Group Mediclaim Insurance policy
OBJECTIVE
Group Mediclaim Insurance policy is a welfare policy, which shall enable the employees to claim reimbursement of expenses in case of hospitalization for illness/diseases or injury sustained.
SCOPE
This policy is applicable to all the units of __________ group.
POLICY
This policy will be taken on the date of joining itself. Company will deposit an advance amount with Insurance company for inclusion of new joinees. On the day of joining, Unit HRM will intimate Insurance company for inclusion of new employee in mediclaim insurance from day one. Company will take floater policy including Maternity benefits having child care coverage for all employees, other than covered under ESI. Once an Employee is out of ESI scheme, company will immediately take the Mediclaim policy. Floater policy means all family members will be covered under the same amount collectively and not individually. The meaning of family is self, spouse and children. No other family members/ dependents of the employees will be included in the policy. If insurance company allows inclusion of any member at extra premium, the additional premium will be borne by the employee.
In case employee is already having Mediclaim policy, is exempted under this scheme subject to submission of copy of policy to the concerned HRM Head and he is entitled for reimbursement of the amount against the same as per his entitlement of premium amount.
APPLICABILITY
This policy shall be applicable throughout the country.
GENERAL POINTS
HRM will be responsible for all the activities related to Mediclaim i.e. information about illness to settlement of the claim, updation of employee’s list etc.
The sum insured in the different categories shall be as under:
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S. No.
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CATEGORY
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SUM INSURED
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1.
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Level VIII & above
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Rs. 1,50,000/-
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2
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Level VI & VII
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Rs. 1,00,000/-
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3
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Upto Level V
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Rs. 75,000/-
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CLAIM
Fundamental notice of claim with particulars identifying with approach number, name of guaranteed individual in regard of whom assert is made, nature of sickness/damage name and address of the going to therapeutic expert/healing facility/nursing home ought to be given to the insurance agency inside seven days from the date of hospitalization/damage/passing.
PROCEDURE
Policy will be taken in the Company’s name on the behalf of the employees, the premium shall be paid by the company.
In case employee Leaves Company during the policy period, he/she can get it renewed himself/herself in order to maintain the continuity of the policy. However in this case he/she will not be eligible for advantage of discount.
After taking this policy, employee can avail the weekly benefits of accident insurance policy also side by side.