Group Mediclaim Insurance Policy

A Group Hospitalisation Policy is available to any Body Corporate / Association / Institution / Group constituted of more than 50 persons.

The policy covers individuals aged between 5 and 75 years. However, children aged between 3 months and 5 years can be covered if one or both parents are covered concurrently.

The policy covers

The policy covers hospitalisation and domiciliary hospitalisation expenses incurred by the employees/members (including family members) of the Insured for illness/disease or accidental injury and shall include hospital charges(room & boarding and operation theatre), fees of surgeon, anesthetist, nurses, cost of medicine, oxygen, blood, cost of appliances like pacemaker, artificial limbs and cost of organs.

The policy provides for following extensions

The policy can be extended to cover Maternity Benefits subject to the condition that all employees/members of the Insured are covered under this extension. Maternity Benefits have to be availed of at inception of the policy. The maximum allowable of Maternity Benefits shall be Rs. 50,000/- or the sum insured opted by the employee/member, whichever is less.

The policy does not cover

• Treatment of asthma, chronic nephritis and nephritis syndrome, gastro-enteritis, diabetes mellitus and insipidus, epilepsy, hypertension, influenza, cough and cold, all psychiatric or psychosomatic disorders, pyrexia of unknown origin for less than 10 days, tonsillitis and UTRI, arthritis, rheumatism (as far as domiciliary hospitalisation is concerned).
• Any treatment relating to any illness/disease already in existence.
• Any disease / injury during first 30 days of commencement of policy (accidental injury is not an exclusion).
• Treatment of cataract, benign prosthetic hypertrophy, hysterectomy for menorrhagia or fibromyoma, hernia hydrocele, congenital internal disease, fistula in anus, sinusitis and related disorders during first year of cover.
• Dental treatment of surgery of any kind unless requiring hospitalisation.
• Cost of spectacles, contact lenses and hearing aids.
• Convalescence, general debility, “rundown” condition, sterility, venereal disease, intentional self-injury, use of drugs and intoxicants.
• Any variation of deficiency syndrome or AIDS.
• Voluntary medical termination of pregnancy within first 12 weeks of confinement.
• Vaccination, inoculation, circumcision or change of life or cosmetic or aesthetic treatment, plastic surgery unless necessitated due to accident or as a part of any illness.
• Hospital / nursing home charges not consistent with or incidental to the diagnosis and treatment: vitamins, tonics not forming part of any treatment.
• Nuclear perils and war group or perils.
• Naturopathy treatment.

• We offer custom built covers
• We also offer cash-less services through dedicated TPAs (Third Party Administrators).
• The policy also carries a Tax exemption under Sec 36(1) of the IT Act 1961.