Transcript SyndArogya - Syndicate Bank

“A New Revolution In
Health – Care”
SyndArogya
Mediclaim Insurance cum Personal Accident
Scheme.
Individual Policy with benefit of Group
size of 2 lacs policy holders
Floater Policy 1+3 (Husband, wife & two
dependent children) with premium as per
Plan A table and 1+5 (Husband, wife, two
dependent children & dependent Parents)
with premium as per Plan B table annexed
SyndArogya
Benefits to Policyholders
Mediclaim Scheme meets 100 % of all types of
Hospitalisation Expenses viz.:
 Room Rent
 Doctors’/Surgeon Fees
 Medicine & Drugs
 Anesthesia, OT, Diagnostics Materials
 Blood, Oxygen, X-ray
 Chemotherapy, Radiotherapy
 Nursing expenses
 Cost of pacemaker & Artificial Limbs etc.
Benefits to Policyholders
Cashless Facility at Networked Hospitals of
TPA
Treatment at any Hospital/Nursing Home in
India
Relevant medical expenses 30 days prior to
and 60 days subsequent to hospitalisation
covered
Income Tax relief on Premium under S80D
Attractive Benefits Added to
SyndArogya
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Cover Available to Dependent Parents also
as per Plan B. Entry age for parents also 65
years renewable up to 80 years of age.
Ambulance charge up to Rs 1000/Maternity Benefits and Baby Care covered up
to maximum 5% of Sum Assured
Max Sum Insured Increased to Rs 5 lacs in
multiples of 50000
Cost of Health Check reimbursed up to 1% of
Average Sum Insured after 3 claim free years
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Hospital cash up to Rs 1000 in case of
hospitalisation of child below 12 years age
Treatment anywhere in India, Nepal or
Bhutan in Indian currency
Unique Benefits in
SyndArogya
Floater Policy i.e. any one or all dependant
family members up to 4 (Plan A) or 6(Plan B)
can take benefits to the maximum extent of
Sum Insured
Sum Insured Min Rs 50000/- Max Rs 5 lacs
Uniform Premium irrespective of age of main
policyholder i.e. min 5 years maximum 65
years renewal up to 80 years Min Floater age
3 months baby if covered with parents
Unique Benefits in
SyndArogya
No Medical Checkup even above 45 years
Pre-existing diseases covered from 4th year
subject to certain conditions
In Addition to hospitalisation charges,
following death claim Payable in case of
accident resulting into death within one year
from the date of accident
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Accountholder 100% of Sum Insured selected
Spouse 50% of SI
Child above 5 years 20 % of SI
Child below 5 years 10% of SI
SyndArogya
TPA(Third Party Administrator)
Following Outsourced Third Party agency
(TPAs) are empanelled by United India for
servicing SyndArogya insurance policies
1) Med Save Health Care Ltd. 2) Medicare TPA
Services (I) Pvt.Ltd. 3)TTK Healthcare Services
Pvt. Ltd. 4) GENINS India Ltd. 5) Heritage
Health Services Pvt.Ltd. 6) M/s Vipul Medcorp
Pvt Ltd. 7) E-Meditek Solutions Ltd.
Role of TPA
(Third Party Administrator)
Issues Photo identity card, Insurance
Certificate, Members Guide Book with list of
Network Hospitals, Certificate
Arranges Cashless facility at Networked
Hospitals
Reimburses to Policyholders expenses
incurred in Non networked hospitals
Call centre facility with Toll free no. and
Website
SyndArogya
Claim Procedures
For treatment at Non-networked hospitals:
 Intimation immediately after hospitalisation
 Claim for reimbursement within 15 days
from discharge or completion of post hosp treatment
Documents required:
 Copy of policy & Photo Identity card
 Original of discharged summary & consolidated bills
with breakup
 Original reports and pharmacy bills with break up.
SyndArogya
Claim Procedures
For Treatment at Networked Hosp. no claim
as cashless facility. Prior Authorisation
required from TPA before commencing
treatment for cashless facility.
For Personal Accident death claim
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Notice to Nodal Office of Insurance Co.to get
claim form
Filled up claim form , FIR, Death Certificate,
Postmortem report, legal heir certificate etc.
Main Exclusions
Domiciliary hospitalisation
Pre-existing diseases (covered from 4th year onwards if without any
break in cover)
Waiting period of first 30 days - commencement of policy except
those arising out of accident.
Treatment for Cataract, benign, prostatihypertrophy, hysterectomy,
hernia, hydrocele, piles, sinusitis, etc., during the first year of
operation of insurance cover.
Cost of spectacles, hearing aids, vitamins, tonics and expenses
relating to dental treatment, convalescence, general debility,
naturopathy, etc.
Dental treatment unless requiring hospitalisation
Premium Table
(Amt in Rs.)
Sum Insured
Plan-A(1+3)
Plan-B(1+5)
with “Parents”
50,000
956
1597
1,00,000
1848
3085
1,50,000
2709
4519
2,00,000
3488
5815
2,50,000
4181
6967
3,00,000
4875
8120
3,50,000
5484
9131
4,00,000
6094
10143
4,50,000
6706
11156
5,00,000
7316
12167
NB:Premium all inclusive of charges for TPA and Service Tax
Thank You