Group Insurance


Exclusive Features we can provide you!!

GROUP HEALTH INSURANCE

Sum Insured: As Desired

Self, Spouse, Kids & Parents

30 Days Exclusions: Waived

24Hrs Hospitalization Required (Except for Day Care)

2 Yr Exclusions: Waived

Pre-Existing Illness: Covered

Maternity: Covered as per Requirement

Room Rent: No Limit

ICU Rent: No Limit

Pre-Hospitalization: 30Days

Post-Hospitalization: 60Days

Network Hospitals: Cashless

Non-Network Hospitals: Re- Imbursement

Day Care Procedures: Covered

Mid-Term Additions: Allowed for New Joiners

Special Coverage:

Psychiatric Ailments Covered

Laser Eye Correction Covered for Over + - 5.5 D

Cyber Knife & Stem Cell Transplant: Covered

Cochlear Implant Covered

Nasal Sinus Surgeries Covered

Holter Monitoring: Covered for in-patient

Life Saving Prosthesis: Covered

Value Added Services:

Once a Year Free Health Checkup

Health Awareness Sessions

Health Line / SMS Alerts / Newsletters

Pharmacy & Investigation Discounts

ONLINE ACCESS:

Cashless Hospitals: List provided.

Online Print of Health Cards: Available

Track Claim Status Online: Yes

GROUP ACCIDENTAL INSURANCE

Sum Insured: As desired

Employees Only Covered

Risk Covered: Accidental Only

Death: 100% of Sum Insured + Additional Sum for Children't Education Allowance

Complete loss of any two limbs (Eye / Hand / Legs): 100% of Sum Insured

Permanent Inability to Earn: 100% of Sum Insured

Loss of One Eye / Hand / Leg: 50% of Sum Insured

Permanent Partial Disability: Below % of Sum Insured

Loss of Toes - All

20%

Loss of Middle Finger - 3 Phalange

6%

Great both Phalanges

5%

Loss of Middle Finger - 2 Phalange

4%

Great- One Phalanx

2%

Loss of Middle Finger - 1 Phalange

2%

Other than great if more than one Toe lost each

1%

Loss of Ring Finger - 3 Phalange

5%

Loss of hearing - Both Ears

75%

Loss of Ring Finger - 2 Phalange

4%

Loss of hearing - One Ear

30%

Loss of Ring Finger - 1 Phalange

2%

Loss of Four Fingers and Thumb of one hand

40%

Loss of Little Finger - 3 Phalange

4%

Loss of Four Fingers

35%

Loss of Little Finger - 2 Phalange

3%

Loss of Thumb - Both Phalange

25%

Loss of Little Finger - 1 Phalange

2%

Loss of Thumb - One Phalange

10%

Loss of Metacarpus


Loss of Index Finger - 3 Phalange

10%

-First or Second (Additional)

3%

Loss of Index Finger - 2 Phalange

8%

-Third, Fourth or Fifth (Additional)

2%

Loss of Index Finger - 1 Phalange

4%

Any other Permanent Partial Disability

As per Doctor

Accidental Bed Rest: 1% of Sum Insured per week, upto 100 weeks

Medical Expenses: 50% of Claim upto max 15% of Sum Insured

EXCLUSIONS & PROCESS

Legal Violations

Septoplasty, HIV, Congenital Illness, Infertility & Related Ailments incl. Male sterility; Treatment on trial/experimental basis; Admin/ Registration/ Service/ Misc. Charges


Diseases, illness, accident or injuries directly or indirectly arising from war, invasion, act of foreign enemy, war like operations (whether war be declared or not)


The cost of spectacles and contact lenses, hearing aids.

Intentional SelfInjury, Drugs, Alcohol

Dental treatment or surgery of any kind unless requiring hospitalization.

Voluntary Diagnostic & Investigations unrelated to illness / treatment

* Pls refer to Policy Wordings.

CLAIM REIMBURSEMENT PROCESS

Intimation within 24 hrs of Injury/ Illness through HR Department

Original Documents Submission at Discharge ASAP

Claim form Duly filled, sealed and signed by Hospital and Insured

All Original Prescriptios, Consultations, Reports, Films, Medicine Bills, Receipts, Final Bill etc



Copy of Health Card & Patient's Goverment ID Card

May require HR Leave cum Salary Certificate, MLC Report, Death Certificate, Disability Certificate etc based on case.


It takes approx 20-30 days (after all query submission) to get the claim settled. Have patience.

For Further Queries: Call +91-9828067687
or Mail to: vikram@meriplanning.com
or Visit:
C/o Authentic Insurance Brokers India Ltd.,
C-77, Shyam Appartments, Sarojini Marg,
C- Scheme, Jaipur - 302001



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