group_mediclaim_insurance Group Mediclaim Insurance Home / Corporate / Group Mediclaim Insurance As the costs of hospital treatment are getting expensive day by day one must financially secure under family floater health insurance plans. Rebate under income tax under section 80D can also be availed Who can be covered? Self – Employees, Workers can also be covered (This was recently included due to Corona Pandemic) Spouse Dependent Children Dependant Parents Special Benefits Coverage for Pre- Existing Diseases 30 days waiting period waiver First, Second, Third & Fourth year exclusion waiver Out –Patient Department (OPD) Expenses Pre and Post Hospitalization Disease wise Sub – Limit Domiciliary Hospitalization Loss of Wages / Salary Due to Hospitalization (Hospital Cash Allowance Limit on Room Rent, Nursing Charges, Consultation Fees, Diagnostic Charges, OT Charges etc. Maternity Expenses Day one cover for new born child Waiver of 9 months waiting period for maternity claims Cashless facility Addition and deletion clause Corporate buffer REQUIREMENTS The policy does not cover any loss if: Admission in a hospital / nursing home for a minimum period of 24 hours Definition of Hospital/Nursing Home Minimum 15 beds or registered as hospital with appropriate authority Round the clock qualified doctors Round the clock qualified nursing Operation Theatre Benefits of Policy All reasonable expenses incurred for the following ROOM RENT – As per the Cap provided. NURSING CHARGES (PRIVATE NURSING NOT ADMISSIBLE). SURGEON , ANESTHETIST, MEDICAL PRACTITIONER, CONSULTANTS, SPECIALIST FEES MEDICINE CHARGES DIAGNOSTIC CHARGES (IN LINE WITH DIAGNOSED AILMENT/DISEASES DURING HOSPITALISATION) DIALYSIS, CHEMOTHERAPY, RADIOTHERAPY, PACEMAKER, COST OF ORGANS ARTIFICIAL LIMBS Expenses incurred before and after hospitalization Pre Hospitalization 30 days prior to hospitalization Post Hospitalization upto 60 days from the date of discharge – Expenses incurred for the ailment for which the insured is hospitalized EXCLUSIONS - WHAT ARE NOT COVERED CIRCUMCISION CHANGE OF LIFE DENTAL TREATMENT OR SURGERY UNLESS HOSPITALISED COST OF SPECTACLES, CONTACT LENSES COST OF HEARING AIDS VOLUNTARY TERMINATION OF PREGNANCY ANY INTERAL/EXTERNAL CONGINETAL DISEASE VACCINATIONS / INNOCULATION HORMONE REPLACEMENT THERAPHY PSYCHIATRIC, MENTAL , NERVOUS CONDITIONS, INSANITY – TREATMENT COSMETIC / PLASTIC / ASETHETIC TREATMENT USE OF INTOXICATING DRUGS/ALCOHOL TREATMENT OUTSIDE INDIA AYURVEDIC/HOMEOPATHY/NATUROPATHY TREATMENT Reimbursement claims - Documents required Duly filled in Claim form – Medical certificate to be filled by the attending doctor Original discharge summary Original bills/prescriptions Original Advance / Final Receipt X-ray / scan film and reports All investigation reports like Pathology FIR in case of Accident
