Group Health Insurance

Try our Group Health and Hospitalization Policy. All your specific and quite expensive needs like coverage for hospital stays, maternity expenses and dread diseases are well covered and taken care of. Being generous and customizable, our Policy is the perfect choice for the corporate client interested in providing the best medical cover to the employees and their families. We have an independent division for management of group health Insurance. This division is managed by some of the most well trained and experienced persons in the health insurance business. Within our policy, coverage is provided to the client's employee, their spouse, children and parents.

We have a wide range of hospitals on our panel providing quality healthcare services throughout the country. Our panel hospitals not only have the best reputation in the industry but they are also very well equipped. The hospitals are providing several medical services including Diagnostic Centers, Emergency Treatment, Pathology Labs, X-ray Clinic, CT and MRI Centers, Fitness Centers etc. If you have any question about the services provided by our panel hospitals, you may contact us. Please click here for a complete list of hospitals on our panel.

Explanation of Benefits:

a) Hospitalization Insurance:

This section provides coverage for hospital stays (including day care surgery) due to sickness or accidental injuries. Eligible hospitalization expenses include:

•  Daily room charges.

•  Consultant's fees.

•  Surgeon fees.

•  Medicines & drugs.

•  Blood & Oxygen supplies.

•  Diagnostic tests.

•  Anesthetist fees (up to 30% of surgeon fees).

•  Operation theater charges (up to 30% of surgeon fees).

•  Laboratory and X-Ray tests (including ECG and EEG).

•  Miscellaneous costs (ambulance cost, plaster casts, physiotherapy, etc.)

Optional Coverage:

•  Dental treatment is included to cover the consultant fee of the dentist and/or the    remedial prescription/procedures (Ortho dental and/or Cosmetic dental surgery is    strictly excluded).

•  Eye treatment to cover the consultant's fee and/or the remedial prescription     (Refractive errors of the eyes and the provision of appliances such as spectacles,     lenses etc strictly excluded).

Besides this, we also provide coverage for the following expenses:

•  Charges for pre-hospitalization diagnostic services, which includes specialist's fees    for consultation, diagnostic x-ray and laboratory tests following referral from the    hospital doctor but incurring prior to a scheduled hospitalization. Benefit is not    payable for outpatient treatment nor if the patient is not subsequently hospitalized    or surgically treated after such diagnostic services have been performed.

•  Charges for post-hospitalization treatment incurring after discharge from hospital    provided that it is with the same hospital doctor.

•  Hospitalization charges for pre-existing conditions provided that the ailment is     disclosed initially on the Employee's Enrollment Form (EEF). However, note that     coverage is subject to the underwriter's decision and payment of additional     premium.

(b) Maternity Insurance:

This section provides coverage to female employees or spouse of male employees for hospital stay as a result of pregnancy, which includes normal birth, caesarean surgery or multiple births. Eligible maternity expenses include:

•  Gynecologist's fees.

•  Labour room charges - for normal birth.

•  Medicines and drugs.

•  Miscarriage (on doctor's advise or accidental).

•  Diagnostic tests.

•  Blood & Oxygen supplies.

•  Daily room charges.

•  Surgeon fees - for cesarean birth.

•  Baby's nursing care.

•  Miscellaneous charges.

•  Operation Theater charges - for cesarean birth (up to 30% of surgeon fees).

•  Anesthetist fees - for cesarean birth (up to 30%of surgeon fees).

Besides this, we also provide coverage for the following expenses within maternity insurance:

•  Charges for pre-hospitalization diagnostic services and post-hospitalization treatment     are allowed as described in the hospitalization insurance section.

•  Circumcision expenses for baby boys within maximum limit.

•  Separate hospitalization coverage for newborn babies is allowed.

Our basic group health and hospitalization coverage as described above can be further enhanced with any of the following riders:

Critical Illness Care Rider
Outpatient Treatment Rider

Our policy can be customized in any manner as desired by the prospective client.