Best Health Insurance Plans in India 2021
Types of Health Insurance Plans in India
Buying best health insurance online is easy only when the buyer is aware of the different types of plans available in the market. Health insurance companies in India offer 7 types of health insurance plans that cater to the varied needs of people in different age groups and with different health conditions. Explained below are the types of health insurance plans that one can opt for as per their requirements:
1. Individual Health Insurance Plans
Individual health insurance plans cover only one individual, the policyholder, who gains all the coverage benefits offered under them. Under an individual health insurance plan, the insurance company covers the medical expenses of the insured as per the sum insured opted and premium paid. Some common coverage benefits offered under these plans include in-patient hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, daycare expenses, domiciliary hospitalisation expenses, organ donor expenses, etc. Best suited for people with higher health risks, individual health insurance plans generally come without any limit on the maximum age for policy renewal. This means that the plan offers lifetime renewability benefits to the insured. Also, one can include their parents and immediate family members under the policy, on an individual sum insured basis. Individual health insurance plans cover people on an individual sum insured basis, hence there is no restriction on the number of claims made during a policy term.
Some popular individual health insurance plans available in the market are:
- Individual Health Insurance Policy by United India Insurance Company
- Individual Health Insurance Plan by Universal Sompo General Insurance Company
- Individual Health Protector Policy by Iffco Tokio General Insurance
2. Family Floater Health Insurance Plans
Unlike individual health insurance plans, a family floater health insurance plan extends coverage to the entire family, on a floater sum insured basis. One of the best advantages of family floater health insurance plans is that it allows an individual to cover him/herself as well as their family members under a single health insurance plan, thereby making it easier for the insured to manage. When it comes to covering your parents under a health insurance policy, a family floater health insurance policy is an affordable option as compared to a senior citizen health insurance policy. A family floater health insurance policy covers your family members including legally wedded spouse, dependent children, parents, parents-in-law, brother, sister, and other relations varying from plan to plan, at affordable premiums. These plans are recommended for young families as then the chances of making more than one claim are lesser. This allows the member making a claim to get greater coverage at lesser premiums.
Some popular family floater health insurance plans available in the market are:
- Complete Health Insurance Policy by ICICI Lombard General Insurance Company
- Family Medicare 2014 Policy by United India Insurance Company
- Complete Healthcare Insurance by Universal Sompo General Insurance Company
3. Senior Citizens Health Insurance Plans
Senior citizen health insurance plans are tailor-made for people aged between 60 years and 75 years to cater to their respective insurance-related needs. It is recommended to get a senior citizen health insurance policy as most individual or family floater health insurance plans do not offer coverage to people aged above 65 years. Beyond 65 years, they only allow renewals. Some of the unique coverage benefits of senior citizen health insurance plans include daycare expenses, domiciliary hospitalisation expenses, cashless hospitalisation, cover for pre-existing diseases, and cover for specific diseases.
Some popular senior citizen health insurance plans available in the market are:
- Care Senior by Care Health Insurance
- Red Carpet Policy by Star Health And Allied Insurance
- Senior Citizen Mediclaim Policy by New India Assurance
4. Critical Illness Insurance Plans
Critical illness plans cover the insured for life-threatening illnesses that are serious and long-term in nature like heart attack, stroke, paralysis, cancer, renal failure, etc. These plans provide the insured a lump sum amount on the first diagnosis of the critical illnesses covered under the plan. The insured can use the amount received not only to avail of the required treatment in India but outside India as well. The insured can also utilise the amount to pay for debts if any, for the child’s education, or in any other way as per the requirement. It is recommended to be covered under a critical illness policy as the treatments of critical illnesses are expensive. If someone is diagnosed with a critical illness, it may hurt their pocket in case one has to bear the expenses on his/her own.
Some popular critical illness health insurance plans available in the market are:
- UNI Criticare Policy by United India Insurance Company
- Critical Illness Insurance Policy by Iffco-Tokio General Insurance
- Critical Healthline Policy by Cholamandalam MS General Insurance
5. Women-Specific Health Insurance Plans
Women-specific health insurance plans are especially designed to meet the insurance-related requirements of women in different stages of their lives. For instance, these plans protect women from healthcare expenses at the time of retirement, maternity expenses, cover for newborn baby, cover for child’s education, etc. they also cover women for specific diseases which they are prone to, after a specific age. Even if a woman has an individual health insurance policy provided by her employer, it is still recommended that she should be covered under a women-specific policy. This is because sometimes an individual health insurance policy, unlike a women-specific health insurance plan, does not cater to the specific needs of women and hence they miss out on coverage benefits. Also, these plans come at affordable premiums and generally offer lifetime renewability benefits to the insured.
Some popular specific health insurance plans available in the market are:
- My: Health Women Suraksha Policy by HDFC General Insurance
- Wellsurance Women Policy by Tata AIG General Insurance
- Care Joy Policy by Care Health Insurance
6. Top-Up Health Insurance Plan And Super Top-up Health Insurance Plans
Top-up and super top-up health insurance plans let the insured enhance the sum insured of their base health insurance policy to cover the shortfall, in case the hospital bills exceed the limit. A top-up health insurance policy kicks in when the amount of claim exceeds the deductible value and the sum insured of the base health insurance policy during a policy term, in case of single hospitalisation. All claims are treated individually in these plans. Whereas, in super top-up plans, the insured gets paid for claims for cumulative healthcare expenses within a policy term when it exceeds the deductible and sum insured limit of the base health insurance plan. A super top-up policy covers you for expenses that are not covered under your top-up or base policy. The only difference is that the super top-up policy takes into account multiple hospitalisations. One can purchase a super top-up insurance policy from any insurance company irrespective of which insurance company’s base policy one has.
Some popular top-up and super top-up health insurance plans available in the market are:
- Health Surplus Policy by Future Generali
- Super Healthcare Policy by Universal Sompo General Insurance
- Smart Super Top-Up Insurance Policy by Bharti AXA General Insurance Company
7. Disease-Specific Health Plans
Disease-specific health insurance plans cater to a particular disease such as cancer, diabetes, heart diseases, etc. It is suitable for people looking for wide coverage for a particular disease. One can choose this plan even if they are already covered under a corporate health insurance plan or any regular health insurance plan. This is because those plans may not always offer sufficient coverage for specific diseases. Disease-specific health insurance plans eliminate the waiting period, which otherwise you are required to complete if covered under a regular health insurance plan. The plan is best suited for people with a family history of a particular disease like hypertension, diabetes, etc.
Some popular critical illness health insurance plans available in the market are:
- Cancer Guard Policy by New India Assurance
- Dengue Care Plan by HDFC Ergo General Insurance
- Diabetes Safe Policy offered by Star Health And Allied Insurance
How to Choose the Best Health Insurance Plans in India?
You can consider the following tips to select the best medical insurance policy:
1. Right Coverage
Select a medical insurance policy that offers cover against expenses arising due to many health issues and provides various health care facilities such as daycare expenses, pre-hospitalisation expenses, post-hospitalisation expenses, ambulance cover, etc. In case you opt for health insurance for your entire family, then make sure to check if the health plan meets the requirement of each member. Compare the plans on the basis of the benefit offered and reasonable cost before making a decision.
2. Lifetime Renewability Option
While purchasing a health insurance policy do not forget to check the duration for which the plan is offering you coverage or if it comes with a lifetime renewability option or not. It is always recommended to buy an insurance plan that offers a lifetime renewability option.
3. Compare Quotes of Various Insurance Company
Compare various health insurance policies online to make sure that you purchase a health plan that meets all your requirements. Also, you can get quotes for various different plans online by providing the necessary details to get an estimated premium of different policies. Gather best quotes and compare in order to make an informed decision. So, all those wondering how to choose the best health insurance plan online must read the things to consider:
4. High Claim Settlement Ratio
A claim settlement ratio is the total number of settled claims over by the insurer over the total number of claims received. Therefore, while buying a health insurance plan make sure to check the claim settlement ratio and always opt for the insurance provider that has a high claim settlement ratio.
5. List of Network Hospitals
After selecting medical insurance plans, make sure to check if your preferred hospitals or doctors are there in the list of network hospitals provided by your insurance provider. Choose an insurance company that has a wide range of network hospitals across India.
6. Choose Family Health Policy Over Individual Health Plans
People who do not have a family to support should choose Individual health plans. However, if you are purchasing a health insurance plan keeping your family in the picture, then opt for a family health plan to avail more benefits at a reasonable cost.
7. Affordable Health Policy
While purchasing a medical insurance policy, it is important to select a plan that caters to your requirements. However, you should select a health plan that fits within your budget but make sure to consider the benefits before going for the cost. Compare the plans thoroughly to make a wise decision and to ensure an overall protection against health issues at an affordable cost. Also, you can enhance your coverage with time after considering important factors such as size of family, rise in income and needs of the family members.
Benefits of Comparing Health Insurance Plans
There are several benefits of comparing health insurance plans online. It not only allows you to choose the best one to meet your healthcare requirements but also helps you make an informed decision. But there are various health insurance companies in the market that offer various health insurance plans, so sometimes one may end up buying a health insurance policy that comes at a low premium, but may compromise on the coverage benefits. On the contrary, it may also be the case that someone pays a higher premium for a health insurance policy but still does not get the features as required. Keeping into consideration the increasing healthcare costs of treatment, a health insurance policy protects a medical emergency from becoming a financial emergency, and hence should be chosen wisely.
Listed below are some common benefits of comparing health insurance plans online:
1. Access to Accurate Information: All the information about different health insurance plans in the market is easily accessible online. So, comparing health insurance plans online saves you from dealing with agents who are known to provide biased and unreliable information most of the time and help you access accurate information.
2. Time Efficient And Convenient: Comparing health insurance plans online helps you save time, which is not the case when you meet agents and discuss policies. Also, it is comparatively easy to pay health insurance premiums or renew health insurance plans online. So, the process is transparent and does not take much of your time.
3. Pocket Friendly: When you buy health insurance plans online, you compare them in terms of premium, benefits, etc, thereby shortlisting the most affordable one as per your budget. So, in this case, you end up buying a health insurance policy that fits your budget. But if an agent is involved, then he/she might trick you into buying a policy that you do not actually require or is out of your budget.
4. Customer Reviews: At InsuranceDekho, you will find several customer reviews of different health insurance plans. When shortlisting a policy, you can go through the reviews to be certain of your decision.
How to Make a Claim Under Your Health Insurance Plan?
Under health insurance plans, you can make a claim in two ways, i.e. cashless claim and a reimbursement claim. A cashless claim is when you do not pay anything at the hospital for the treatment availed. Whereas in reimbursement claim, you will be first required to pay for the treatment taken, at the hospital, and the insurance company pays to you later. The claim processes for them are mentioned below:
To make a cashless claim, you will be required to follow the steps given below:
- Immediately inform the insurance company in the event of hospitalisation at a network hospital of your choice. Generally, you are required to inform the insurance company within 24 hours of hospitalisation in case of emergency, whereas 48 hours prior in case of planned hospitalisation.
- You will be required to share health insurance details at the network hospital. Show your Health ID card or your policy number with a valid photo ID proof at the desk of the hospital.
- Once the identification has been done, the network hospital will send you the pre-authorisation request form to the insurance company.
- The insurance company will then verify and analyse the documents and may ask the network hospital for more information if required.
- Once the formalities have been completed, the insurance company will pay the medical expenses excluding co-payment if any, directly at the network hospital. You will be informed about the same within the stipulated time. Even if the claim is rejected, you will be informed about the same.
To avail reimbursement treatment, you must follow the steps given below:
- Inform the insurance company within the stipulated time, in case of hospitalisation. You can also connect directly with the insurance company via Email.
- Avail the required treatment at the hospital if your policy covers you for the same. Collect all the medical test reports, discharge summary, medical invoices, and other relevant documents from the hospital to share to the insurance provider.
- Submit the claim documents along with required medical documents to the insurance provider.
You will be required to submit the following documents to the insurance company in case of reimbursement claim:
- Valid ID proof
- Medical practioner’s advising letter for hospitalisation
- Original hospital bills and discharge certificate signed by the medical practitioner
- Medical practioner’s prescription for consultation, medicine, and medical tests
- Original pharmacy bills
- Original reports of diagnostic tests, reports, etc.
- First Information Report (FIR), in a police case
- Post Mortem Report, if applicable.
Key Benefits of Health Insurance Plans
Health insurance plans protect your savings from getting ruined in case of serious health conditions that result in hospitalisation during the policy period. But most of the people believe that health insurance plans only cover them for hospitalisation expenses, which is not true. The key purpose of health insurance plans is to provide comprehensive coverage to the insured, which they do so by offering protection for various healthcare expenses. Some of these include cover for in-patient hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, daycare expenses, domiciliary treatment expenses, organ donor expenses, etc. Apart from coverage benefits, health insurance plans also offer other benefits. To understand them in detail, read below:
1. Cashless Treatment
Health insurance companies, generally, have tie-ups with hospitals wherein the insured can avail the required treatment without paying anything except the non-medical expenses or the expenses that the policy does not cover. Network hospitals are present across India and you can avail treatment in any of them, provided the treatment availed is in accordance with the terms and conditions mentioned under your health insurance plan.
2. Comprehensive Coverage
Health insurance plans offer comprehensive coverage by protecting you from several healthcare expenses. These include the following:
- In-Patient Hospitalisation Expenses: These include expenses incurred during hospitalisation for at least 24 hours. Under this benefit, the health insurance plans mostly cover you for room rent, nursing, boarding expenses, ICU/ICCU expenses, doctor’s fee, etc.
- Pre-Hospitalisation And Post-hospitalisation Expenses: These are the expenses incurred for a specific number of days before and after hospitalisation. These include doctor’s consultation fee, x-rays, other tests, etc. Different insurance companies have different periods for which they cover these expenses.
- Ambulance Expenses: These are the expenses incurred due to transportation of the patient to the nearest hospital in case of an emergency. Usually, insurance companies have a limit to these expenses, which varies from one insurance company to another.
- Domiciliary Expenses: These are the expenses incurred due to treatment availed at home, mainly due to unavailability of beds in the hospital. Mostly, health insurance companies cover you for these expenses.
- Daycare Treatments: Daycare treatments are those which can be availed in less than 24 hours. These include radiotherapy, dialysis, chemotherapy, cataract treatment, etc. The number of daycare treatments covered may vary from one insurance company to another.
- Organ Donor Expenses: Most health insurance plans offer cover for expenses incurred on organ donors for harvesting. These include expenses related to surgery and storage of organs.
3. Portability Benefits
Another benefit of health insurance is that it offers flexibility to port from one health insurance policy to another in case you are not satisfied with the benefits offered under the existing one. Apart from giving the customers flexibility, it also saves them from being taken for granted by the insurance companies.
4. Financial Security Even During Rising Healthcare Expenses
A health insurance plan helps you in combating financial stress in case of an emergency even during rising healthcare expenses. It offers you wide coverage even in times of inflation. Therefore, it is recommended to buy a suitable health insurance policy.
5. Tax Benefits Under Section 80D of the Income Tax Act, 1961
The government of India promotes health insurance by offering tax deductions on the premium paid for the plans, under Section 80D of the Income Tax Act, 1961. To understand the tax benefits in detail, refer to the table below:
|Situations||Premium Paid (Self, Family, Children)||Premium Paid (Parents)||Deduction under Section 80D of the Income Tax Act|
|When Policyholder and Parents are below 60 years||Rs. 25,000||Rs. 25,000||Rs. 50,000|
|When Policyholder and family members are below 60 years with parents above 60 years||Rs. 25,000||Rs. 50,000||Rs. 75,000|
|When Policyholder, family members and parents are above 60 years||Rs. 50,000||Rs. 50,000||Rs. 1,00,000|
|Members of HUF||Rs. 25,000||Rs. 25,000||Rs. 25,000|
|Non-resident Individuals||Rs. 25,000||Rs. 25,000||Rs. 25,000|
The utility of health insurance plans not only depends on the features and benefits offered under them but also on how the insured is able to make the most of it. So, if you don’t want your health insurance policy to be underused, you must thoroughly understand its benefits as well as the process to avail of them.
Role of Health Insurance Plans During the COVID-19 Outbreak
The pandemic declared coronavirus has impacted the lives of many in India. During times like these when medical emergencies can arise any time, having a health insurance policy comes in handy. Whether you are married, single, have children, are young, old, or do not have any children, you must have a reliable health insurance policy that protects you in case of serious illness, sickness, disease, or an accident. Whether you choose individual health insurance plans or family health insurance plans, remember that the choice will not only affect the quality of healthcare but also affect your wallet.
During coronavirus times, the policyholders are often confused if the policy under which they are covered protects them from hospitalisation expenses arising due to coronavirus or not. The answer is 'YES'. All new health insurance plans in the market will cover the insured for coronavirus cases after 30 days i.e. the initial waiting period. COVID-19 related claims will follow the normal processes and will be treated as a normal illness like chikungunya, pneumonia, or any other virus. The good news is that so far there is no exclusion.
So, if you still have not insured yourself and your family, then you should get coronavirus health insurance as soon as possible.
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Type of health insurance plans
Individual Health Insurance Plan
It is an agreement between an insurer and a policyholder where former promises of bearing the medical expenses of the latter subject to the limits of the plan. To own this coverage, the policyholder is required to pay premiums to the insurer for getting the coverage without any break.
- Coverage for pre and post hospitalization expenses
- You can opt for the best treatments for your loved ones
- Your savings will not be affected due to any medical emergency
- Most of the daycare procedures are covered under different plans
- Tax benefits under the section 80D of Income Tax Act
Senior Citizen Health Insurance Plan
With age, the probability of falling prey to diseases increases. Therefore, a senior citizen health insurance plan is an excellent option, as in older age, the lesser or no income enhances the trouble. These plans are designed to cover senior people aged 60 years and above and provides coverage for diseases, critical illnesses, accidents, etc.
- Frequent medical expenses can easily be borne with the plan
- Can afford proper treatment and medication with lesser income too
- May increase life expectancy with regular and advanced treatment
- Investment in health policy save the tax under section 80D of IT Act
- Enhance the savings and bring independence in terms of financial security
Critical Illness Insurance Plan
Treatment of critical diseases is never easy. The procedures related to critical illnesses are highly expensive and prolonged that lead to the loss of a significant amount of savings. These plans provide cover for diseases like kidney failure, heart attack, cancer, muscular dystrophy, and many others.
- Lump sum amount is offered to maintain the lifestyle
- The recuperation aid is covered under the critical illness plan
- Regular health check-ups are also available under such policies
- Offers the best treatment when it comes to life-threatening disease
- TA good amount of tax can be saved under section 80D of IT act
Maternity Health Insurance Plans
Pregnancy is a turning point in every woman’s life. At this time, they require the utmost care. With time, medical technology has made delivery procedures safer, more comfortable, but expensive. Everyone wants that the mother and baby should get the most possible comfort during the delivery procedure. Thus, taking a maternity plan is a gesture of perfect planning.
- Easy to get the delivery done in the best-equipped hospital
- Regular expenses are curbed with the coverage of consultations, health check-ups, tests, etc.
- The coverage of newborn baby don’t let the budget be affected
- Normal and Cesarean deliver cover avoid the financial crisis before delivery
- With tax benefits, you can save money under section 80D of IT act
Group Health Insurance Plans
The group health provides the insurance to eligible professionals of an organization. Under this segment of insurance plans, the employers purchase the health policies for their employees. The payment for it is made two ways, half of the amount is paid by the employer and the remaining by the employees. It is generally given to enhance the morale of the employees and also to retain the employees.
- Enhance the retention rate in the firm
- Boost the morale of employees
- Make employees avail the plan at economical rates
- Tax benefits can be earned under section 80D of IT act
Personal Accident Insurance Plans
An accident is an unforeseen and unfortunate event that can happen to anybody and anytime. Also, its consequences may go disastrous and catastrophic. Therefore, a personal accident insurance plan is necessary for dealing with financial hardships during an accident.
- Expenses of accident-related treatments are covered
- Severe injuries due to an accident can be treated in the best manner
- Many personal accident plans covers funeral and legal expenses
- Worldwide coverage is offered as accidents can happen anywhere, anytime
- Some plans provide the coverage to the entire family for complete health care
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FAQ About Best Health Insurance Plans in India 2021
What are the parameters that I should consider when purchasing a health insurance plan?
Some of the parameters that you must consider in order to purchase the most suitable health insurance policy include waiting periods for pre-existing diseases, capping or sub-limits, waiting period for specific illnesses/diseases/procedures, co-payment clause, if any, exclusions under the policy, number of network hospitals and if your preferred hospital is a part of the network or not, claim settlement ratio of the insurance company, incurred claim ratio, premium, add-on benefits, if any, inclusions and exclusions, etc.
What are the common exclusions under health insurance plans?
Health insurance plans do not offer cover for all healthcare expenses. Some common exclusions include expenses incurred on treatment due to self-inflicted injuries including suicide, expenses incurred due to participation in any adventurous sport, pre-existing conditions are not covered during the waiting period, venereal or sexually transmitted disease, cosmetic treatments, treatments related to dental, hearing, and vision, expenses incurred on treatment of obesity, and cover for accidents due to participation in defence operations.
Do health insurance plans cover healthcare expenses related to COVID-19?
Yes. Standard health insurance plans offer cover for expenses incurred due to positive diagnosis of COVID-19. The health insurance policy will cover you for in-patient and outpatient expenses arising due to treatment of COVID-19. You can also purchase health insurance plans especially designed for coronavirus. These include Corona Kavach Policy and Corona Rakshak Policy. These are short term policies that offer cover against the pandemic declared coronavirus. For more information about these policies, you can connect to the customer care executives at InsuranceDekho and they will help you understand them in detail.
What are the benefits of having a health insurance policy?
A health insurance policy offers you a cashless treatment facility allowing you to get the required medical treatment at the network hospital without paying even a single penny. It offers you several benefits apart from cashless treatment, such as pre-hospitalisation and post-hospitalisation expenses, tax benefits under Section 80D of the Income Tax Act, 1961, daily hospital cash benefit in some plans, organ transplant expenses, No Claim Bonus, lifetime renewability benefit, automatic restoration of sum insured, etc.
What is the restoration benefit under health insurance plans?
If your sum insured amount gets exhausted under a health insurance insurance policy due to claims made in a policy year, then the insurance company will restore the amount automatically without having you to pay anything extra to avail the benefit. Health insurance plans that offer restoration benefits are generally available at higher health insurance premiums.
Can I make a claim for all healthcare expenses up to the sum insured limit?
No. Health insurance plans come with multiple sub-limits which can be for specific treatments, doctor’s consultation fees, pre-planned surgeries like cataract, joint replacements, pre-planned surgeries, etc. You cannot claim an amount that exceeds your sum insured limit. Many health insurance plans also come with room rent limits, ICU charges, surgery expenses, doctor’s fees, lab test expenses, etc. for which the cover is offered proportionately.
What are some good health insurance plans in India?
Some popular health insurance plans that offer wide coverage and yet come at affordable premium include Essential Privilege Plan offered by Universal Sompo Health Insurance, Health Guard Plan offered by Bajaj Allianz Health Insurance, Family Health Optima offered by Star Health insurance, and My: health Suraksha offered by HDFC Ergo General Insurance.
Which is the best medical insurance policy in India?
There is not one, but many health insurance plans in India that offer great benefits to the policyholders. These include Prohealth Plus offered by ManipalCigna Health Insurance, Lifeline Supreme offered by Royal Sundaram Health Insurance, and Activ Assure Diamond offered by Aditya Birla Health Insurance.
What is the importance of health insurance in India?
Purchasing health insurance for yourself as well as your family is important in India because lifestyle diseases are becoming very common and healthcare expenses are skyrocketing, especially in private hospitals. So, if you do not have a suitable health insurance plan, it may burn a hole in your pocket.
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*Standard T&C Apply. All savings/offers are provided by the Insurers, which are subject to modification .For more details on risk factors, terms and conditions, please read the sales brochure of respective insurers carefully before concluding a sale. Tax benefits are subject to changes in applicable tax laws. Girnar Insurance Brokers Private Limited, (CIN: U66010RJ2016PTC054811, Regd .Off: Girnar 21, Govind Marg, Moti Doongari Road, Dharam Singh Circle, Jaipur, Rajasthan- 302004; Corp. Off: 11th Floor, Tower B, Emaar Digital Greens, Golf Course Extension Road, Sector-61, Gurugram-122102, Haryana. IRDAI License no 588. Direct Broker (Life & General) valid till 19th March 2023. Email - firstname.lastname@example.org ; Helpline number: 7551196989.
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