What is Mediclaim Insurance?

Mediclaim insurance, also known as health insurance, is a type of insurance coverage that pays for medical and surgical expenses incurred by the insured. Depending on the policy terms, mediclaim can either reimburse the insured for expenses incurred from illness or injury, or pay the care provider directly.

Benefits of Mediclaim Insurance

Financial Protection

Our mediclaim policies provide comprehensive coverage for hospitalization, medical treatments, and surgeries, protecting you from the high costs of medical care. This includes expenses for room rent, ICU charges, doctor’s fees, and medication.

Cashless Treatment

With our extensive network of hospitals, you can avail cashless treatment, eliminating the need for upfront payments during emergencies. Simply present your mediclaim card at any of our network hospitals, and we will handle the rest.

Pre and Post-Hospitalization Coverage

Our mediclaim insurance not only covers the expenses incurred during hospitalization but also takes care of medical costs incurred before and after hospitalization, such as diagnostic tests and follow-up consultations.

Daycare Procedures

Advances in medical technology have led to an increase in treatments that do not require a prolonged hospital stay. Our policies cover numerous daycare procedures, ensuring you receive the necessary treatment without extended hospitalization.

Ambulance Charges

In the event of an emergency, ambulance services can be critical. Our mediclaim policies cover the costs of ambulance transportation to ensure you get swift and safe access to medical care.

No Claim Bonus

As a reward for staying healthy, we offer a no-claim bonus for every claim-free year. This bonus can increase the sum insured in the subsequent policy year, providing you with higher coverage at no additional cost.

Tax Benefits

Under Section 80D of the Income Tax Act, premiums paid for mediclaim policies are eligible for tax deductions, providing you with significant tax savings.

Types of Mediclaim Policies

Individual Mediclaim Policy

Designed for individuals, this policy covers the medical expenses of a single person. It’s an ideal choice if you are looking for coverage tailored to your specific health needs.

Family Floater Mediclaim Policy

Our family floater plan covers the entire family under a single policy. The sum insured is shared among all family members, making it a cost-effective way to ensure comprehensive health coverage for your loved ones.

Senior Citizen Mediclaim Policy

Specially designed for the elderly, our senior citizen mediclaim policy offers extensive coverage for age-related health issues, ensuring your parents or elderly relatives receive the best possible care.

Group Mediclaim Policy

Aimed at businesses and organizations, our group mediclaim policy provides health coverage for employees, enhancing their well-being and job satisfaction. It’s an excellent benefit to attract and retain talent.

How to Choose the Right Mediclaim Policy

Assess Your Needs

Evaluate your health needs and those of your family members. Consider factors like age, medical history, and any existing health conditions to determine the coverage amount and type of policy that best suits your needs.

Compare Plans

Review different mediclaim policies to understand the coverage, benefits, and exclusions. Compare the premium amounts and choose a plan that offers maximum benefits at a reasonable cost.

Network Hospitals

Check the list of network hospitals associated with the mediclaim policy. A larger network of hospitals ensures you have easy access to cashless treatment in case of an emergency.

Read the Fine Print

Understand the policy terms and conditions, including waiting periods, co-payment clauses, and sub-limits. Being aware of these details helps avoid any surprises during claim settlement.

Claim Process

Cashless Claims

1. Pre-Authorization: Inform us about your hospitalization at least 48 hours in advance for planned treatment or within 24 hours for emergencies. Obtain a pre-authorization form from the hospital and submit it to our TPA desk.
2. Verification: Our team will verify the details and approve the cashless treatment if the claim is within policy terms.
3. Treatment: Proceed with the treatment without worrying about upfront payments. We will settle the hospital bills directly.

Reimbursement Claims

1. Hospitalization: Pay the hospital bills at the time of discharge.
2. Claim Submission: Submit the claim form along with original bills, discharge summary, and other relevant documents to us.
3. Verification and Payment: Our team will verify the documents and process the claim. The approved amount will be reimbursed to your account.