Group Health/Mediclaim Insurance Policy
This is a Health insurance policy issued to a group rather than individuals, covering the cost of Medical Expenses of members included in the group. This policy will always be named policy and cannot be issued on an unnamed basis. It covers in-patient hospitalization of a minimum of 24 hrs due to disease or accident. Major Factors determining the premium are the sum insured opted, Size of the Group, Demographics of the Group like Age, Occupation Etc., Covers Opted in the Policy, and claim ratio if it is a renewal.
This policy is tailor-made, so any Reasonable & Customary Medical expenses could be covered at the time of purchasing the policy, on payment of the agreed premium. Some of the common covers are inpatient Hospitalization Expenses (Room & Nursing Charges, Tests and Investigation expenses, Medicines & Injections), Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees, Pre & Post Hospitalization expenses for a specified number of days, Cover for Pre-Existing Diseases, Ambulance charges, etc.
- Cashless Treatment at Network Hospitals
- Reimbursement of incurred medical expenses in case of Non-Network hospital or any other case
Group Personal Accident Insurance Policy
As the name suggests, this is a personal accident policy, issued to a group rather than individuals, covering consequences of unexpected accidents resulting in Death or Disability to the members included in the group. Major Factors determining the premium are the sum insured opted, Size of the Group, Demographics of the Group like Age, Occupation Etc., Covers Opted in the Policy, and claim ratio if it is a renewal.
Basic covers offered in this policy are Death, Permanent Total Disablement (PTD), Permanent Partial Disablement (PPD), Temporary Total Disablement (TTD), and Reimbursement of Medical Expenses. There is some scope of customization of covers on payment of agreed premium like Cost of prosthetic limbs, Vehicle & Home modification expenses, etc in case of disability, Cremation charges, Carriage of Dead body, Child Education Benefit, etc in case of death.
- Notify the insurer as soon as possible
- Lodge FIR with police as per the situation, if need be
- Arrange and provide the documents, as required by the insurer to settle the claim
Group Travel Insurance
A group travel policy offers coverage and protection to anyone traveling from that organization on a business trip or an official trip. It is an insurance product for covering unforeseen losses incurred while traveling, either internationally or domestically.
Basic Mediclaim policies generally only cover emergency medical expenses while overseas, while travel policies typically include coverage for trip cancellation, lost luggage, flight delays, public liability, and other expenses.
- Inform the Insurance Company with a rough estimate of the loss as soon as possible.
- If your belongings are lost or stolen, you should tell the local police within 24 hours of the items going missing. If this isn't possible, tell someone else such as your tour rep, hotel manager, or transport provider, and get a written report.
- If you have to replace essential items, such as toiletries or emergency clothing, ask for receipts to send as evidence with your claim.
- If you need medical treatment while you're away, try to contact your insurer straightaway and get them to agree to the treatment. You should do this before it's carried out, although this may not be possible in an emergency.
- Always make sure to get receipts for any treatment or medication you're given.
- Furnish all such Information and documentary evidence as the Insurer may require
Workmen/Employee Compensation Insurance
The WC policy offers legal liability coverage to employers in respect of compensation paid to employees for bodily injury or death caused due to accidents, or occupational ailments arising out of and during employment. As per the guidelines laid by Workmen Compensation Act 1923 and its subsequent amendments, employers have to give compensation to their employees &/or to their families in case of Job-related injuries that may result in death & disability.
The compensation amount depends upon the nature of the injury, age, and earnings of the claimant.
This policy operates strictly as per the provisions laid down by WC Act 1923 & subsequent amendments thereof, Fatal Accidents Act 1855 & subsequent amendments thereof, and Common Law. It covers any legal liability towards employees against any accident during and in the course of employment due to Death and/or disability.
- Notice to the Insurer as soon as possible after the accident by the employee
- Claim Will be settled on a reimbursement basis only
- Amount will depend on awarded by the WC commissioner or other competent Authority
- The claimant shall give notice of the accident to the employer or by entering the notice book within a reasonable period.
- Every such notice shall give the name and address of the person injured, the cause of the injury, and the date on which the accident happened and Submit the claim application to the commissioner within two years from the date of the accident.
- Defectsif any in the notice or not giving notice or delayed application will not bar the compensation claim.