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Insurer : Bajaj Allianz General Insurance Co. Ltd
Group Mediclaim Top-Up Policy : 2013-14
Top Up Policy – Features of the policy
This is a Top up cover over the Group Mediclaim Family Floater Policy for the employees and dependents of United Phosphorous & Tatva Global Group.
The Sum Insured under the Top up cover is on individual basis and will remain the same for the entire family. The cover would trigger after the exhaustion of the limit of sum insured under the base policy vide policy No:
OG-14-1901-8403-00000037 and 8403-00000036
Family definition – As per base policy. Coverage remains the same as the employee policy but this policy can be utilised only when the base policy sum insured gets exhausted
Pre-existing diseases covered and all pre-existing diseases would be covered
without any waiting periods under the scheme.Maternity benefit : Maternity limit Rs.35,000/- for normal and
Rs.45,000/- for Caesarian
Cashless e-cards will be provided for each family covered under the base policy. Cashless Facility only to employees and not to dependants.
Only addition for new joinees/spouse/new born baby allowed during the policy period subject to getting enrolled to the policy.
Premium: Per family premium table inclusive of service tax
Service Tax @ 12.36% included in the above
Above quote and Premium would be available subject to 30% of the employees getting enrolled under the Additional/Top-UP Cover.
Top Up Sum Insured
Premium With Maternity Cover
Premium Without Maternity Cover
Annual Prorata01/09/2013 Annual
Prorata we.f01/09/2013
100000 8136 5276 7160 4806
150000 8946 5803 7873 5284
200000 9760 6331 8589 5765
300000 11714 7598 10308 6919
500000 16867 10941 14843 9963
1000000 29195 18937 25691 17245
Claim Intimation and Escalation Matrix
Claim Intimation and Escalation Matrix:
All reimbursement claim intimation emails to be sent directly to:
Escalation Matrix:
Levels Contact Person Contact nos
Email ids
First point Saveena Hegde 022-66197508
Second Point
Dr. Rashmi Sachdev 7738395815 [email protected]
Ajay Kurup 7738257002 [email protected]
Third Point Jayesh Kadam 8451914209 [email protected]
For any other issues/queries please call on the below Nos:
Cashless: 020 -30305858 or send an emai to: [email protected]
General queries on e-cards – email to: [email protected]
All other queries: [email protected],
Necessary Documents for claim submission
Bajaj Allianz claim form duly signed by insured with a copy of the E-card
Reimbursement check list
Bill detail sheet
First Consultation Letter
Original Discharge Summary
Original Final Hospital Bill giving detailed break up of all expense heads
mentioned in the bill
Stamped receipt for final hospital bill
Pharmacy cash receipts/ cash bills along with supporting prescription Reports
towards investigations done, Pathology/ Radiology/ Cardiology
Original paid receipt towards the investigation charges
In case of a Cataract Operation, the IOL Sticker
( Each bill with prescription pasted & numbered on separate paper)
Claims Procedure & Health Helpline
In case the claim amount is more than the base sum insured both the card
details to be updated.
BAGICL Register claim & intimate requirements to insured
Process claim after receipt of complete documents
Dispatch Cheques along with discharge vouchers are sent to Insured
Health Helpline
Exclusive Health Call Centre to service our cardholders
24 X 7 helpline available for emergencies
Facility to send online requests /queries & response Turn Around Time 20
Min.
Follow up with member for complaints received
Information on special discounts / packages / schemes
Information on hospitals, doctors, diagnostic centres, ambulance services
and health products
