Beruflich Dokumente
Kultur Dokumente
SyndArogya
Mediclaim Insurance cum Personal Accident Scheme. Individual Policy with benefit of Group size of 2 lacs policy holders Floater Policy 1+3 (Husband, wife & two dependent children) with premium as per Plan A table and 1+5 (Husband, wife, two dependent children & dependent Parents) with premium as per Plan B table annexed
SyndArogya
Benefits to Policyholders
Mediclaim Scheme meets 100 % of all types of Hospitalisation Expenses viz.: Room Rent Doctors/Surgeon Fees Medicine & Drugs Anesthesia, OT, Diagnostics Materials Blood, Oxygen, X-ray Chemotherapy, Radiotherapy Nursing expenses Cost of pacemaker & Artificial Limbs etc.
Benefits to Policyholders
Cashless Facility at Networked Hospitals of TPA Treatment at any Hospital/Nursing Home in India Relevant medical expenses 30 days prior to and 60 days subsequent to hospitalisation covered Income Tax relief on Premium under S80D
Cover Available to Dependent Parents also as per Plan B. Entry age for parents also 65 years renewable up to 80 years of age. Ambulance charge up to Rs 1000/Maternity Benefits and Baby Care covered up to maximum 5% of Sum Assured Max Sum Insured Increased to Rs 5 lacs in multiples of 50000 Cost of Health Check reimbursed up to 1% of Average Sum Insured after 3 claim free years
Hospital cash up to Rs 1000 in case of hospitalisation of child below 12 years age Treatment anywhere in India, Nepal or Bhutan in Indian currency
Accountholder 100% of Sum Insured selected Spouse 50% of SI Child above 5 years 20 % of SI Child below 5 years 10% of SI
SyndArogya
Role of TPA
SyndArogya
Claim Procedures
For treatment at Non-networked hospitals: Intimation immediately after hospitalisation Claim for reimbursement within 15 days from discharge or completion of post hosp treatment
Documents required:
Copy of policy & Photo Identity card Original of discharged summary & consolidated bills with breakup Original reports and pharmacy bills with break up.
SyndArogya
Claim Procedures
For Treatment at Networked Hosp. no claim as cashless facility. Prior Authorisation required from TPA before commencing treatment for cashless facility. For Personal Accident death claim
Notice to Nodal Office of Insurance Co.to get claim form Filled up claim form , FIR, Death Certificate, Postmortem report, legal heir certificate etc.
Main Exclusions
Domiciliary hospitalisation Pre-existing diseases (covered from 4th year onwards if without any break in cover) Waiting period of first 30 days - commencement of policy except those arising out of accident. Treatment for Cataract, benign, prostatihypertrophy, hysterectomy, hernia, hydrocele, piles, sinusitis, etc., during the first year of operation of insurance cover. Cost of spectacles, hearing aids, vitamins, tonics and expenses relating to dental treatment, convalescence, general debility, naturopathy, etc. Dental treatment unless requiring hospitalisation
Premium Table
(Amt in Rs.)
Sum Insured
Plan-A(1+3)
2,00,000
2,50,000 3,00,000 3,50,000 4,00,000 4,50,000 5,00,000
3488
4181 4875 5484 6094 6706 7316
5815
6967 8120 9131 10143 11156 12167
Thank You