syndarog new

“A New Revolution In Health – Care”

SyndArogyaMediclaim Insurance cum Personal Accident Scheme.Individual Policy with benefit of Group

size of 2 lacs policy holdersFloater 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

SyndArogyaBenefits 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.

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

Benefits to Policyholders

Attractive Benefits Added to SyndArogya

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

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 yearsPre-existing diseases covered from 4th year subject to certain conditionsIn Addition to hospitalisation charges, following death claim Payable in case of accident resulting into death within one year from the date of accident

Accountholder 100% of Sum Insured selected Spouse 50% of SI Child above 5 years 20 % of SI Child below 5 years 10% of SI

SyndArogyaTPA(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 HospitalsReimburses to Policyholders expenses incurred in Non networked hospitalsCall 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 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 ExclusionsDomiciliary 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