x
Yes No
Self Spouse Child 1 Child 2 Child 3 Child 4
Parent 1 Parent 2 Parent-In-Law 1 Parent-In-Law 2
Yes No
Yes, waived off No
Yes, waived off No
Yes, waived off No
Yes, waived off No
Internal Covered No
Yes No
Applicable Not Applicable
Yes No
Yes No
Yes No
Days
Days
Special Condition