Dear Collugues/friends, I have been asked to present (PT) on Employee Group Medi Sheild Policy & Group Personal Accident policies/Acts Can any body help me to get the Data from different sources.
From India, Hyderabad
Mediclaim Insurance policy
The Medi Classic insurance policy aims to provide reimbursement of hospitalisation expenses incurred as a result of illness/disease/sickness and / or accidental injuries.

Benefits:
  • Hospitalisation Cover - In-patient hospitalisation expenses for a minimum of 24hours. This includes room rent & boarding @ 2% of sum insured subject to a maximum of Rs.4000/- per day.
  • Nursing expenses.
  • Surgeon's fees, Consultant's fees, Anasethetist's fees.
  • Cost of blood, oxygen, diagnostic expenses, cost of pacemakers.
  • Cost of medicines and drugs
  • Emergency ambulance charges for transporting the insured patient to the hospital @ Rs.750/- per hospitalisation and Rs.1500/- per policy period.
  • Pre-hospitalisation medical expenses up to 30 days prior to date of admission into the hospital.
  • A lumpsum calculated at 7% of the hospitalisation expenses payable towards post - hospitalisation , subject to a maximum of Rs.5000/- per occurrence as per the policy.
  • Non-allopathic treatments up to Rs. 25,000/- per occurence, subject to a maximum of 25% of Sum insured per policy period.

What Cannot be claimed
  • Expenses incurred for treatment of any illness/disease/condition, which is pre-existing at the time of commencement of insurance.
  • Any expenses incurred for treatment of illness/disease/sickness contracted by the insured person during the first 30 days from the commencement of the policy.
  • First Year Exclusions- Hernia, Piles, Hydrocele, Congenital internal disease/ defect, Sinusitis, Gall Stone/Renal Stone removal/ treatment, and Benign Prostrate Hypertrophy.
  • Two Years Exclusions - Hysterectomy, Cataract, Joint / Knee replacement surgery (other than caused by an accident). Prolapsed intervertibral Disc.Varicose veins/ulcers.
  • Naturopathy treatment. Expenses, which are purely diagnostic in nature with no positive existence of any disease. Expenses that are mainly cosmetic in nature
For Taking Group Mediclaim policy first the Size of the group(No. of Employees) and their Date of Birth is required. As this is the basis upon which the premium will be calulated and arrived. then decide amount of Sum Insured going to opted,Wheather you want the standard p[olicy. or you want the policy to be tailor made for your organisation.
You can waive the 30 days waiting period.
waiver of Ist year exclusions
Waiver of @nd year Exclusions
Pre existing diseases coverage reuirement may added
You can also extend the policy to cover the spouse of the employee, their children.
Maternity coverage is also possible. the company may opt if the organisation consists more women employees.
9 months maternity waiting period for medclaim covrage also can be removed.
New born cover can be added
op consultation may be added


We specialise in Mediclaim, Overseas Mediclaim and Personal Accident.
Promoting Health, Protecting Health. Medical 24 hour helpline. Cashless hospitalisation facility.Free general physician advice. Unlimited free out patient consultation for a small premium.No medical examination up to 50 years.For persons age above, medical examination cost borne by the company. Faster disbursement of claims. No TPA.Large network of over 2800 hospitals across India. Over 200 hospitals in Chennai. Health consultation through Tele and Video conference.




Feel free to contact us for any details/clarifications.

From India, Pune
hi, I think it entirly depends on the company through which you are getting the insurance done. I have sample with me, but i hardly see any use to you. rgds, Swapna
From India, Pune
Attached Files (Download Requires Membership)
File Type: doc Mediclaim_Guidelines1.doc (71.5 KB, 715 views)
File Type: ppt IPA Presentation_TATA AIG1.ppt (2.30 MB, 699 views)

Hi Swapna,
Thanks For Your Valuble Information.
The Info, Which u have attached here is based on indivisual Not on company or as a group.
PLEASE SEND, If You have any thing On Group Medisheild & Personal Accident as per Governament Act.
Awaiting for ur updation on the same.

From India, Hyderabad
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