Group Mediclaim

 The essential part of an organization is human beings. As a part of HR policy, many organizations take a Group Health Insurance cover to seek protection to their employees.

The policy is meant to cover Hospitalization Expenses incurred by the members of an organization in case they happen to suffer from a disease or sustain an accidental injury, the following Hospitalization expenses will be paid under following heads:

  1. Room, Boarding and Nursing Expense.
  2. Medical Practitioner/ Anesthetist, Consultant fees, fees of surgeon
  3. Expenses on Anesthesia, Blood, Oxygen, Operation Theatre, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs, Cost of Organ and similar expenses
  4. Expenses on Vitamins and Tonics only if forming part of treatment as certified by the attending Medical Practitioner.
  5. The relevant expenses incurred for Domiciliary Hospitalisation
  6.   An additional Daily Allowance for the duration of Hospitalisation towards defraying of miscellaneous expenses.
  7. Ambulance charges in connection with any admissible claim limited
  8. Admissible day care treatment (less than 24 hrs hospitalization), pre and post hospitalization
  9. Cost of Health Check up – Reimbursement of cost of medical check-up once at the end of a block of every four continuous claim free policy years, subject to maximum of 1% of the average sum insured during the period
  10. Other admissible expenses.

This policy will trigger when there is minimum 24 hours hospitalisation.

The hospital where treatment is taken should have minimum 15 beds.

The policy holder can avail cashless facility for the treatment taken or he may go for reimbursement of expenses incurred.

The basic cover can be enhanced by opting for Add-on covers by paying an extra premium and such Add-on covers are as below:

  1. Waiver for Pre-existing diseases.
  2. Waiver for first 30 days exclusion.
  3. Waiver for first year / first two years / first four years exclusion.
  4. Maternity Benefits and New Born Baby cover from day one.
  5. Corporate Buffer.

This policy is a very good tool to for an organization to ensure that their employees are fully covered to meet any sort of medical emergency.