1. “A New Revolution In Health – Care”
SyndArogya
“A New Revolution In
Health – Care”

2. SyndArogya Mediclaim Insurance cum Personal Accident Scheme.
Individual Policy with benefit of Group
size of 2 lacs policy holders
Floater 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

3. SyndArogya Benefits 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.

4. Benefits to Policyholders
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

5. 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

6. 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

7. 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

8. Unique Benefits in SyndArogya
No Medical Checkup even above 45 years
Pre-existing diseases covered from 4th year subject to certain conditions
In 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

9. SyndArogya TPA(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.

10. 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 Hospitals
Reimburses to Policyholders expenses incurred in Non networked hospitals
Call centre facility with Toll free no. and Website

11. 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.

12. 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.

13. Main Exclusions Domiciliary 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

14. Premium Table Sum Insured Plan-A(1+3) Plan-B(1+5) with “Parents”
(Amt in Rs.)
Sum Insured Plan-A(1+3) Plan-B(1+5)
with “Parents”
50,
1,00,
1,50,
2,00,
2,50,
3,00,
3,50,
4,00,
4,50,
5,00,
NB:Premium all inclusive of charges for TPA and Service Tax

15. Thank You