Simplifying healthcare

Multiplying Prosperity
Presentation of Services and Health Insurance benefits
offered by National Insurance Co Ltd

For Students of XLRI

Network Of Hospitals
⚫
⚫
5400 + HOSPITALS
5400 + HOSPITALS

⚫ COVERING 20STATES
STATES/ 75
/ 75 DISTRICTS
> Cashless Service
⚫ COVERING 20 DISTRICTS > Reimbursement Claims
Network hospitalsatatJamshedpur
Network hospitals Jamshedpur location:
location:
> Sum Insured Per Person – 5 lacs
> Mobile Apps and Portal to facilitate with e-cards
⚫ Tata Main
Tata MainHospital
Hospital and claims status
⚫ Steel
Steel City
CityClinic
ClinicAnd
AndResearch Centre
Research Centre > Pre-existing diseases covered
⚫
⚫ Kantilal
KantilalGandhi
GandhiMemorial
MemorialHospital
Hospital > 30 days Pre Hospitalization and 60 days Post
⚫
⚫ Brahmananda
BrahmanandaNarayana
NarayanaHrudayalaya
Hrudayalaya Hospitalization coverage
⚫
⚫ Asg
Asg Hospital
HospitalPvt
PvtLtd
Ltd > No room rent capping
⚫
⚫
Purnima Netralaya
Purnima Netralaya= > No waiting period for any treatment
⚫ Jamshedpur Eye Hospital >Cataract Treatment Limit – Rs. 30,000/- Per Eye
⚫
⚫
Jamshedpur Eye Hospital – (Empanelment in process)
Tata Motors Hospital – (Empanelment in process)
>Ambulance facility for emergency transportation
⚫
⚫
Tata Motors Hospital – (Empanelment in process)
ADMH Hospital – (Empanelment in process)
– Rs. 3000/- per hospitalization.
⚫ ADMH Hospital – (Empanelment in process)
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 Other Terms

Insured Persons : Students of XLRI

Type of Policy : Group Mediclaim Policy

Policy Period : 17.06.2019 to 16.06.2020

• Ayurvedic and homeopathic treatments are covered

• Psychiatric treatments are covered
• No sub limit / Co pay clause is applicable
• No intimation clause is applicable for reimbursement claims
• Day care surgeries are covered
• 50% Co- pay for cyber knife treatment / Stem cell transplantation
• Reimbursement claim documents should be submitted within 30 days from the date of discharge

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 Exclusions:

• Intentional self-injury/use of intoxicating drugs or Exclusions under the policy

liquor or Disease directly due to one or more of them
• Vaccination/ Inoculation/ Circumcision other than Treatment Others
medical grounds
Lasic Surgery (Laser barrage etc) /
• Venereal diseases
Refractive error correction / Squint Genetic Disorder
• Beauty treatment (including plastic surgery unless
necessitated by an accident) Harmonic Replacement therapy Admission for investment / evaluation
• Cost of eye glasses /lenses/frames
• Cost of diagnostic studies not related to medical Weight control programme Pre/ Post hospitalization under maternity
treatment covered under the policy.
• Injury/disease related to radio activity Cost incurred to replace batteries or leads of
Donor Screening charges pacemaker
• Injury/disease due to war and war related operations.
• HIV , Aids and diseases related to T cells. Dental treatment Cochlear implant
• Dental treatment unless caused due to an accident
where hospitalization is required. Home visit charges Multifocal lens under cataract treatment
In case of any dispute on the disease / treatment interpretation, insurance co's
decision will be final.
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 Reimbursement Claims - CHECK LIST :
• For Hospitalization/Daycare Reimbursement claim.
• A) Original Detailed Discharge Summary of Hospital/Nursing Home.
• B) Original Detailed Final Bill of Hospital/Nursing Home.
• C) Original Detailed Break-Up of Final Bill.
• D) Original Receipt of Payment of Final bill (advance & balance amt.).
• E) Original reports of all investigation & radiology
• F) All Doctor Prescriptions for Medicines & Lab Investigations.
• G) All Lab Investigation Reports.
• H) All Medicines/Pharmacy/Medical Store Bills.
• In Case of Road Traffic Accident & Fracture.
• Non Alcohol Influence Certificate to the Treating Doctor.
• Medico Legal Certificate (MLC Copy) / Copy of FIR
• GPLA History (Gravida Para Living Abortion) Certificate to the Treating
Doctor.
• Duly filled and signed reimbursement claim form Part A & B ( Form Part B
needs to get filled and signed by the hospital. )
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For Pre/Post Hospitalization Reimbursement Claim.
A)- Receipt of Payments.
B)- All Doctor Prescriptions for Medicines & Lab Investigations.
C)- All Lab Investigation Reports.
D)- All Medicines/Pharmacy/Medical Store Bills.
For Major Investigation Reimbursement claim.
A)- Receipt of Payments.
B)- All Doctor Prescriptions for investigations.
C)- All Investigation Reports.
• Duly filled and signed reimbursement claim form – Part A
Please submit all original claim documents within 30 days from date
of discharge to our representative.
NOTE:- Kindly keep a set of Xerox copy of all the documents at your
end for further reference
 Contact Details / Escalation Matrix of Medi Assist:
Please contact the below mentioned executives for any queries.

Level Contact Person Mobile No : Email ID Nature Of Services

1st Barish Kumar Sinha 7781003588 Barishkumar.sinha@mediassist.in CRM

2nd Vikash Kr. Gupta 9523099045 vikas.gupta@mediassist.in Team Leader

3rd
Subhendu Banerjee 9523099047 subhendu.banerjee@medibuddy.in Manager

Wish you a healthy and happy future !

Thank you ☺
Medi Assist Insurance TPA Pvt. Ltd.
www.mediassistindia.com
5 Copyright © 2017 Medi Assist