Our Policies

Mediclaim Insurance Scheme for Retired Employees

1. Company to extend the Mediclaim facility:  Bajaj Allianz General Insurance Co. Ltd.

2. Objective:  To extend mediclaim insurance benefits upto a maximum limit of Rs.1.5 lacs on floater basis to each of the retired employees and his/her spouse who would become the member of the scheme for treatment in India against payment of Premium of Rs.2928/-.

3. Eligibility:  Employees retired on attaining the age of superannuation/voluntary retirement/ spouse of the employees who died whilst in service or after retirement. Employees terminated on grounds of misconduct will NOT be eligible.

4. Family: Retired employee himself/herself and his/her spouse.

5. Maximum Entry Age Limit:   80 years.

6. Disease: Any illness, ailment, disease or injury warranting hospitalization. All pre-existing diseases will remain covered.

7. Hospitalisation:  Expenses on hospitalisation for minimum period of 24 hours are admissible excepting certain listed “Day Care Procedures” where 24-hours hospitalisation will not be mandatory. 

8. Pre & Post Hospitalisation period: 30 days as pre-hospitalisation and 60 days post-hospitalization period.

9. Room Tariff Per Day:  Rs.750/-(for ICU/ICCU-Rs.2,000/- & Cataract Operation- Rs.7,500/-)

10. Minimum Group Size: 1000 retired employees.(Scheme will be launched with atleast 500 nos)

11. Cash-less Facility/Claim for Reimbursement under the Scheme: The Insurance Company will provide Cash-less facility for hospitalisation through their network Hospitals as per the list of Hospitals (to be sent to the individual members directly by the Insurance Company along with the Health Card). Health Card is to be produced at the time of Admission. Prior to hospitalisation at a Network Hospital a member will be required to obtain  pre-authorisation from the Insurance Company by sending intimation on the toll free number - 1800225858, 18001025858 or 02030305858 and Cell-9903999847 (Anjana Das) or 9831435715 (Debolina Sarkar). A member of the scheme may also get him/her admitted in a non-network hospital.  In such cases, intimation may be sent to one of the above telephone numbers of the Insurance Company within a period of 07 (seven) days from the date of admission in the hospital.In such cases, related claims are to be sent directly to the Insurance Company to their address located at Bajaj Allianz General Insurance Co. Ltd., Horizon, 57, Chowringhee Road, Kolkata - 700 071:  a)Self attested photocopy of First prescription from the Doctor, b)The Claim Form duly signed by the claimant or family member, c)Self attested photocopy of the Hospital discharge card, d)Self attested photocopies of all laboratory and diagnostic test reports, e)All original bills and money receipts and f)In case of cataract operation, IOL sticker.

12. False Claim/Information: In case any false claim/information/document is found to have been submitted by any member at any stage, his/her membership will be cancelled forthwith and appropriate actions will be taken against him.

13. General: Employees who have retired prior to 31.03.2008 may join the scheme on or before 15.04.2008. Mid-term inclusion of employees who would be retiring on and after 31.03.2008 up to 28.02.2009 is permissible within 2 months of their retirement against payment of pro-rata premium.

Click here to download the Annexure