1

Indian Institute of Information Technology, Design and Manufacturing Kancheepuram

Tender Document

For

Group Mediclaim (GMC) and

Group Personal Accident (GPA)

Insurance Policy

Date: 02.06.2020

2

Tender Enquiry No : IIITDM/GMC&GPA/2020/1 dated 02 June 2020

Sealed Tenders are invited from General Insurance Companies towards Group mediclaim and Group Personal Accident Insurance for 1. Employees 2. Students of Indian Institute of Information Technology Design and Manufacturing Kancheepuram.

Two Bid System

Two bid system will be followed in this tender.

In this system the bidder must submit his offer in two separate sealed envelopes. Both the technical bid and commercial bid, the envelopes should be securely sealed and stamped separately

and clearly marked as “Envelope No: 1 – Technical Bid” and “Envelope No: 2 – Commercial Bid” respectively.

These two sealed envelopes should be placed in a different envelope super scribing the tender No and description of the item and sent to:

The Registrar IIITDM Kancheepuram Melakottaiyur, Chennai 600127

Important: All communications are to be addressed to in the name of Registrar, IIITDM Kancheepuram only and not in the name of any officer and mails has to be sent to official email id registrar@iiitdm.ac.in

Crucial Dates of Tender Document

Sl.No Particulars Date Time

1 Date of Publication of Tender / Download of Tender 02 June 2020

2 Pre-Bid Meeting 16 June 2020

3 Pre-Bid Meeting Clarifications (through Web Site only) 20 June 2020

4 Bid Submission Close Date 30 June 2020 / 1000 hrs

5 Opening of Technical Bids 30 June 2020 / 1200 Noon

3

Terms and Conditions

1. The Bidders are requested to give detailed tender in two bid format.

Envelope-I : Technical Bid

Envelope-II : Commercial Bid

2. The bidder has to accept all terms and conditions of the Institute and conditional offers will

not be accepted.

3. The Tender Document can be downloaded from the Institute website http://iiitdm.ac.in and the duly

filled tenders should be submitted to the Registrar Indian Institute of Information Technology,

Design and Manufacturing, Kancheepuram on or before 30.06.2020( 10.00 AM).

4. Eligibility Criteria:

I. The bidder should be a registered Indian Insurer in accordance with the Insurance

Act, (registered and licensed by IRDA (Insurance Regulatory Development Authority)

as Medical/Health Insurer and should have a license to carry out Medical insurance

business on a Pan India basis and the copy of the same should be enclosed.

II. The Insurance Company shall be in the Medical Insurance business in India at least

for five years as on the scheduled date of tender opening. The turnover in the

medical insurance business during each of the last three financial years (FY 2016-17

to FY 2017-18 FY 2018-19 ) should have been Rs. 5 crore or higher per year and

certificate to the effect should be enclosed.

III. The Insurance Company should be having Medical insurance participation in a

minimum of three major companies/institutions/ organizations etc. (Documentary

evidence to be furnished) on or after 01.01.2017

IV. Tenderer has to submit declaration along with unpriced technical bid (Part-1)

stating that they have not been Black-Listed/De-listed or are put to any holiday

by any Indian Institutional Agency/Government Department/Public Sector

Undertaking in the last three years. In case they have been black listed by any of

the Institutions, details of the same be furnished.

4

Technical and Financial Bids:

This is a two-part tender. The technical bid shall be submitted in a separate sealed cover

indicating the Tender No., description of tender clearly indicating Part-I (Technical Bid) and

containing the details of Part-1 along with required supporting documents.

The Financial bid shall be submitted in a separate sealed cover subscribing the Tender No.,

description of tender clearly indicating Part-II (Financial bid) and containing the filled forms as

specified in Part-II along with any required supporting documents.

This both the covers should be placed in a single envelop superscribing the Tender no.,

description of tender and submitted before close of tender date.

On the date and time specified in the tender, Part-I (Un-priced technical bid) of the offers

received will be opened. The Part-II (Financial bid) will be kept sealed and financial bids of only

the technically acceptable offers would be opened. Date and time of opening of the financial

bids will be intimated separately to the short listed bidders.

If the bidder desires to be present at the time of opening, he shall depute his representatives (not

more than two persons) with due authorization for participating in the tender opening.

Incomplete offers would be summarily rejected. No extension of time shall be permitted for the

collection of Tender Documents and/or Tender opening date.

Any cutting or overwriting should be attested by the tenderer with full signature and seal.

Offers submitted against tender documents only will be considered and the offer shall be in the

name of the insurer on whose behalf the tender document has been issued.

IIITDM Kancheepuram takes no responsibility for delays, loss or non-receipt of tender

documents or any letters sent by post/courier either way and also reserve the right to reject

any offer in part or full without assigning any reasons thereof.

IIITDM Kancheepuram shall always be at liberty to reject or accept any offer or offers or part

thereof at its sole discretion. The submission of offer shall have no cause of action or claim

against IIITDM Kancheepuram for rejection of offer. The Insurer, whose offer is not accepted

shall not be entitled to claim any costs, charges and expenses incidental to or incurred in

connection with submission of offer or its consideration by IIITDM Kancheepuram, even though

IIITDM Kancheepuram may opt to modify/withdraw the Invitation to Tender or does not accept

the offer or cancel the tender as a whole.

5

The Premium to include cost of services offered by Third Party Administrator (TPA) for all claims

settled by the insurance company.

During the validity of the current policy, no revision in premium shall be considered by IIITDM

Kancheepuram on the basis of actual claim ratio or any enhancement in the premium pointed

out by any statutory or other authority.

The period of insurance contract will be for 12 Months from the effective date of award of

contract which may further be extended on the discretion of the Institute on satisfactory

performance and claim settlement. In case the insurance company wants to modify the

premium for the extended period i.e., beyond one year, it has to give a notice of at least 2

months prior to the expiry of the current contract period. The terms and conditions regarding

the premium may be reviewed in parlance with the norms applicable and enforced by IRDA and

regulatory bodies.

The terms and conditions of insurance are provided at Annexure I.

1) Number of students would be around 1600. The students would be in the age bracket of 17-

25 years.

2) The employees’ present strength is around 75 and likely to grow in near future. The employees

and their members will be around 100 to 150. It is presumed that the family may consist of

minimum of One member (Self) and the maximum of Six members (Self, spouse, Two children,

Parents) and family is one unit for calculation of premium.

3) Premium will be paid for full tenure with a clause for free entry and exit any time.

4) Waiver of pre-existing diseases & cover period which means that insurance cover starts

from the day one and the pre-existing diseases are also covered from day one.

5) It is informed that the Institute has currently student insurance policy in vogue and Incurred

Claim Ratio (ICR) under the expiring Mediclaim policy is approximately 58.55% and

two claims under accidental insurance policy as on 31.03.2020. The faculty & staff insurance

policies are proposed for First time.

6) The insurance company shall ensure that re-imbursement of claims are processed and

settled within 10 working days.

7) Taking into account the above points, the insurance companies are requested to calculate the premium.

6

Arbitration

All disputes of any kind arising out of supply, commissioning, acceptance, warranty

maintenance etc., shall be referred by either party (IIITDM Kancheepuram or the bidder) after

issuance of 30 days’ notice in writing to the other party clearly mentioning the nature of dispute

and will be referred to the arbitrator to be nominated by The Registrar, IIITDM Kancheepuram.

The Venue for arbitration shall be Chennai, India.

Acceptance of the terms and conditions of tender document

The bidders has to accept all the terms and conditions of this tender document and it is made

known that the bidders quoting for this tender had impliedly accepted the terms and conditions

of this tender

Interpretation of the clauses in the Tender Document

In case of any ambiguity / dispute in the interpretation of any of the clause in this tender

document, interpretation of The Registrar, IIITD&M Kancheepuram shall be final and binding

on all parties. The IIITD&M Kancheepuram reserves the right to accept the offer in full or in

parts or reject the offer summarily or partly without assigning any reasons.

Registrar

IIITDM KANCHEEPURAM

7

Part - A Student Group Mediclaim and Group personal accident policy

Terms & Conditions: Part I

1. Group Mediclaim (GMC) Policy of Rs. 1 Lakh.

2. Corporate buffer of Rs. 50.00 lakhs. The utilization will be at the discretion of the

competent authority of the Institute

3. Pre- existing diseases/ Illness are to be covered from day one.

4. Waiver of 30 days waiting period.

5. Waiver of 1 to 4 years exclusions.

6. 30/60 days pre & post hospitalization to be covered.

7. Premium will be paid for full tenure with a clause for entry at any time on payment of

premium for new students.

8. Cashless facility preferred.

9. Room Rent Restriction: 2% for Normal Room and 4% for ICU on sum insured.

10. Disease Capping is not applicable.

11. Addition/deletion of names of students will be communicated the insurance firm in

a centralized manner by the institute..

12. Claim amount shall be credited directly to students' bank account by NEFT with

intimation to the institute.

13. Turnaround Time (TAT) for processing of claims will be 10 working days, subject to submission of all prerequisite documents i.e. from receipt of claim form by Insurance firm to reimbursement to student by NEFT.

Part II

1. Group Personal Accident (GPA) Policy of Rs. 1 Lakh covering

• Death

• Loss of Limbs, eyes

• Permanent Total Disablement

• Permanent Partial Disablement

• Temporary Total Disablement

8

Part - B Group Employee & Family Group Mediclaim Policy

Terms & Conditions:

I. Group Mediclaim Cover

- Base cover of Rs.3,00,000/- Floater amongst employee and their dependents

Buffer Comprehensive Medical Cover

- Rs.50,00,000/- Floater amongst employees and their dependents with a ceiling of Rs.4,00,000/- per employee/family under conditions listed in buffer utilization – A and enhanced to a ceiling of Rs. 8,00,000/- per employee/family under conditions listed in buffer utilization - B

Claim procedure for buffer (comprehensive medical cover) utilization:

- The treatment which comes under critical illness which are covered for buffer utilization (as listed below) will be recommended by the Institute and forwarded to the Insurance company.

- Illness covered for buffer utilization- A

- Major Surgeries include cardiac surgeries, Neuro Surgeries, Brain tumor, pace maker implantation, cancer and cancer surgeries, hip, knee, joint replacement surgeries, organ transplant.

- Any debilitating illness that may lead to cancer (or) a permanent disability.

- Diseases of the Head & Neck, limbs, Thorax and abdomen where surgeries are indicated for near normal function of life.

- Renal failure.

- Stroke.

- Multiple Sclerosis.

- Major transplants other than those listed in buffer utilization - B

- Major accident claims involving RTA / burns / Lab Accidents where expenditure may incur more than the Sum Insured.

- Complication arising out of surgery performed during the policy period.

- CVA and complications.

- Any Life threatening medical conditions necessitating lifesaving critical care interventions (Not more than 3 claims during the policy period)

Illness covered under buffer utilization B

All Cancers excludes the

following:

(a) Carcinoma in situ including of the cervix

(b) Ductal Carcinoma in situ of the breast

(c) Papillary Carcinoma of the bladder and Stage 1 Prostate Cancer

(d) All skin cancers except malignant melanoma

9

(e) Stage I Hodgkin's disease

(f) Tumors manifesting as complications of Acquired Immune Deficiency Syndrome.

(g) Stage one malignancy (h) Fulminant Viral Hepatitis

Major Organ Transplant, such as for:

(a) Kidney

(b) Lung(s)

(c) Liver

(d) Heart

(e) Bone marrow

- AIDS

- Terminal Illness

Sub-limits

Maternity:

I. Normal Delivery claims:

- Rs.50,000/- (for normal delivery)

- Rs.75,000/- (For Caesarean Delivery claims)

- Rs.75,000/- (For Cataract claims)

- Room rent: 5% & 10 %of the Insurance sum for normal rooms and ICU respectively.

Ambulance charges covered up to Rs.2000/-

Conditions

- Type of Cover – Family Floater Policy.

- Family Definition – family may consist of minimum of one member (Self) and the maximum of Six members (Self, spouse, Two children, Parents).

- Pre-existing disease covered.

- Waiting period for the first 30 days waived off.

- 1,2,3,4 years waiting period waived off.

- Maternity covered with 9 months waiting period waiver.

- Baby day-one cover benefit within the floater SI.

- Pre-post-natal coverage within the maternity limit.

- Day care treatment covered up to the Basic Coverage of SI. Pre-Post hospitalization coverage of 30/60 days respectively.

Entitled room category clause waived off/ No proportionate clause applicable.

- Ayurvedic / Homeopathic /Unani hospitalization expenses are admissible up to Rs.25,000/- only when the treatment is taken as in patient in a Government hospital / medical college hospital.

10

- In case of bilateral knee/hip surgery done during the same hospitalization, reimbursement to be made up to twice ceiling of overall sum insured – Maximum to the limit Rs.2 Lakh per Knee/Hip (The maximum limit of Rs.2 lakh refers to the surgery of per Knee/Hip, irrespective of the enhanced coverage by the employee).

- Both congenital and Psychiatric disorder treatments are payable.

- Dental treatment or surgery due to accidents are payable.

- Corporate buffer will not be applicable for maternity claims and cases of complication of maternity ailments.

- Claim intimation is not mandatory.

- 10% Co-payment will be applicable for each and every claim treated in non PPN hospitals. (This condition need not be insisted for treatments in cities where PPN hospitals are not available.) - All other conditions and terms shall be as per Standard Group Mediclaim policy.

- Domiciliary Hospitalization is not covered.

Exclusions

- Lasik Surgery, Septoplasty, Infertility and related ailment including male sterility, treatment on trial / experimental basis, admin/ registration / Miscellaneous/Service charges, expenses on fitting of external prosthesis, Any device/instrument/machine contributing / replacing the function of an organ, Holter monitoring / Sleep study are outside the scope of the policy.

- Outpatient treatment is not payable.

- Any disease/complication caused due to alcohol intake.

- Any disease/injury caused by war/Nuclear weapons/Radiations/breach of criminal law.

- Circumcision, cosmetic or plastic surgery unless necessitated by an accident or as part of any disease/illness.

- All health check-ups, routine eye examinations, and cost of glasses and contact lenses.

- Naturopathy treatment.

- All other conditions and terms shall be as per Standard Group Mediclaim policy

Hospitalization Period:

Expenses on hospitalization are admissible only if hospitalization is for a minimum

period of 24 hrs. However, this time limit of 24 hours will not apply to following specific

treatments taken in the Network Hospital/Nursing Home/Specialty Centres irrespective of

the bed strength where the insured is discharged on the same day. Such treatment will be

considered to have been taken under Hospitalization Benefit.

- Haemo Dialysis,

- Parenteral Chemotherapy,

- Parenteral Immunotherapy,

- Radiotherapy,

- Lithotripsy (Kidney Stone removal),

- Surgery of Eye,

11

- Surgery of Nose,

- Surgery of Throat,

- Tonsillectomy,

- Bronchoscopic therapeutic procedures,

- Surgery of Hernia,

- Surgery of Hydrocele, Surgery of Prostrate,

Gastrointestinal Surgery,

- Genital Surgery,

- Hysterectomy,

- D&C, MTP,

- Dental surgery / treatment following an accident is covered without hospitalization also (as Out-patient)

- Coronary Angioplasty,

- Coronary Angiography,

- Orthopaedic procedures including POP applications,

- Laproscopic and Endoscopic therapeutic procedures,

- Minor surgical procedures under General Anaesthesia,

- Laser Surgical Procedure under Local naesthesia

- EECP

- OR any other treatments agreed by TPA / Company which require less than 24 hrs.

hospitalization due to advancement in Medical Technology.

Time limit for preferring claim

Whenever treatment is taken for the employees/dependents covered under the scheme in any of the non-network hospital of the TPA, and the employee pays the hospital bills, the Insurance claim should be sent in the prescribed claim form along with all supporting documents, such as Discharge Summary, prescription and Pharmacy bills, Lab / investigation reports in original, ECS form & cancelled cheque (or) First page of Bank Passbook copy within 30 days direct to the TPA

II. Employees only: Group Personal Accident (GPA) Policy of Rs. 10 Lakh cover

• Death

• Loss of Limbs, eyes

• Permanent Total Disablement

• Permanent Partial Disablement

• Temporary Total Disablement

12

Part - I : TECHNICAL BID

Name of the Bidder

Address of the Bidder

Status of the Company (Public Ltd. / Pvt. Ltd.)

Details of the Incorporation of the Company Date

Valid GST No

State of Registration (IRDA Registration) Attach Document

Permanent Account No. (PAN)

Name & Designation of the Contact person to whom all

references shall be made regarding this tender

Telephone No. (with STD Code)

Email Address of the contact person

Fax No. (with STD Code)

Website

Annual Turnover for last three years

(Document Proof to be attached)

2016-17: 2017-18 / 2018-19

Medical insurance participation in a minimum three major

companies / institutions (Document Proof to be attached)

after 01 Jan 2017

1…………………….. 2…………………..

3…………….

Declaration stating that they have not been Black-

Listed/De-listed or are put to any holiday by any Indian

Institutional Agency/Government Department/Public

Sector Undertaking in the last three years.

13

Part II : Financial Bid

Part - A - Students

Policy Premium per student

Group Mediclaim Policy

Group Personal Accident Insurance

Policy

Total

Part - B – Employee

Policy Premium per employee

Group Mediclaim Policy for employee

and family

Group Personal Accident Insurance

Policy for employee

Total

GST extra if applicable:

Note:

1. A composite score with 60% of weightage shall be given to the Student Premium and 40%

for Employee Premium value.

2. The lowest bid of the students premium will be given a score of 60% and lowest bid of the

employees premium will be given a score of 40% weightage. The score obtained will be

added and the bidder getting the highest score will be awarded tender.

Authorized Signatory of the Insurance Firm

Name & Address of the Insurance Firm with Office Stamp

Place: Date: