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    Hospitalization_Insurance_IN [8]

    Uploaded by

    Vinod Kumar Chettiar

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Hospitalization_Insurance_IN [8]

    Uploaded by

    Vinod Kumar Chettiar
    3 views1 page

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    3 views1 page

    Hospitalization_Insurance_IN [8]

    Uploaded by

    Vinod Kumar Chettiar

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    • Please note that investigation expenses are not payable at the initial stage.

    Within 60 days, if
    the investigation leads to hospitalization (minimum of 24 Hrs. hospitalizations) then this can be
    claimed from the insurance company as reimbursement.
    • Restriction on Parental Base Policy exit: A team member who has made / Placed a claim for
    Parents / Family including self in 2023-24 policy year shall not be allowed to move out of
    Parental Base Policy during the annual enrollment.
    • There are exit restrictions on Top-Up options during the policy period. Team member can
    remain / enhance / decrease Top-Up coverage only during annual enrollment window for the
    next policy year
    • In case of team member exiting company, team member contribution towards voluntary
    Parental Base Plan would be refunded back on pro-rata basis. This is subject to “No claims”
    being made or claims placed, by the team member and their dependents (spouse/partner,
    children, and parents) under the base medical policy and Parental Base Plan during that
    policy period.
    • There will be no refund for Top-up (ESC or ESCP) at the time of team member exiting the
    company.
    • During exit, team member has an option to convert Family / Family + Parental Base Plan into
    a retail policy by approaching Insurer, at least 20 working days in advance, before the last
    working day. Any additional costs arising out of such conversion have to be borne by
    Employee. Top Up Policies will continue to be active till the policy end date, i.e., June 30th,
    2025. For ESC Top-Up, the deductible will be INR 5 Lakhs and for Parental Top-Up,
    deductible of INR 3 Lakhs will be applicable, i.e., the top-up policy will trigger after exhaustion
    of INR 5 Lakhs for ESC and 3 Lakhs for Parental respectively.

    Caps applicable for all options:


    Table: Applicable Limits

    Ailment / Procedure Applicable cap in INR

    Maternity Normal or Caesarean – INR 75,000

    Maternity Complications INR 5 Lakhs

    Cataract INR 30,000 per eye per year

    Ambulance INR 3,000 per incident

    Dental INR 5,000 per person per year with a cap of INR
    20,000 per family

    Emotional Well-being Covered with full sum insured (inpatient treatment)


    and INR 1 Lakh for OPD

    Air Ambulance INR 1,00,000 applicable as per defined conditions


    (Applicable only for team member)

    Room Rental Cap Room rent capped at INR 7,500/as per hospital
    (For Employee, Spouse/Partner, Children and tariff
    Parents)

    To Note:

    Internal Use - Confidential Page 8 of 15

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