Important Download
  • Group Mediclaim Policy (Base Policy) 2019
    • Family Definition: Self+ Spouse+ 2 children + Parents or Parents-in-Law
    • Sum insured:  Self, spouse & two children:  Floater cover of INR 500,000/-
    • Sum Insured: Parents / Parents in laws covered separately for a Floater cover of INR 300,000/-
    • Premium for Parents / In-Laws, 3rd and 4th child will be borne by the employee.
    • Only 2 dependent Parents / In-Laws can be enrolled. The cross-combination of Parents and In Laws is not allowed in the policy.
    • If you are enrolling your Parents / In-Laws for the first time, they cannot be changed or deleted for the next 3 years.
    • Room Rent restriction- Allowed up to single standard AC room (In case insured opted the higher category  room cost of incremental  charges on the entire bill will be borne by employee)
    • ICU / ICCU is covered as per actuals
    • Maternity Capped at INR 100,000 for Normal as well as C-section for 2 deliveries only
    • New born baby- Covered from day 1
    • Ambulance charges covered for INR 1000 per claim
    • Pre and Post Hospitalization – Covered for 30 & 60 days respectively.
    • Mid-term addition of child / spouse will be permitted only in case of new born / newly married spouse subject to intimation within 30 days from the date of birth /marriage.
    • Any other mid-term addition will not be permitted.

 

Mandatory Conditions for Top Up Plan:

  • Employees have an option to enhance their coverage with additional Sum Insured.
  • The Top-up Sum Insured options are – INR 100,000, INR 200,000 or INR 300,000.
  • Premium for Top-up to be borne by the employee
  • Top up policy is given subject to certain minimum participation of the employee’s strength.
  • If an employee decides to take a Top Up plan, he / she will need to take it for his entire family.
  • Top up sum insured will be triggered only after the exhaustion of the base sum insured under the GMC policy.
  • Top up policy will be offered only to those members who are covered under our GMC policy.
  • The addition of existing employees or dependents will not be allowed under the policy after the policy inception (1-jun-2019)
  • The claims prior to the inception of the top up cover would not be considered.
  • Maternity claims are excluded under top up cover.
  • In case an employee exits the organization during the policy period he/she will be deleted from the main policy and top up policy. The effective date for this would be the last date as per the company records. The employee would be eligible to receive a refund of a pro rata premium for the remaining policy period, subject to no claims being made for that employee/ member.