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UPDATED OCT 22, 2026Toku provides employer-sponsored health and accident insurance in India to support employees and their families. Coverage includes group medical insurance (with outpatient, dental and vision cover), group personal accident insurance, an annual health check-up, and wellness benefits through Plum.
Employees and eligible dependents are covered under the plan in accordance with policy terms.
2026 - 27 policy year: October 11, 2026 - October 10, 2027. Your full Plum employee handbook (coverage, claims guide, health check-up booking and emergency contacts) is in your Toku documents.
Summary of India Health Insurance (ICICI Lombard)
Toku partners with ICICI Lombard, a leading Indian health insurer, to provide comprehensive group medical insurance coverage for employees and their eligible family members. The plan is administered by Plum.
📄 Toku X Plum 2026 - 2027 Employee Handbook PDF
Plan Sponsorship & Coverage Overview
- This plan is 100% employer-sponsored for both you and your eligible family members!
- Sum insured: ₹7,00,000 per family, shared across all covered members
- No co-pay, no deductible, no room rent limit and no disease-wise capping
- Pre-existing conditions are covered from Day 1, with no waiting period
Eligibility & Enrollment
Prior to your effective date, you will receive an email from [email protected] to confirm whether you would like to enroll in or opt out of coverage. At that time, you will also have the option to add eligible dependents to your plan.
| Category | Coverage |
|---|---|
| Employee | Covered (primary member) |
| Spouse / Partner | Covered |
| Children | Up to 4 children |
| Parents* | Covered |
| Parents-in-Law* | Covered |
| Maximum Members | Employee + spouse + up to 4 children + parents or parents-in-law |
- *You can cover your parents or your parents-in-law, not both (no cross-selection).
- Members can be aged 1 day to 90 years.
- Dependents must be added at enrollment. Mid-year additions are only possible for a newborn (within 30 days of birth) or a new spouse (within 30 days of marriage).
How to Use Your Health Insurance
Insurance services and claims are managed digitally through Plum.
Accessing Your Coverage
Download the Plum app to manage your benefits:
Through the app, you can:
- Access your digital health ID card (Benefits > select policy and member > download health card)
- Search for nearby network hospitals and check which hospitals to avoid
- Start and track claims (Claims tab)
- See what's covered (Benefits > your policy > What's covered) or ask PolicyGPT about coverage and limits
- Estimate treatment costs with the expense calculator
- Book telehealth consultations (Health > choose specialization and doctor)
- Book your annual health check-up and use wellness benefits and discounts
Choosing a Hospital
| Hospital type | Cashless | Reimbursement |
|---|---|---|
| Network hospital | ✅ | ✅ |
| Non-network hospital | ❌ | ✅ |
| Blacklisted / excluded hospital | ❌ | ❌ |
Use Find cashless hospitals in the Plum app before admission, and tap Avoid blacklisted hospitals to check the excluded list.
Cashless Claims
Recommended for planned procedures or treatment at network hospitals. The hospital and insurer settle the bill directly, so no upfront payment is required.
In an emergency: call Plum's 24×7 Claims Buddy at 1800 30 911 911. They'll guide you from admission to discharge.
Planning a hospital visit:
- Open the Plum app and select Planned Cashless
- Choose the member who is being admitted
- Select the type of insurance that applies (e.g., group health)
- You're registered for cashless hospitalization - a Plum expert will call to help with every step Start planned cashless requests 2 - 3 days before admission. About 90% of cashless claims are approved in under an hour. Show your health card or policy number at the hospital help desk. Non-covered items (such as registration fees, food or personal items) may still need to be paid by you.
Reimbursement Claims
Used when you're treated at a non-network hospital, cashless isn't available, or for outpatient (OPD) expenses. You pay the bill first, then claim it back.
Process:
- In the Plum app, tap Claims → Reimbursement
- Enter the patient's name, reason for hospitalization, and admission and discharge dates
- Select the nature of expenses (hospitalization, diagnostics, etc.) and the type of insurance
- Upload all bills, receipts, reports and other proofs
- Review and submit, then track progress under Claims → Reimbursement Submit soon after discharge (typically within 7 - 30 days) and keep all original documents. Once approved, payment is processed within 15 days and a receipt is shared. You can book a consult with a Plum Claims Expert in the app if you need help.
Core Medical Benefits
| Benefit | Coverage |
|---|---|
| Sum Insured | ₹7,00,000 per family |
| Pre-Existing Diseases | Covered from Day 1 |
| Pre-Hospitalization | 60 days |
| Post-Hospitalization | 90 days |
| Daycare Treatments | Covered |
| Domiciliary Hospitalization | Covered |
| Road Ambulance | Up to ₹5,000 per hospitalization |
| Air Ambulance | Up to ₹1,00,000 |
| Attendant Charges | ₹5,000 per family within sum insured, if the patient's stay is more than 5 days |
| AYUSH Treatments | Covered |
| Modern Treatments | Covered up to 50% of sum insured (e.g., CyberKnife, Stem Cell therapy) |
| Oral Chemotherapy | Up to ₹3,00,000 |
| Psychiatric & Mental Illness Hospitalization | Covered up to sum insured |
| Cochlear Implant | Covered up to sum insured |
| Functional Endoscopic Sinus Surgery | Up to ₹35,000 |
| Organ Donor | Treatment expenses covered (not the cost of the organ) |
| Internal Congenital Conditions | Covered |
| External Congenital Conditions | Covered in life-threatening situations |
| Cataract | Covered |
| LASIK Surgery | Covered (±6.5D correction index) |
| Lucentis | Covered up to sum insured |
| Terrorism | Covered |
Mother & Child
| Benefit | Coverage |
|---|---|
| Maternity Coverage | Up to ₹1,00,000 (first two children; includes normal & C-section) |
| Pre- and Post-Natal Expenses | Up to ₹20,000, within the maternity limit |
| Newborn Baby | Covered from Day 1 up to sum insured |
| Well Mother, Well Baby Expenses | Covered up to the maternity limit |
Outpatient (OPD) Coverage incl. Dental & Vision
Up to ₹10,000 per year with no sub-limits, claimed through reimbursement in the Plum app. Covers, wherever medically advised:
- Consultation fees across all specialities
- Prescribed diagnostics, medicines, vitamins and supplements
- Vision, including spectacles and lenses
- Dental treatments, including fillings, root canals, scaling and cleaning, extraction and replacement
- Vaccinations
- Mental health therapy
- Physiotherapy
- Nursing care after hospitalization
- AYUSH treatments
- Health check-ups
- Minor surgeries and dressing
- Dietician fees and consultations Cosmetic treatments are not covered.
Annual Health Check-Up
Your plan includes one Plum Core Health Check-up per family per year, for you or any one covered family member. It covers 98 markers, including complete blood count, urine routine, diabetes (HbA1c), liver, lipid, kidney and thyroid panels, vitamin D and B12, electrolytes, iron profile and inflammation markers. A phlebotomist collects samples at your address.
How to book:
- Open the Plum app and go to Home > Tests & Checkups
- Select Pulse Health Checkup
- Choose the member the check-up is for
- Enter the address for sample collection
- Pick your preferred date and time slot - you're all set!
Summary of Group Personal Accident Insurance
Toku provides Group Personal Accident Insurance through ICICI Lombard to offer financial protection in the event of accidental injury or death. This cover is for employees only (ages 18 - 65) and applies worldwide.
Coverage Amount
- Sum Insured: ₹50,00,000 per employee
Accident Coverage Details
| Benefit | Coverage |
|---|---|
| Accidental Death | 100% of sum insured |
| Permanent Total Disability | 100% of sum insured |
| Permanent Partial Disability | Up to 100% of sum insured, based on extent of disability |
| Temporary Total Disability | 2% of sum insured, ₹10,000 per week, or actual weekly salary, whichever is lowest (up to 104 weeks) |
| Accident Medical Expenses | Up to ₹2,00,000 or actual, whichever is lower |
| Children's Education Benefit | Up to ₹10,000 per child (max 2 children, up to age 25) in case of death or permanent total disability |
| Burns | Up to ₹10,000 or actual, whichever is lower |
| Road Ambulance | Up to ₹10,000 or actual, whichever is lower |
| Repatriation of Mortal Remains | Up to ₹10,000 or actual, whichever is lower |
| Carriage of Dead Body | 2% of sum insured, up to ₹2,500 |
| Terrorism | Covered |
Health & Wellness Benefits
Available in the Plum app at no cost to you:
- Telehealth: consult general physicians and specialists online
- Online wellness sessions: interactive live sessions with experts and creators
- Financial wellness: 1:1 expert consultations on financial risk planning and personal insurance
- Plum Perks: exclusive discounts across 100+ health and wellness brands, including dental, eyewear, fitness and medicines
- Wellness resources: health assessments and articles
Need Help?
| What you need | Where to go |
|---|---|
| Emergency or planned hospitalization | Call Plum 24×7: 1800 30 911 911 (please use this number only for hospitalizations) |
| Claims, coverage or general questions | Plum app → chat icon (top-right) to raise a support ticket |
| Escalations | [email protected] (you can also request a call back) |
| Enrollment, dependents or anything Toku-related | [email protected] |
This page is a summary. Full terms and conditions are in the ICICI Lombard policy documents; the policy wording applies if anything differs.