Sample Reports

See exactly what you receive when you upload your policy PDF.
These are plain-English, informational reports—not recommendations and not advice.

We don’t sell insurance. We don’t earn commissions. We only explain what your document says.

Insurance documents often look “standard”, but payout changes based on caps, exclusions, waiting periods, and definitions hidden in clauses. These samples show how PolicyTruth converts those clauses into a clear summary.

Clause → plain-English explanation
Numbers → caps/limits translated into “what you may actually pay”
Red flags → highlighted areas that typically affect claims
Question bank → what to ask your insurer/agent in writing

When people find this useful

Before a medical emergency
Before renewal decisions
When policies were bought through agents
When comparing 2–3 options

Sample Report #1

This sample shows how we surface co-pay, deductibles, room-rent/ICU caps, and non-payables that can increase out-of-pocket cost even when a claim is approved.

# PolicyTruth Customer Report

## Document Reviewed
doc_type: Policy Document
doc_type_confidence: 95%
completeness_score_0_100: 95
doc_age_years: 1 year

## Scope, Limits, and Privacy
This report is based solely on the provided document.
All personal data is masked using: [NAME], [DOB], [ID], [PHONE], [EMAIL], [ADDRESS], [URL], [DATE].
It summarizes confirmed items and flags unknowns or conflicts.

## Verified Snapshot
Plan Name: ProHealth - Accumulate
Evidence: "Name of Your Plan ProHealth - Accumulate"
Policy Term / Tenure: 3 years
Evidence: "Policy Term 3 years"
Sum Insured (base): 250000
Evidence: "1 [NAME] ... Sum Insured 250000"
Total Premium (Rs.): 134137.50
Evidence: "Total Premium (Rs.) 134137.50"
Add-on Rider(s) / Optional/Rider Cover: ManipalCigna Health 360 - Shield, ManipalCigna Health 360 - Advance, Cumulative Bonus Booster

## Confirmed Terms
Initial Waiting Period: 30 days (Except accident and for renewal policies without break)
Evidence: "Initial Waiting Period 30 days (Except accident and for renewal policies without break)"
Pre Existing Disease (PED) Waiting period: 36 months of continuous coverage
Evidence: "Pre Existing Disease (PED) Waiting period Covered after 36 months of continuous coverage"
Specific Waiting Period: 24 months since inception of first policy with us
Evidence: "Specific Waiting Period 24 months since inception of first policy with us"
Maternity Waiting Period: Not Available (for Accumulate plan)
Evidence: "Maternity Expenses Not Available (applicable to Protect and Accumulate plan)"
Room Rent Limit: Covered upto Single Private Room (for Sum Insured up to Rs. 5.5 Lacs)
Evidence: "For Sum Insured up to `5.5 Lacs - Covered up to Single Private Room"
Ambulance Cover Limit: Up to Rs. 2000 per hospitalization event
Evidence: "Ambulance Cover Up to `2000 paid per hospitalisation event"
Donor Expenses Limit: Covered upto full Sum Insured
Evidence: "Donor Expenses Covered up to full Sum Insured"
Worldwide Emergency Cover Limit: Covered upto full Sum Insured once in a Policy Year
Evidence: "Worldwide Emergency Cover Covered up to full Sum Insured once in a Policy Year"
Restoration of Sum Insured: Multiple Restoration is available in a Policy Year for unrelated illnesses in addition to the Sum Insured opted
Evidence: "Multiple Restoration is available in a Policy Year for unrelated illnesses in addition to the Sum Insured opted"
AYUSH Cover Limit: Covered up to full Sum Insured
Evidence: "AYUSH Cover Covered up to full Sum Insured"
Health Maintenance Benefit Options: Rs. 5000, 10000, 15000, 20000 per policy year
Evidence: "Option to choose from - `5000, `10,000, `15,000, `20,000 per policy year"
Health Maintenance Benefit Usage Rules: Can also be used to pay for Co-pay or Deductible. Up to 50 % of the accumulated Health Maintenance Benefit can be utilised for payment against premium from first renewal of the policy
Evidence: "Can also be used to pay for Co-pay or Deductible. Up to 50 % of the accumulated Health Maintenance Benefit can be utilised for payment against premium from first renewal of the policy"
Rider: ManipalCigna Health 360 - Shield: Coverage for listed Non-medical items and Durable Medical equipment within the base policy Sum Insured
Evidence: "ManipalCigna Health 360 - Shield: Coverage for listed Non-medical items up to base policy Sum Insured and Durable Medical equipment up to maximum of Rs.1 Lac"
Rider: ManipalCigna Health 360 - Advance: Coverage for ‘Any room’ category and unlimited restoration of Sum Insured within the base policy Sum Insured.
Evidence: "ManipalCigna Health 360 - Advance: Coverage for ‘Any room’ category and unlimited restoration of Sum Insured within the base policy Sum Insured."
Rider: Cumulative Bonus Booster: A guaranteed 25% increase in Sum Insured per policy year, maximum up to 200% of Sum Insured
Evidence: "Cumulative Bonus Booster A guaranteed 25% increase in Sum Insured per policy year, maximum up to 200% of Sum Insured"
Exclusion 1: Investigation & Evaluation- Code- Excl. 04
Evidence: "- Investigation & Evaluation- Code- Excl. 04"
Exclusion 2: Rest Cure, rehabilitation and respite care- Code- Excl. 05
Evidence: "- Rest Cure, rehabilitation and respite care- Code- Excl. 05"
Exclusion 3: Obesity/ Weight Control: Code- Excl. 06
Evidence: "- Obesity/ Weight Control: Code- Excl. 06"

## Unknowns That Matter (Fail-Closed)
- Base Sum Insured (Conflict)
- Cover Start Date
- Cover End Date
- Selected HMB option
- Rider purchase/activation status
- Full exclusions list
- Free look period details

## Consistency & Contradictions (Show Checks)
Policy Number consistency: Match
Evidence: "Policy Number [ID]...Policy Number [ID]...Policy Number [ID]"
Proposer/Policyholder name consistency: Match
Evidence: "Dear [NAME]...Name: [NAME]...Mr. [NAME] has paid the premium"
Policy start/end dates consistency: Match
Evidence: "Cover Start Date [DATE]...Cover End Date [DATE]...Inception Date: From: [DATE] Expiry date: To: [DATE]"

## Regulatory Presence Checks (Found/Not Found)
Customer Information Sheet (CIS) present: Found
Policy wording present: Found
Free look mentioned: Not Found
Grievance redressal mentioned: Found

## Action Checklist (Documents + Written Clarifications)
- Request clarification on Base Sum Insured (Conflict)
- Clarify Cover Start Date
- Clarify Cover End Date
- Clarify Selected HMB option
- Clarify Rider purchase/activation status
- Request Full exclusions list
- Request Free look period details
- Request details on free look period

## Questions to Ask in Writing (Copy/Paste)
1. Please confirm the base Sum Insured, as the document shows conflicting values: 250000 vs 1500000.0 vs 1000000.0.
2. Please confirm the cover start and end dates shown on the schedule.
3. What is the selected Health Maintenance Benefit option for this policy (e.g., Rs. 5000, 10000, etc. per policy year)?
4. Which riders, if any, are purchased and active: ManipalCigna Health 360 - Shield, ManipalCigna Health 360 - Advance, Cumulative Bonus Booster?
5. Please provide the full list of policy exclusions.
6. Please provide details on the free look period.

## Ready-to-Send Email
Subject: ProHealth - Accumulate - Policy [ID]

Dear Insurer Support,

Key confirmed details from the policy document: Plan Name ProHealth - Accumulate, Policy Term 3 years, Base Sum Insured 250000 (note conflict flagged), Total Premium Rs. 134137.50, with riders like ManipalCigna Health 360 - Shield, Advance, and Cumulative Bonus Booster. Waiting periods: Initial 30 days, PED 36 months, Specific 24 months. Limits include room rent up to Single Private Room (SI up to 5.5 Lacs), ambulance Rs. 2000, donor/full SI, worldwide emergency/full SI once/year, restoration multiple times, AYUSH full SI.

Please address these questions:
1. Please confirm the base Sum Insured, as the document shows conflicting values: 250000 vs 1500000.0 vs 1000000.0.
2. Please confirm the cover start and end dates shown on the schedule.
3. What is the selected Health Maintenance Benefit option for this policy (e.g., Rs. 5000, 10000, etc. per policy year)?
4. Which riders, if any, are purchased and active: ManipalCigna Health 360 - Shield, ManipalCigna Health 360 - Advance, Cumulative Bonus Booster?
5. Please provide the full list of policy exclusions.
6. Please provide details on the free look period.

Best regards,

PolicyTruth Team

## Important Educational Note (Disclaimer)
This report summarizes visible facts from the provided document only and flags potential issues like conflicts. It is not financial, legal, medical, or insurance advice. Always verify directly with your insurer for binding confirmations, as documents may have nuances or updates not fully captured here. PolicyTruth aids understanding, but consult qualified professionals for decisions.

Sample Reports (Health Insurance Policy Review)

See exactly what you receive when you upload your policy PDF.

Ease of understanding

These are plain-English, informational reports—not recommendations and not advice.

What these samples show

What a real policy clause looks like—and what it actually means. Insurance documents often look “standard”, but payout changes based on caps, exclusions, waiting periods, and definitions hidden in clauses. These samples show how PolicyTruth converts those clauses into a clear summary.

Clause → plain-English explanation
Numbers → caps/limits translated into “what you may actually pay”
Red flags → highlighted areas that typically affect claims
Question bank → what to ask your insurer/agent in writing

Costs you may actually pay