Never compromise on your and your loved one’s health

The Mediclaim Policy allows reimbursement of medical expenses incurred towards the ailment / disease for which hospitalization was necessitated prior to hospitalization and up to a certain number of days after discharge.

This is subject to the limits as described in the policy. The medical expenses incurred prior to Hospitalization are called pre- hospitalization expenses and those incurred subsequent to discharge as post Hospitalization expenses.

Send all bills in original with supporting documents along with a copy of the discharge summary and a copy of the authorization letter to the nearest TPA Office. TPA will scrutinize the claim and settle the bills subject to the overall limit of the policy, provided the main hospitalization claim is admissible. The bills must be sent to TPA within the defined period from the date of completion of treatment.

MLC Copy, a Medico – Legal certificate is the certificate signed by the policeman and issued by the hospital for medico legal cases (cases where police need to be kept informed). On admission to the hospital, hospital medical staff will identify the cause or nature of illness / disease / accident and if required will inform the police about the case. Policeman will visit the hospital to enquire the cause and sign the MLC Copy.

Floater is a privilege offered to the client only in case he opts for "Group Mediclaim Policy". Unlike the individual policy, where a family (Husband / Wife / children) is covered for the Sum Assured so desired, independent of each other, and pays the premium accordingly, in a Floater - a float amount is shared by the family members Or by the employee families.

The policyholder is required to fill the request for pre- authorization letter and send through fax/other means to the nearest TPA office mentioned in the user Guide or TPA web site. TPA will scrutinize the request for authorization letter and send an authorization letter or regret letter. Request for pre-authorization letter are available with TPA office or can be downloaded from TPA website.

Maternity coverage will cover Hospitalization expenses towards delivery (normal / operative) and hospitalization expenses towards complications of maternity during the antenatal & postnatal period. Antenatal and postnatal outpatient expenses are not covered under maternity benefit coverage, unless mentioned in the policy.