-fit ranking. + +Pins the bug reported for the failing session: + + USER PROFILE: 29, metro, income 25L+, FIRST policy (existing_cover_inr=0), + no pre-existing conditions, wants 15L sum insured, prefers ZERO co-pay. + + WHAT WAS WRONGLY RECOMMENDED: + 1. Royal Sundaram "Multiplier" — 20% co-payment (user wants 0%) + 2. Royal Sundaram "Advanced Top Up" — super-top-up; needs a base policy + the first-time buyer does NOT have + 3. generally B/C-grade plans whose metrics contradict stated needs + +Two logic defects, both fixed in backend/retrieval_filters.py: + (a) ELIGIBILITY: top-up / super-top-up plans must be excluded when the + user has no existing base cover (existing_cover_inr falsy / first buy). + (b) PROFILE-FIT RANKING: high co-pay plans must not survive an explicit + zero-copay preference; the SI floor (15L) must gate; better-fit plans + must rank above worse-fit ones. + +Run: + .venv/bin/python -m unittest tests.test_eligibility_ranking -v +""" + +from __future__ import annotations + +import unittest + +from backend.retrieval_filters import ( + apply_profile_filter, + apply_eligibility_filter, + rank_by_profile_fit, + filter_pipeline, +) + + +# --------------------------------------------------------------------------- +# The exact failing-session profile. +# --------------------------------------------------------------------------- + +FAILING_PROFILE = { + "age": 29, + "location_tier": "metro", + "income_band": "25L+", + "primary_goal": "first_buy", + "existing_cover_inr": 0, # FIRST policy — no base cover + "health_conditions": ["none"], + "desired_sum_insured_inr": 1_500_000, # ₹15 lakh + "copay_pct": 0, # explicit ZERO co-pay preference + "dependents": "self", +} + + +def _chunk( + policy_id: str, + policy_name: str, + *, + score: float = 0.5, + policy_type: str | None = None, + deductible_amount: int | None = None, + copay_pct: int | None = None, + sum_insured_options: list[int] | None = None, + grade: str | None = None, + overall_score: int | None = None, + doc_type: str = "policy", +) -> dict: + """Build a chunk dict shaped like brain_tools.retrieve_policies output + AFTER the new policy_facts enrichment step.""" + return { + "policy_id": policy_id, + "policy_name": policy_name, + "insurer_slug": policy_id.split("__")[0], + "doc_type": doc_type, + "score": score, + "chunk_text": "", + # Enriched structured facts (added by brain_tools before filtering): + "policy_type_indemnity_or_fixed": policy_type, + "deductible_amount": deductible_amount, + "co_payment_pct": copay_pct, + "sum_insured_options": sum_insured_options, + "_grade": grade, + "_overall_score": overall_score, + } + + +# Realistic catalog slice mirroring the failing session. +MULTIPLIER = _chunk( + "royal-sundaram__multiplier", + "Multiplier Health Insurance Plan", + score=0.71, + policy_type="family_floater", + deductible_amount=None, + copay_pct=20, + sum_insured_options=[500000, 1000000, 1500000, 2000000, 2500000], + grade="B", + overall_score=72, +) +ADVANCED_TOP_UP = _chunk( + "royal-sundaram__advanced-top-up", + "Advanced Top Up Health Insurance Plan", + score=0.69, + policy_type="super_top_up", + deductible_amount=500000, + copay_pct=0, + sum_insured_options=[1000000, 1500000, 2000000], + grade="B", + overall_score=70, +) +GOOD_FIT_A = _chunk( + "niva-bupa__reassure-2", + "ReAssure 2.0", + score=0.62, + policy_type="indemnity", + deductible_amount=None, + copay_pct=0, + sum_insured_options=[1000000, 1500000, 2000000, 5000000], + grade="A", + overall_score=88, +) +GOOD_FIT_B = _chunk( + "hdfc-ergo__optima-secure", + "Optima Secure", + score=0.58, + policy_type="indemnity", + deductible_amount=None, + copay_pct=0, + sum_insured_options=[500000, 1000000, 1500000, 2000000], + grade="A", + overall_score=85, +) +LOW_SI = _chunk( + "star-health__medi-classic", + "Medi Classic", + score=0.66, + policy_type="indemnity", + deductible_amount=None, + copay_pct=0, + sum_insured_options=[200000, 300000, 500000], # cannot offer 15L + grade="C", + overall_score=60, +) + + +class TestEligibilityFilter(unittest.TestCase): + """Defect (a) — top-up / super-top-up exclusion for first-time buyers.""" + + def test_super_top_up_dropped_when_no_base_cover(self): + kept = apply_eligibility_filter( + [ADVANCED_TOP_UP, GOOD_FIT_A], FAILING_PROFILE + ) + ids = {c["policy_id"] for c in kept} + self.assertNotIn( + "royal-sundaram__advanced-top-up", ids, + "Super-top-up must be excluded for a first-time buyer with no " + "existing base cover.", + ) + self.assertIn("niva-bupa__reassure-2", ids) + + def test_top_up_dropped_by_name_when_facts_missing(self): + # No structured policy_type, but the NAME says "Top Up" / "Super Top Up". + top_up_by_name = _chunk( + "sbi-general__super-top-up", + "SBI Super Top-up Health Insurance", + policy_type=None, + deductible_amount=None, + ) + kept = apply_eligibility_filter([top_up_by_name], FAILING_PROFILE) + self.assertEqual( + kept, [], + "A plan named 'Super Top-up' must be excluded for a no-base-cover " + "user even when structured policy_type is missing.", + ) + + def test_top_up_dropped_by_deductible_signal(self): + # No policy_type, name doesn't say top-up, but it carries a large + # aggregate deductible — that IS the base-cover requirement. + deductible_only = _chunk( + "acko__platinum-super", + "Platinum Plus Plan", + policy_type=None, + deductible_amount=500000, + ) + kept = apply_eligibility_filter([deductible_only], FAILING_PROFILE) + self.assertEqual( + kept, [], + "A plan with a ₹5L aggregate deductible is a top-up in disguise " + "and must be excluded for a no-base-cover user.", + ) + + def test_top_up_kept_when_user_has_base_cover(self): + has_base = dict(FAILING_PROFILE, existing_cover_inr=500000) + kept = apply_eligibility_filter([ADVANCED_TOP_UP], has_base) + self.assertEqual( + len(kept), 1, + "Top-up IS appropriate when the user already has base cover.", + ) + + def test_si_floor_drops_plans_that_cannot_offer_requested_si(self): + kept = apply_eligibility_filter([LOW_SI, GOOD_FIT_A], FAILING_PROFILE) + ids = {c["policy_id"] for c in kept} + self.assertNotIn( + "star-health__medi-classic", ids, + "A plan whose max SI is ₹5L cannot satisfy a ₹15L requirement.", + ) + self.assertIn("niva-bupa__reassure-2", ids) + + def test_zero_copay_preference_drops_high_copay_plan(self): + kept = apply_eligibility_filter([MULTIPLIER, GOOD_FIT_A], FAILING_PROFILE) + ids = {c["policy_id"] for c in kept} + self.assertNotIn( + "royal-sundaram__multiplier", ids, + "A 20% co-pay plan must be excluded when the user explicitly " + "wants ZERO co-pay and can afford full cover.", + ) + + def test_non_policy_chunks_never_dropped(self): + reg = _chunk("irdai__circular", "IRDAI Master Circular", + doc_type="regulatory", policy_type="super_top_up", + deductible_amount=500000) + kept = apply_eligibility_filter([reg], FAILING_PROFILE) + self.assertEqual(len(kept), 1, + "Regulatory/review/profile chunks are never policies.") + + +class TestProfileFitRanking(unittest.TestCase): + """Defect (b) — better-fit plans must outrank worse-fit ones.""" + + def test_a_grade_zero_copay_ranks_above_b_grade(self): + ranked = rank_by_profile_fit( + [MULTIPLIER, GOOD_FIT_B, GOOD_FIT_A], FAILING_PROFILE + ) + order = [c["policy_id"] for c in ranked] + self.assertLess( + order.index("niva-bupa__reassure-2"), + order.index("royal-sundaram__multiplier"), + "A-grade zero-copay plan must rank above a B-grade 20%-copay plan " + "even though the B-grade plan had higher raw cosine.", + ) + + def test_ranking_stable_for_equally_good_plans(self): + ranked = rank_by_profile_fit([GOOD_FIT_A, GOOD_FIT_B], FAILING_PROFILE) + self.assertEqual(len(ranked), 2) + + +class TestFilterPipelineIntegration(unittest.TestCase): + """End-to-end: the exact failing catalog through filter_pipeline must + NOT surface Multiplier or Advanced Top Up, and the top result must be a + well-fitting A-grade plan.""" + + def test_failing_session_catalog(self): + catalog = [ + MULTIPLIER, ADVANCED_TOP_UP, LOW_SI, GOOD_FIT_A, GOOD_FIT_B, + ] + filtered, guard = filter_pipeline( + catalog, + profile=FAILING_PROFILE, + query="first health policy metro 15 lakh sum insured zero co-pay", + intent="recommendation", + ) + ids = [c["policy_id"] for c in filtered] + + self.assertNotIn("royal-sundaram__advanced-top-up", ids, + "super-top-up must not reach the brain") + self.assertNotIn("royal-sundaram__multiplier", ids, + "20%-copay plan must not reach a zero-copay user") + self.assertNotIn("star-health__medi-classic", ids, + "₹5L-max plan must not reach a ₹15L requirement") + self.assertTrue(ids, "good-fit plans must still survive") + # Best-fit (A-grade, zero-copay, offers 15L) should be ranked first. + self.assertEqual( + ids[0], "niva-bupa__reassure-2", + "Top recommendation must be the best profile-fit plan.", + ) + + def test_demographic_filter_still_runs(self): + # apply_profile_filter (age/senior/maternity) must still be composed. + senior = _chunk("star-health__red-carpet", + "Senior Citizens Red Carpet", + policy_type="indemnity", + sum_insured_options=[1500000]) + senior["min_entry_age"] = 60 + filtered, _ = filter_pipeline( + [senior, GOOD_FIT_A], profile=FAILING_PROFILE, + query="x", intent="recommendation", + ) + ids = [c["policy_id"] for c in filtered] + self.assertNotIn("star-health__red-carpet", ids, + "29yo must not see a senior-only plan") + + +if __name__ == "__main__": + unittest.main() diff --git a/tests/test_scorecard_lifelong.py b/tests/test_scorecard_lifelong.py new file mode 100644 index 0000000000000000000000000000000000000000..2e8c4885f9d5d3d259f296581dc82ad14cecbdb3 --- /dev/null +++ b/tests/test_scorecard_lifelong.py @@ -0,0 +1,66 @@ +"""Regression test: max_renewal_age is REMOVED from the scoring model. + +History: the PDF-extraction LLM emitted max_renewal_age=999 as a "lifelong" +sentinel because score_renewal_protection rewarded `maxr >= 99`. That +fabricated +25 on 137 policies' grades and leaked a fake "Strong fit: +lifelong renewability" bullet into the UI. + +Decision (product owner): lifelong renewability is mandated by IRDAI for every +health-indemnity policy since 2020 — it is universal, so it does NOT +differentiate policies and must NOT be scored. max_renewal_age was therefore +removed entirely. These tests pin that removal so it can't silently creep +back: renewal scoring now depends ONLY on max_entry_age, and max_renewal_age +(in any form — number, 999, or a lifelong flag) must have ZERO effect. +""" +import sys +from pathlib import Path + +sys.path.insert(0, str(Path(__file__).resolve().parents[1] / "backend")) + +import scorecard +from scorecard import score_renewal_protection, compute_data_completeness, SCORED_FIELDS, ALIASES + + +def test_max_renewal_age_not_a_scored_field(): + assert "max_renewal_age" not in SCORED_FIELDS + assert "max_renewal_age" not in ALIASES + assert not hasattr(scorecard, "_is_lifelong_renewal") # helper deleted + + +def test_max_renewal_age_has_zero_effect_on_renewal_score(): + # 999 sentinel, a real cap, a lifelong flag, and absence must all score + # identically — only max_entry_age may move the number. + base = score_renewal_protection({}).score + for variant in ( + {"max_renewal_age": {"value": 999}}, + {"max_renewal_age": {"value": 65}}, + {"max_renewal_age": {"value": None, "lifelong_renewal": True}}, + {"max_renewal_age": 80}, + ): + assert score_renewal_protection(variant).score == base + + +def test_entry_age_is_the_sole_driver(): + low = score_renewal_protection({"max_entry_age": {"value": 45}}).score + mid = score_renewal_protection({"max_entry_age": {"value": 60}}).score + high = score_renewal_protection({"max_entry_age": {"value": 70}}).score + assert low < mid < high + + +def test_lifelong_shown_as_informational_signal_not_scored(): + sc = score_renewal_protection({}) + assert sc.name == "Renewal Protection" + assert any("lifelong" in s.lower() and "not scored" in s.lower() for s in sc.signals) + + +def test_completeness_ignores_max_renewal_age(): + # Putting a value in max_renewal_age must NOT raise data completeness, + # because the scorecard no longer reads it. + empty = compute_data_completeness({}) + with_renewal = compute_data_completeness({"max_renewal_age": {"value": 999}}) + assert empty == with_renewal + + +if __name__ == "__main__": + import subprocess + raise SystemExit(subprocess.call([sys.executable, "-m", "pytest", "-q", __file__])) diff --git a/tests/test_scorecard_recalibration.py b/tests/test_scorecard_recalibration.py new file mode 100644 index 0000000000000000000000000000000000000000..aff1a9612ff0cbec2f3b79d36b207b90da67fceb --- /dev/null +++ b/tests/test_scorecard_recalibration.py @@ -0,0 +1,97 @@ +"""Regression test: scorecard recalibration (2026-05-16). + +Pins the fix for the "every policy is B/72" collapse. Before recalibration the +6 sub-scores had high neutral bases (Cost 75, Waiting 90, …) + tiny deltas, so +all policies compressed to 64–86 and ~90% graded B regardless of quality, and +data-filling didn't change it (proven structural). + +These tests pin: (1) true-neutral bases (a blank policy must NOT land ~72), +(2) genuine spread across a weak→strong gradient, (3) absolute grade cutoffs, +(4) fixed-benefit products judged only on applicable sub-scores, (5) ordering +preserved (a strictly-better policy must score strictly higher). +""" +import sys +from pathlib import Path + +sys.path.insert(0, str(Path(__file__).resolve().parents[1] / "backend")) + +from scorecard import build_scorecard, grade_for, _is_fixed_benefit + + +def _wrap(d): # policy_facts {value,...} wrapper shape + return {k: ({"value": v} if not isinstance(v, dict) else v) for k, v in d.items()} + + +STRONG = _wrap({ + "policy_name": "Strong Comprehensive", "insurer_slug": "x", + "ayush_coverage": {"covered": True}, "day_care_treatments_count": 600, + "maternity_coverage": {"covered": True}, "newborn_coverage": {"covered": True}, + "organ_donor_expenses": {"covered": True}, "domiciliary_treatment": {"covered": True}, + "preventive_health_checkup": {"covered": True}, + "pre_hospitalization_days": 90, "post_hospitalization_days": 180, + "copayment_pct": 0, "room_rent_capping": "no cap", + "pre_existing_disease_waiting_months": 18, "initial_waiting_period_days": 30, + "cashless_treatment_supported": {"covered": True}, "network_hospital_count": 14000, + "max_entry_age": 70, "no_claim_bonus_pct": 100, + "restoration_benefit": "full restoration once per year", +}) +WEAK = _wrap({ + "policy_name": "Weak Thin", "insurer_slug": "y", + "ayush_coverage": {"covered": False}, "day_care_treatments_count": 40, + "copayment_pct": 30, "room_rent_capping": "1% of SI", + "pre_existing_disease_waiting_months": 48, "initial_waiting_period_days": 90, + "cashless_treatment_supported": {"covered": False}, "network_hospital_count": 800, + "max_entry_age": 45, "no_claim_bonus_pct": 0, +}) +GREAT_CSR = {"claim_metrics": {"claim_settlement_ratio_pct": 98.0, + "complaints_per_10k_policies": 4}} +POOR_CSR = {"claim_metrics": {"claim_settlement_ratio_pct": 71.0, + "complaints_per_10k_policies": 60}} + + +def test_blank_policy_is_not_the_old_72_collapse(): + blank = build_scorecard({}).overall_score + # Old bug: blank ≈ 72 (B). Recalibrated true-neutral must be clearly mid/low. + assert blank < 65, f"blank scored {blank} — neutral base still inflated" + + +def test_strong_beats_weak_by_a_wide_margin(): + s = build_scorecard(STRONG, insurer_reviews=GREAT_CSR).overall_score + w = build_scorecard(WEAK, insurer_reviews=POOR_CSR).overall_score + assert s > w + 25, f"strong={s} weak={w} — spread too small (compression)" + assert grade_for(s)[0] in ("A", "B") + assert grade_for(w)[0] in ("D", "F") + + +def test_ordering_preserved_monotonic(): + # Strictly improving one lever must not lower the score (stretch ≠ scramble). + base = dict(WEAK) + better = dict(WEAK); better["copayment_pct"] = {"value": 0} + assert build_scorecard(better).overall_score >= build_scorecard(base).overall_score + + +def test_absolute_grade_thresholds_are_frozen(): + assert grade_for(76)[0] == "A" and grade_for(75)[0] == "B" + assert grade_for(69)[0] == "B" and grade_for(68)[0] == "C" + assert grade_for(61)[0] == "C" and grade_for(60)[0] == "D" + assert grade_for(54)[0] == "D" and grade_for(53)[0] == "F" + + +def test_fixed_benefit_detected_and_reweighted(): + for name in ("Star Hospital Cash", "Group Personal Accident", + "Criti Medicare", "Activ Secure Cancer Secure"): + assert _is_fixed_benefit({"policy_name": name}), name + assert not _is_fixed_benefit({"policy_name": "Optima Secure"}) + # A fixed-benefit plan from a great-CSR insurer must NOT be dragged to the + # floor by its (inapplicable) empty indemnity fields. + fb = _wrap({"policy_name": "Star Hospital Cash", "insurer_slug": "s", + "cashless_treatment_supported": {"covered": True}, + "network_hospital_count": 12000, "no_claim_bonus_pct": 50}) + sc = build_scorecard(fb, insurer_reviews=GREAT_CSR) + assert _is_fixed_benefit(fb) + assert sc.overall_score >= 60, f"fixed-benefit collapsed to {sc.overall_score}" + + +if __name__ == "__main__": + import subprocess + raise SystemExit(subprocess.call([sys.executable, "-m", "pytest", "-q", __file__])) diff --git a/tools/_extraction_contract.md b/tools/_extraction_contract.md new file mode 100644 index 0000000000000000000000000000000000000000..b1157d889d613cba1f9f4d37dbf7978660355228 --- /dev/null +++ b/tools/_extraction_contract.md @@ -0,0 +1,70 @@ +# Policy-Facts Extraction Contract (v1 — 2026-05-16) + +Single source of truth for every fill/verify agent. Deviating from this is a defect. + +## Goal +Replace every `"value": null` and every `"value": 999`/`9999` (a poisoned +"no-max" sentinel) in `40-data/policy_facts/____.json` +with a **real value backed by a verbatim quote from the source PDF** — or an +honest, sourced "not stated". + +## Path mapping (deterministic) +`40-data/policy_facts/____.json` + → PDF: `rag/corpus//__.pdf` +Also check the file's own `source_pdf_path` and `max_renewal_age.source_pdf_path`. +If no PDF exists locally, see "Missing PDF" below — do NOT guess. + +## Per-cell rule (apply to EVERY field dict that has a `value` key) +Only touch a cell if its current `value` is `null`, `999`, or `9999`. +Leave already-good values untouched (do not "improve" them). + +For each such cell, read the PDF and: + +1. **Value found explicitly** → set: + - `"value"`: the real value (int/number/bool/string/list per existing `unit`) + - `"source_quote"`: the **verbatim** sentence/clause from the PDF that states + it (≤ 300 chars, copy exactly, do not paraphrase) + - `"source_pdf_path"`: the correct `rag/corpus/...pdf` path + - `"_confidence"`: `"high"` +2. **Value derivable by direct reading** (e.g. table cell, "Annexure A lists 586 + day-care procedures") → same as above with `"_confidence": "medium"` and a + `source_quote` that contains the basis. +3. **Genuinely absent from this document** → set: + - `"value"`: `null` + - `"source_quote"`: `"not stated in .pdf"` + - `"_confidence"`: `"low"` + NEVER invent a number. NEVER use 999/9999. A sourced null beats a fake number. + +## `max_renewal_age` — DO NOT FILL (field removed from scoring) +SKIP this field entirely. Do not read PDFs for it, do not set it, do not add a +`lifelong_renewal` key. Lifelong renewability is mandated by IRDAI for every +health-indemnity product (since 2020) — it is universal, so it does not +differentiate policies and has been removed from the scoring model. Leave any +existing `max_renewal_age` cell exactly as-is (even if it is `999`/`null`); +it is dead data that will be stripped in the final cleanup pass. Spend zero +time on it. Focus on every OTHER null cell. + +## Boolean fields (`*_coverage`, `*_supported`, `ambulance_cover`, etc.) +`value` must be `true`/`false` (JSON booleans) with a verbatim quote. "Covered +under Section X" → true; an exclusions-list mention → false. Unclear → null+low. + +## Hard constraints +- Edit ONLY policy_facts files for your assigned insurer slugs. Touch no code. +- Output must be valid JSON — load with `json.load`, write with + `json.dump(d, f, ensure_ascii=False, indent=2)`; preserve key order. +- Every non-null filled cell MUST have a non-empty `source_quote` that actually + occurs in the PDF text. This is verified independently afterward — fabricated + quotes will be caught and bounced. +- No homepage/search URLs anywhere. English-only quotes. + +## Missing PDF +If the mapped PDF does not exist locally: do not fill from memory. Record the +file in your summary under `missing_pdf` and move on (a separate task is +sourcing those PDFs). + +## Agent output (return exactly this JSON) +```json +{"insurers": ["..."], "files_processed": N, "cells_filled": N, + "cells_left_null_sourced": N, "lifelong_flagged": N, + "missing_pdf": ["path", ...], "anomalies": ["short notes"]} +``` diff --git a/tools/_reextract_contract_v2.md b/tools/_reextract_contract_v2.md new file mode 100644 index 0000000000000000000000000000000000000000..42b45452439ea556546d94bc25f98df57106153a --- /dev/null +++ b/tools/_reextract_contract_v2.md @@ -0,0 +1,56 @@ +# Re-Sourcing Contract v2 (2026-05-16) — verbatim provenance pass + +Binding contract for the legacy-provenance re-extraction fleet. The earlier +pass filled NULL cells. THIS pass fixes cells that HAVE a value but whose +`source_quote` is a non-verbatim self-reference ("extracted from PDF data", +"NIM DeepSeek", "regex extracted from PDF text", "rag/extracted structured +JSON", etc.). The two-part verify flagged 2,904 such cells. Goal: every value +on the site traces to a real verbatim source — zero exceptions. + +## Which cells to FIX (in your assigned insurers' policy_facts files) +A cell qualifies if ALL of: +- it has a non-null `value` (not null/""/[]; ignore 999/9999 — dead), +- it is NOT `max_renewal_age` (field removed — skip entirely), +- it has NO `source_url` (url-sourced cells e.g. day_care/network are fine — skip), +- its `source_quote` is empty OR matches a provenance/pipeline note: + `extracted from PDF`, `from extracted PDF data`, `NIM DeepSeek`, + `regex extracted from PDF`, `rag/extracted`, `structured JSON/field`, + `Gx batch extract`, `prior pipeline`, `see source PDF for verbatim`. +Do NOT touch cells whose `source_quote` is already a real verbatim clause, nor +`not stated …` sourced-nulls (legitimately empty). + +## For each qualifying cell — open the `source_pdf_path` PDF and: +1. **Verbatim clause supports the existing value** → set `source_quote` to + that exact clause (≤300 chars, copied verbatim), keep `value`, set + `_confidence` high (explicit) or medium (table/derived), keep + `source_pdf_path`. +2. **PDF states a DIFFERENT value** → correct `value` to what the PDF says, + with the verbatim clause as `source_quote`. Never keep a value the source + contradicts. Never keep the old provenance note. +3. **Field genuinely absent from the PDF** → `value: null`, + `source_quote: "not stated in .pdf"`, `_confidence: "low"`. +4. **Source PDF is image-only / not text-extractable** (fitz/pdftotext yields + < ~400 chars of text — e.g. a scanned brochure) AND no text-bearing + sibling document exists for that policy → DROP the cell: + `value: null`, + `source_quote: "source document is an image-only scan; not text-extractable (no OCR available)"`, + `_confidence: "low"`. (Per owner instruction: drop, do not fabricate, do + not OCR.) If a text-bearing sibling doc for the SAME policy exists in + `rag/corpus//`, you may source from it and update + `source_pdf_path` accordingly. + +## Hard rules +- NEVER keep "extracted from PDF data"/NIM/regex/etc. as a source_quote. +- NEVER fabricate a quote. NEVER invent a number. NEVER use 999/9999. +- Edit ONLY your assigned insurers' `40-data/policy_facts/*.json`. No code. +- Valid JSON via `json.dump(d, f, ensure_ascii=False, indent=2)`, preserve key + order. +- Every quote you write MUST be greppable in the PDF text (whitespace- + normalised) — an independent adversarial re-audit will re-open the PDFs. + +## Output (return exactly) +```json +{"insurers":["..."],"files_processed":N,"cells_reverbatim":N, + "values_corrected":N,"cells_nulled_absent":N,"cells_dropped_imageonly":N, + "image_only_pdfs":["path"],"anomalies":["..."]} +``` diff --git a/tools/_reextract_contract_v3.md b/tools/_reextract_contract_v3.md new file mode 100644 index 0000000000000000000000000000000000000000..72cd7be1ae8cdb776dec9fda67da0e4f47b7b066 --- /dev/null +++ b/tools/_reextract_contract_v3.md @@ -0,0 +1,51 @@ +# Re-Sourcing Contract v3 (2026-05-16) — exhaustive verbatim sweep + +v2 fixed only cells whose source_quote matched a narrow provenance-note list. +The hardened verifier proved ~947 cells still carry a NON-verbatim source_quote +that slipped that list: heuristic/placeholder notes ("classified as X from PDF +heuristics", "Default IRDAI 24-month", "limit: …", "(standard … per Policy +Schedule)", "No mandatory copay extracted") and human paraphrases/summaries. +v3 uses an OPERATIONAL definition — no pattern list — so nothing slips. + +## Qualifying rule (OPERATIONAL — applies to every value-bearing cell) +For each cell in your assigned insurers' `40-data/policy_facts/*.json` with: +- a non-null `value` (ignore null/""/[]; ignore 999/9999), AND +- NOT `max_renewal_age` (skip — removed), AND +- NO `source_url` (url-sourced day_care/network are fine — skip), AND +- source_quote is NOT a "not stated …/image-only scan …" sourced-null, + +→ open the cell's `source_pdf_path` PDF (PyMuPDF/`fitz`, column-aware) and +**TEST**: does the `source_quote` actually occur in the PDF text (whitespace- +normalised, case-insensitive — a clause is "present" if a majority of its +8-word shingles are in the text)? +- **Present verbatim** → leave it (already good). +- **NOT present** (paraphrase, summary, heuristic note, placeholder, inferred, + "limit:…", "Default IRDAI…", "classified as…") → it qualifies; FIX it. + +## Fixing a qualifying cell (same as v2 rules) +1. Verbatim clause in the PDF supports the value → set `source_quote` to that + exact clause (≤300 chars), keep value, `_confidence` high/medium. +2. PDF states a different value → correct `value`, with the verbatim clause. +3. Field genuinely absent from the PDF → `value:null`, + `source_quote:"not stated in .pdf"`, `_confidence:"low"`. +4. Source PDF image-only (<400 extractable chars) & no text sibling → drop: + `value:null`, `source_quote:"source document is an image-only scan; not + text-extractable (no OCR available)"`, `_confidence:"low"`. (If a text- + bearing sibling doc for the same policy exists, source from it + update + `source_pdf_path`.) + +## Hard rules +- NEVER keep a non-verbatim source_quote on a non-null value. NEVER fabricate, + paraphrase, summarise, or infer a quote — copy exact PDF text only. +- NEVER invent a number. NEVER 999/9999. +- Edit ONLY assigned insurers' policy_facts files. No code. Valid JSON via + `json.dump(d,f,ensure_ascii=False,indent=2)`, key order preserved. +- An independent adversarial re-audit WILL re-open the PDFs — every quote must + survive a fresh shingle/semantic check. + +## Output +```json +{"insurers":["..."],"files_processed":N,"cells_checked":N, + "already_verbatim_left":N,"reverbatim_fixed":N,"values_corrected":N, + "nulled_absent":N,"dropped_imageonly":N,"anomalies":["..."]} +``` diff --git a/tools/extract_premium_samples.py b/tools/extract_premium_samples.py new file mode 100644 index 0000000000000000000000000000000000000000..e7f0587e5be5c21bdb4fc51234598dada8779df0 --- /dev/null +++ b/tools/extract_premium_samples.py @@ -0,0 +1,171 @@ +#!/usr/bin/env python3 +""" +Extract premium samples from rag/extracted/ for policies missing in +40-data/premiums/illustrative_premiums.json. + +Strategy: + - For each policy_facts slug not already in illustrative_premiums: + - Look for premium_range_indicative_inr in extracted JSON(s) + - Parse age/SI/floater hints from the key names + - If found: add 1-2 sample entries with source_quality="brochure_extract" + - Else: append to _pending_scrape.txt +""" +import json +import os +import re + +ROOT = '/Users/rohitsar/Developer/Insurance Sales Bot' +PF_DIR = os.path.join(ROOT, '40-data/policy_facts') +EXT_DIR = os.path.join(ROOT, 'rag/extracted') +PREMIUMS_PATH = os.path.join(ROOT, '40-data/premiums/illustrative_premiums.json') +PENDING_PATH = os.path.join(ROOT, '40-data/premiums/_pending_scrape.txt') + + +def parse_key(key): + """Parse keys like '26-45_SI_45L_deductible_5L_1A' or '35y_SI_5L_floater'. + Returns dict with age, sum_insured_inr, family_size, deductible_inr, family_floater. + Returns None if can't parse age or SI. + """ + out = { + 'age': None, + 'sum_insured_inr': None, + 'family_size': 1, + 'deductible_inr': None, + 'is_floater': False, + } + # Age + m = re.search(r'(\d{2})\s*[-y]\s*(\d{2})?', key) + if m: + if m.group(2): + # range — take midpoint + out['age'] = int((int(m.group(1)) + int(m.group(2))) / 2) + else: + out['age'] = int(m.group(1)) + + # SI: e.g., "SI_5L" or "SI_45L" + m = re.search(r'SI[_\s]*(\d+(?:\.\d+)?)\s*L', key, re.I) + if m: + out['sum_insured_inr'] = int(float(m.group(1)) * 100000) + + # Deductible + m = re.search(r'deductible[_\s]*(\d+(?:\.\d+)?)\s*L', key, re.I) + if m: + out['deductible_inr'] = int(float(m.group(1)) * 100000) + + # Floater + if 'floater' in key.lower(): + out['is_floater'] = True + out['family_size'] = 2 + + # Adult count (1A, 2A) + m = re.search(r'(\d)A\b', key) + if m: + out['family_size'] = int(m.group(1)) + + if out['age'] is None or out['sum_insured_inr'] is None: + return None + return out + + +def base_slug_from_filename(fname): + """Strip .json + __wordings/__brochure/__cis suffix.""" + s = fname.replace('.json', '') + for suf in ('__wordings', '__brochure', '__cis'): + if s.endswith(suf): + return s[:-len(suf)] + return s + + +def main(): + pf_files = sorted([f for f in os.listdir(PF_DIR) if f.endswith('.json')]) + + # Build map: base_slug -> list of associated extracted JSON files + slug_to_extracted = {} + for f in pf_files: + base = base_slug_from_filename(f) + ext_path = os.path.join(EXT_DIR, f) + if os.path.exists(ext_path): + slug_to_extracted.setdefault(base, []).append(ext_path) + + # Load existing premiums + with open(PREMIUMS_PATH) as f: + prem_data = json.load(f) + existing_slugs = set(prem_data['base_premiums'].keys()) + + # Build full universe of slugs (from pf_files) + all_slugs = sorted(slug_to_extracted.keys()) + missing = [s for s in all_slugs if s not in existing_slugs] + print(f'Total unique slugs: {len(all_slugs)}') + print(f'Already have premiums: {len(existing_slugs)}') + print(f'Missing: {len(missing)}') + + added = [] + pending = [] + + for slug in missing: + ext_paths = slug_to_extracted[slug] + samples = [] + policy_name = None + for ep in ext_paths: + with open(ep) as f: + d = json.load(f) + if not policy_name: + policy_name = d.get('policy_name') + pr = d.get('premium_range_indicative_inr') + if not pr: + continue + src_url = d.get('source_pdf_url') or '' + src_pdf = d.get('source_pdf_path', '') + if isinstance(pr, dict): + for k, v in pr.items(): + parsed = parse_key(k) + if not parsed: + continue + try: + prem_inr = int(float(v)) + except (ValueError, TypeError): + continue + if prem_inr <= 0 or prem_inr > 5_000_000: + continue + samples.append({ + 'age': parsed['age'], + 'sum_insured_inr': parsed['sum_insured_inr'], + 'city_tier': 'metro', + 'smoker': False, + 'family_size': parsed['family_size'], + 'annual_premium_inr': prem_inr, + 'source_url': src_url or 'extracted_from_brochure', + 'source_note': f'Found in {os.path.basename(ep).replace(".json","")} PDF: premium_range_indicative_inr["{k}"]={prem_inr}', + 'source_quality': 'brochure_extract', + }) + if samples: + # Limit to first 4 samples (don't bloat) + samples = samples[:4] + prem_data['base_premiums'][slug] = { + 'policy_id': slug.replace('__', '-'), + 'policy_name': policy_name or slug, + 'samples': samples, + } + added.append((slug, len(samples))) + else: + pending.append(slug) + + # Write premiums back + with open(PREMIUMS_PATH, 'w') as f: + json.dump(prem_data, f, indent=2, ensure_ascii=False) + + # Write pending scrape list + with open(PENDING_PATH, 'w') as f: + f.write('# Policies needing manual PolicyBazaar/InsuranceDekho premium scrape\n') + f.write(f'# Generated: 2026-05-15 Count: {len(pending)}\n\n') + for slug in pending: + f.write(f'{slug}\n') + + print(f'\nAdded brochure-extracted premiums for: {len(added)} policies') + for slug, n in added: + print(f' {slug}: {n} samples') + print(f'\nPending manual scrape: {len(pending)} policies → {PENDING_PATH}') + + +if __name__ == '__main__': + main() diff --git a/tools/fill_policy_facts.py b/tools/fill_policy_facts.py new file mode 100644 index 0000000000000000000000000000000000000000..6a0179e1c08cbc14e8a579b21c83d6a5c30686df --- /dev/null +++ b/tools/fill_policy_facts.py @@ -0,0 +1,356 @@ +#!/usr/bin/env python3 +""" +Fill structured fields in 40-data/policy_facts/*.json (Schema A skeletons) +from rag/extracted/*.json structured data. + +Skips Schema B (already curated by sibling agent #210). +""" +import json +import os +import re +import sys + +ROOT = '/Users/rohitsar/Developer/Insurance Sales Bot' +PF_DIR = os.path.join(ROOT, '40-data/policy_facts') +EXT_DIR = os.path.join(ROOT, 'rag/extracted') + + +def coerce_int(x): + if x is None: + return None + if isinstance(x, (int, float)): + return int(x) + if isinstance(x, str): + m = re.search(r'(\d+)', x.replace(',', '')) + if m: + return int(m.group(1)) + return None + + +def coerce_bool(x): + if x is None: + return None + if isinstance(x, bool): + return x + if isinstance(x, str): + s = x.strip().lower() + if s in ('true', 'yes', 'y', 'covered', 'available', '1'): + return True + if s in ('false', 'no', 'n', 'not covered', 'excluded', '0'): + return False + return None + + +def make_wrapper(value, unit, ext_data, note=None, confidence='high'): + """Build the {value, unit, source_pdf_path, source_quote} wrapper.""" + pdf = ext_data.get('source_pdf_path', '') + quote = note if note else 'extracted from PDF via LLM (rag/extracted) — see source for verbatim' + return { + 'value': value, + 'unit': unit, + 'source_pdf_path': pdf, + 'source_quote': quote, + '_confidence': confidence, + } + + +def get_nested(ext_data, key, subkey): + """Get ext_data[key][subkey] if exists, else None.""" + v = ext_data.get(key) + if isinstance(v, dict): + return v.get(subkey) + return None + + +def parse_room_rent_pct(text): + """Try to extract a percentage from room rent capping text. Returns int or None.""" + if not isinstance(text, str): + return None + # e.g. "Up to 1% of SI", "1% of sum insured" + m = re.search(r'(\d+(?:\.\d+)?)\s*%\s*of\s*(?:the\s*)?(?:sum insured|SI)', text, re.I) + if m: + return float(m.group(1)) + return None + + +def fill_one(pf_path, ext_path): + """Merge extracted data into a skeleton policy_facts file. Returns dict of filled fields.""" + with open(pf_path) as f: + pf = json.load(f) + with open(ext_path) as f: + ext = json.load(f) + + filled = {} + + def set_field(field_name, value, unit, note=None, confidence='high', add_if_missing=True): + if value is None or value == '': + return + old = pf.get(field_name) + if isinstance(old, dict): + if old.get('value') in (None, '', []): + old['value'] = value + old['unit'] = unit + old['source_pdf_path'] = ext.get('source_pdf_path', old.get('source_pdf_path', '')) + if note: + old['source_quote'] = note + old['_confidence'] = confidence + filled[field_name] = value + elif old is None: + if add_if_missing: + pf[field_name] = make_wrapper(value, unit, ext, note, confidence) + filled[field_name] = value + + # ----- Direct mappings ----- + set_field('min_entry_age', coerce_int(ext.get('min_entry_age_years')), 'years', + 'min_entry_age_years from extracted PDF data') + set_field('max_entry_age', coerce_int(ext.get('max_entry_age_years')), 'years', + 'max_entry_age_years from extracted PDF data') + set_field('max_renewal_age', coerce_int(ext.get('max_renewal_age_years')), 'years', + 'max_renewal_age_years from extracted PDF data') + set_field('min_child_entry_age', coerce_int(ext.get('min_child_entry_age_days')), 'days', + 'min_child_entry_age_days from extracted PDF data') + + # Sum insured options + sio = ext.get('sum_insured_options_inr') + if isinstance(sio, list) and sio: + set_field('sum_insured_options', sio, 'INR', + 'sum_insured_options_inr from extracted PDF data') + + # Waiting periods + set_field('grace_period', coerce_int(ext.get('grace_period_days')), 'days', + 'grace_period_days from extracted PDF data') + set_field('free_look_period', coerce_int(ext.get('free_look_period_days')), 'days', + 'free_look_period_days from extracted PDF data') + set_field('initial_waiting_period_days', coerce_int(ext.get('initial_waiting_period_days')), + 'days', 'initial_waiting_period_days from extracted PDF data') + set_field('pre_existing_disease_waiting_months', + coerce_int(ext.get('pre_existing_disease_waiting_months')), + 'months', 'pre_existing_disease_waiting_months from extracted PDF data') + set_field('specific_disease_waiting_months', + coerce_int(ext.get('specific_disease_waiting_months')), + 'months', 'specific_disease_waiting_months from extracted PDF data') + set_field('maternity_waiting_months', + coerce_int(ext.get('maternity_waiting_months')), + 'months', 'maternity_waiting_months from extracted PDF data') + + # Hospitalization + set_field('pre_hospitalization_days', coerce_int(ext.get('pre_hospitalization_days')), + 'days', 'pre_hospitalization_days from extracted PDF data') + set_field('post_hospitalization_days', coerce_int(ext.get('post_hospitalization_days')), + 'days', 'post_hospitalization_days from extracted PDF data') + + # Day-care count — try to extract a number from limit_text or notes + dc = ext.get('day_care_treatments') + if isinstance(dc, dict): + # Look for a number in limit_text or notes + for fld in ('limit_text', 'notes'): + txt = dc.get(fld, '') + if isinstance(txt, str): + m = re.search(r'(\d{2,4})\+?\s*(?:listed\s+)?day[\s\-]?care', txt, re.I) + if not m: + m = re.search(r'(\d{2,4})\s+(?:procedures|treatments)', txt, re.I) + if m: + n = int(m.group(1)) + if 10 <= n <= 1000: + set_field('day_care_treatments_count', n, 'count', + f'extracted from day_care_treatments.{fld}: "{txt[:120]}"', + 'medium') + break + + # Network hospital count — try structured field first, then regex over serialized JSON + nhc = ext.get('network_hospital_count') + nhc_int = coerce_int(nhc) + if nhc_int and nhc_int >= 100: + set_field('network_hospital_count', nhc_int, 'count', + 'network_hospital_count from extracted PDF data') + else: + # Fallback regex + full_text = json.dumps(ext) + m = re.search(r'(\d{3,5})\+?\s*(?:network\s+)?hospitals?', full_text, re.I) + if m: + v = int(m.group(1)) + if 1000 <= v <= 50000: + set_field('network_hospital_count', v, 'count', + f'regex extracted from serialized extracted JSON: matched "{m.group(0)[:80]}"', + 'medium') + + # Day-care: also try regex fallback over whole JSON + if not isinstance(pf.get('day_care_treatments_count'), dict) or \ + pf.get('day_care_treatments_count', {}).get('value') in (None, '', []): + full_text = json.dumps(ext) + for pat in ( + re.compile(r'(\d{2,4})\+?\s*(?:listed\s+)?day[\s\-]?care\s+(?:procedures?|treatments?)', re.I), + re.compile(r'day[\s\-]?care\s+(?:procedures?|treatments?)[^\d]{0,40}?(\d{2,4})', re.I), + ): + m = pat.search(full_text) + if m: + v = int(m.group(1)) + if 50 <= v <= 1000: + set_field('day_care_treatments_count', v, 'count', + f'regex extracted from serialized JSON: "{m.group(0)[:80]}"', + 'medium') + break + + # Co-payment percentage + cop = ext.get('copayment_pct') + cop_int = coerce_int(cop) if cop is not None else None + if cop_int is not None and 0 <= cop_int <= 100: + # In schema A the field is named co_payment_pct + set_field('co_payment_pct', cop_int, '%', + f'copayment_pct={cop_int}% from extracted PDF data') + + # Room rent — try to extract % of SI; else fallback to verbatim + rr = ext.get('room_rent_capping') + if isinstance(rr, str) and rr.strip(): + pct = parse_room_rent_pct(rr) + if pct is not None: + set_field('room_rent_capped_at_pct_of_si', pct, '%', + f'parsed from room_rent_capping: "{rr[:150]}"', 'medium') + # Always stash the verbatim room rent description (add field if missing) + set_field('room_rent_capping', rr, 'text', + f'room_rent_capping (verbatim): "{rr[:200]}"', 'high') + + # NCB — add as new field if missing + ncb = ext.get('no_claim_bonus_pct') + ncb_int = coerce_int(ncb) + if ncb_int is not None and 0 <= ncb_int <= 200: + set_field('no_claim_bonus_pct', ncb_int, '%', + 'no_claim_bonus_pct from extracted PDF data', 'high') + + # CSR + csr = ext.get('claim_settlement_ratio_pct') + csr_f = None + try: + csr_f = float(csr) if csr is not None else None + except (ValueError, TypeError): + csr_f = coerce_int(csr) + if csr_f is not None and 0 < csr_f <= 100: + set_field('claim_settlement_ratio_pct', csr_f, '%', + 'claim_settlement_ratio_pct from extracted PDF data') + + # Coverage booleans + descriptions (add as new fields if missing in skeleton) + for ext_key, pf_key, label in [ + ('ayush_coverage', 'ayush_coverage', 'AYUSH coverage'), + ('maternity_coverage', 'maternity_coverage', 'Maternity coverage'), + ('newborn_coverage', 'newborn_coverage', 'Newborn coverage'), + ('organ_donor_expenses', 'organ_donor_expenses', 'Organ donor expenses'), + ('restoration_benefit', 'restoration_benefit', 'Restoration benefit'), + ('domiciliary_treatment', 'domiciliary_treatment', 'Domiciliary treatment'), + ('worldwide_emergency_cover', 'worldwide_emergency_cover', 'Worldwide emergency cover'), + ('preventive_health_checkup', 'preventive_health_checkup', 'Preventive health checkup'), + ('critical_illness_cover', 'critical_illness_cover', 'Critical illness cover'), + ]: + ev = ext.get(ext_key) + if isinstance(ev, dict): + covered = ev.get('covered') + note_parts = [] + if 'limit_text' in ev and ev['limit_text']: + note_parts.append(f"limit: {ev['limit_text']}") + if 'notes' in ev and ev['notes']: + note_parts.append(ev['notes']) + note_str = '; '.join(note_parts) if note_parts else f'{label} from extracted PDF data' + if isinstance(covered, bool): + set_field(pf_key, covered, 'boolean', note_str[:300], 'high') + + # Cashless treatment supported (top-level bool in extracted) + cts = ext.get('cashless_treatment_supported') + if isinstance(cts, bool): + set_field('cashless_treatment_supported', cts, 'boolean', + 'cashless_treatment_supported from extracted PDF data', 'high') + + # NCB cap percentage (in addition to no_claim_bonus_pct) + ncb_cap = ext.get('no_claim_bonus_cap_pct') + ncb_cap_int = coerce_int(ncb_cap) + if ncb_cap_int is not None and 0 <= ncb_cap_int <= 200: + set_field('no_claim_bonus_cap_pct', ncb_cap_int, '%', + 'no_claim_bonus_cap_pct from extracted PDF data', 'high') + + # TAT cashless authorization + tat = ext.get('tat_cashless_authorization_hours') + tat_int = coerce_int(tat) + if tat_int is not None and 0 < tat_int <= 72: + set_field('tat_cashless_authorization_hours', tat_int, 'hours', + 'tat_cashless_authorization_hours from extracted PDF data', 'high') + + # Geographic coverage + geo = ext.get('geographic_coverage') + if isinstance(geo, str) and geo.strip(): + set_field('geographic_coverage', geo, 'enum', + f'geographic_coverage from extracted PDF data: "{geo}"', 'high') + + # Policy type (indemnity / fixed-benefit / etc) + pt = ext.get('policy_type') + if isinstance(pt, str) and pt.strip(): + set_field('policy_type_indemnity_or_fixed', pt, 'enum', + f'policy_type from extracted PDF data: "{pt}"', 'high') + + # Deductible amount + dam = ext.get('deductible_amount_inr') + dam_int = coerce_int(dam) + if dam_int is not None and dam_int > 0: + set_field('deductible_amount', dam_int, 'INR', + 'deductible_amount_inr from extracted PDF data', 'high') + + # Modern treatments boolean + mt = ext.get('modern_treatments') + if isinstance(mt, dict): + mc = mt.get('covered') + if isinstance(mc, bool): + set_field('modern_treatments_covered', mc, 'boolean', + mt.get('notes', 'modern_treatments from extracted PDF data')[:300], 'high') + + # Policy term + ppt = ext.get('premium_payment_term_years') + if isinstance(ppt, list) and ppt: + set_field('policy_term_options_years', ppt, 'years', + 'premium_payment_term_years from extracted PDF data') + elif isinstance(ppt, (int, str)): + v = coerce_int(ppt) + if v: + set_field('policy_term_options_years', [v], 'years', + 'premium_payment_term_years from extracted PDF data') + + return pf, filled + + +def main(): + pf_files = sorted([f for f in os.listdir(PF_DIR) if f.endswith('.json')]) + skipped_schema_b = 0 + skipped_no_ext = 0 + processed = 0 + total_filled = {} + log_lines = [] + + for fname in pf_files: + pf_path = os.path.join(PF_DIR, fname) + with open(pf_path) as f: + pf = json.load(f) + # Skip Schema B (already curated) + if 'co_payment_pct' not in pf: + skipped_schema_b += 1 + continue + ext_path = os.path.join(EXT_DIR, fname) + if not os.path.exists(ext_path): + skipped_no_ext += 1 + log_lines.append(f'SKIP no_ext: {fname}') + continue + + new_pf, filled = fill_one(pf_path, ext_path) + # Write back + with open(pf_path, 'w') as f: + json.dump(new_pf, f, indent=2, ensure_ascii=False) + processed += 1 + for k in filled: + total_filled[k] = total_filled.get(k, 0) + 1 + + print(f'Processed: {processed}') + print(f'Skipped (already curated, Schema B): {skipped_schema_b}') + print(f'Skipped (no extracted source): {skipped_no_ext}') + print() + print('Fields filled (count of files):') + for k in sorted(total_filled, key=lambda x: -total_filled[x]): + print(f' {k:50s} {total_filled[k]}') + + +if __name__ == '__main__': + main() diff --git a/tools/verify_policy_facts.py b/tools/verify_policy_facts.py new file mode 100644 index 0000000000000000000000000000000000000000..616fa2f82f28ecc5627f6a3d2a10c5ff8e29552f --- /dev/null +++ b/tools/verify_policy_facts.py @@ -0,0 +1,213 @@ +#!/usr/bin/env python3 +"""Two-part verification — PART 1 (automated, deterministic). + +Gate that must pass before the policy_facts pass is committed. Part 2 is an +independent re-audit agent run separately at commit time. + +Checks, per 40-data/policy_facts/*.json: + 1. Valid JSON. + 2. No fabricated sentinels: zero `"value": 999/9999` in ANY field except + max_renewal_age (which is dead/removed and stripped by tools task #12). + 3. Every cell with a non-null `value` has a non-empty `source_quote`. + 4. `source_pdf_path`, when present, points to a file that exists. + 5. Quote-occurrence (sampled): for up to N filled cells per file whose + source_quote looks like a real extracted phrase (not "not stated ...", + not a pipeline-provenance note), the quote text actually occurs in the + source PDF's extracted text. Fabricated quotes fail the gate. + +Exit 0 = PASS (safe to commit). Exit 1 = FAIL (prints offending files/cells). + +Usage: + ./.venv/bin/python tools/verify_policy_facts.py # sampled (fast) + ./.venv/bin/python tools/verify_policy_facts.py --full # all filled cells + ./.venv/bin/python tools/verify_policy_facts.py --sample 8 # N quotes/file +""" +from __future__ import annotations + +import json +import re +import sys +from pathlib import Path + +ROOT = Path(__file__).resolve().parents[1] +PF_DIR = ROOT / "40-data" / "policy_facts" + +# source_quote values that are legitimately NOT verbatim PDF text +# Quotes that are NOT verbatim PDF text. Two sub-classes: +# - sourced-null notes ("not stated …") → legitimately empty cell +# - legacy-pipeline provenance notes ("extracted from PDF data", "NIM +# DeepSeek", "regex extracted …", "rag/extracted") → cell HAS a value but +# its only "source" is an unverifiable self-reference. These are NOT +# fabrication, but they are NOT independently verbatim-verifiable either — +# counted and surfaced separately, never silently passed. +_NON_QUOTE = re.compile( + r"not stated|not extracted|field absent|unable to infer|" + r"batch extract|extracted\.json|structured field|prior[- ]pipeline|" + r"author'?s inference|from extracted pdf data|extracted from pdf|" + r"regex extracted from pdf|nim deepseek|see source pdf for verbatim|" + r"rag/extracted|structured json|from extracted pdf|g\d+ batch extract", + re.I, +) +_SOURCED_NULL = re.compile(r"not stated|not extracted|field absent|unable to infer", re.I) +# Heuristic / inference / placeholder notes that masquerade as a verbatim quote +# but are NOT document text (slipped past the narrower _NON_QUOTE list). +_HEURISTIC_NOTE = re.compile( + r"classified as|from pdf heuristics|default irdai|no mandatory copay extracted|" + r"extracted from day_care|may have age-based|not explicitly quoted|" + r"\(standard .*per policy|interpreted from|inferred from|from pdf heuristic|" + r"^limit:\s|synthesi[sz]ed|placeholder", + re.I, +) +_DEAD_FIELDS = {"max_renewal_age"} # removed from scoring; stripped in task #12 + + +def _pdf_text(pdf_path: Path, _cache: dict[str, str] = {}) -> str | None: + key = str(pdf_path) + if key in _cache: + return _cache[key] + try: + import fitz # PyMuPDF — the extractor the fill agents used + + doc = fitz.open(key) + txt = " ".join(pg.get_text() for pg in doc) + doc.close() + norm = re.sub(r"\s+", " ", txt).lower() + except Exception: + norm = None + _cache[key] = norm + return norm + + +def _norm(s: str) -> str: + return re.sub(r"\s+", " ", s).strip().lower() + + +def main() -> int: + full = "--full" in sys.argv + sample_n = 6 + if "--sample" in sys.argv: + sample_n = int(sys.argv[sys.argv.index("--sample") + 1]) + + files = sorted(PF_DIR.glob("*.json")) + if not files: + print("FAIL: no policy_facts files found") + return 1 + + errors: list[str] = [] # hard, commit-blocking + legacy_prov: list[str] = [] # value present but provenance is a self- + # referential note (not verbatim, no url) + quote_ok = quote_fail = 0 + field_legacy: dict[str, int] = {} + + for f in files: + try: + d = json.loads(f.read_text()) + except Exception as e: + errors.append(f"[invalid-json] {f.name}: {e}") + continue + + verbatim_cells = [] + for k, v in d.items(): + if not (isinstance(v, dict) and "value" in v): + continue + val = v.get("value") + if k in _DEAD_FIELDS: + continue + if val in (999, 9999): + errors.append(f"[sentinel-999] {f.name}:{k} → fabricated 999/9999") + continue + if val in (None, "", []): + continue + sq = (v.get("source_quote") or "").strip() + surl = (v.get("source_url") or "").strip() + snote = (v.get("source_note") or "").strip() + spp = v.get("source_pdf_path") + if not (sq or surl or snote or spp): + errors.append(f"[unsourced] {f.name}:{k} value present but no quote/url/note/pdf") + continue + if spp and not (ROOT / spp).exists(): + errors.append(f"[missing-source-pdf] {f.name}:{k} → {spp}") + if surl: + continue # externally sourced (insurer site/aggregator) — OK + if _SOURCED_NULL.search(sq): + continue # legitimately empty-but-explained cell + if not sq or _NON_QUOTE.search(sq): + # Has a value + a PDF path but the "quote" is a provenance + # self-reference, not verbatim text → not independently + # verifiable. Legacy prior-pipeline cell. + legacy_prov.append(f"{f.name}:{k}") + field_legacy[k] = field_legacy.get(k, 0) + 1 + continue + if spp and (ROOT / spp).exists(): + verbatim_cells.append((k, sq, ROOT / spp)) + + sample = verbatim_cells if full else verbatim_cells[:sample_n] + for k, sq, pdf in sample: + txt = _pdf_text(pdf) + if txt is None: + continue + # Image-only / non-text-extractable PDF (e.g. a scanned brochure): + # a confident verbatim-style quote on it CANNOT have been + # text-extracted — it is hallucinated provenance (the Acko + # acko-health-iii-platinum__brochure class). Hard fail. + if len(txt) < 400: + quote_fail += 1 + errors.append( + f"[fabricated-quote-image-pdf] {f.name}:{k} → cited PDF has " + f"only {len(txt)} extractable chars (image-only scan) yet " + f"carries a verbatim quote ⟶ “{sq[:60]}…”" + ) + continue + # Heuristic / placeholder note dressed as a quote — never verbatim. + if _HEURISTIC_NOTE.search(sq): + quote_fail += 1 + errors.append(f"[non-verbatim-note] {f.name}:{k} ⟶ “{sq[:70]}…”") + continue + # Shingle match: a genuine clause copied from a multi-column / table + # PDF survives column-interleaved extraction in fragments, so a + # single 60-char substring is too brittle (false-fails real quotes). + # Require a majority of the quote's 8-word shingles to appear. + qn = _norm(sq) + words = qn.split() + if len(words) < 8: + ok = qn in txt + else: + shingles = [" ".join(words[i:i + 8]) for i in range(0, len(words) - 7, 3)] + hits = sum(1 for s in shingles if s in txt) + ok = shingles and hits / len(shingles) >= 0.5 + if ok: + quote_ok += 1 + else: + quote_fail += 1 + errors.append(f"[quote-not-in-pdf] {f.name}:{k} ⟶ “{sq[:70]}…”") + + print(f"files={len(files)} verbatim_quotes_OK={quote_ok} " + f"verbatim_quotes_FAIL={quote_fail} " + f"legacy_provenance_cells={len(legacy_prov)} " + f"hard_errors={len(errors)}") + if field_legacy: + print("legacy-provenance by field (value present, source not verbatim-" + "verifiable):") + for fld, n in sorted(field_legacy.items(), key=lambda x: -x[1]): + print(f" {fld:42s} {n}") + if quote_ok == 0 and quote_fail == 0: + print("FAIL — checked 0 verbatim quotes (PDF reader broken). Not a PASS.") + return 1 + if errors: + print(f"\n-- HARD FAIL ({len(errors)}; first 30) --") + for e in errors[:30]: + print(" ", e) + return 1 + if legacy_prov: + print(f"\n-- NOT COMMIT-READY: {len(legacy_prov)} cells carry a value " + f"whose source is a provenance note, not a verbatim/url source. " + f"Per the never-unsourced rule these must be re-extracted to a " + f"verbatim quote (or nulled+sourced) before commit. --") + return 2 + print(f"PASS — {quote_ok} verbatim quotes confirmed in-PDF, no fabricated " + f"sentinels, no unsourced values, no legacy-provenance cells.") + return 0 + + +if __name__ == "__main__": + raise SystemExit(main())