1. Insurer : Bajaj Allianz General Insurance Co. Ltd Policy No: OG-14-1901-8403-00000037 Policy Period: 25 th April 2013 to 24 th April 2014 Group Mediclaim Policy Renewed Terms : 2013-14

2. Group Mediclaim – Standard Coverage features of the policy Hospital Expenses, Pre Hospitalisation expenses (30 days) & Post Hospitalisation expenses (60 days) excluding Maternity Cashless Hospitalisation at over 2300 hospitals all over India Reimbursement claims GENERAL HOSPITALISATION EXPENSES: In-patient hospitalisation (for a period exceeding 24 hours) Expenses on hospitalisation for minimum period of 24 hours are admissible. However, this time limit will not apply for specific treatments i.e. Dialysis, Chemotherapy, Radiotherapy, Eye Surgery, Lithotripsy (kidney stone removal), tonsillectomy, D&C taken in the hospital/Nursing Home. Expenses reimbursed under the policy: Room Charges as provided by the hospital / nursing home, Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists fees Anaesthesia, Blood oxygen, operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Diagnostics Materials & X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs & Cost of organs & similar expenses

3. Group Mediclaim – Policy Coverage Details Floater Policy: Sum insured Various as specified. Cover: Employee/Self + any 5 dependants Dependants – Self, Spouse, 2 children – Upto the age of 21 and 2 Dependant Parents / Parents – in law (Parents - Only 1 set of parents upto the age of 90 years) Maternity limito Rs.35,000/- for normal and Rs.45,000/- for Caesarian. No waiting period. Baby cover from day one. Maternity coverage applicable only for self and spouse. Pre & post natal expenses covered within maternity limit only in case of hospitalization. OPD treatment for pre and post natal expenses will not be covered Room rent restricted to 1% of the SI in case of Normal Hospitalization & 2% of the SI in case of ICU. All other charges in accordance with room rent restrictions. Pre-existing diseases are covered./1yr exclusion + 30 days exclusions are waived. Pre & post hospitalization is 30 & 60 days.

4. Group Mediclaim – Policy Coverage Details Capping on below : a)C ataract Rs. 25,000/- b) Appendicitis Rs. 30,000/- c) Hernia Rs. 30,000/- d) Haemorthoids Rs. 20,000/- Internal congenital diseases are covered under the policy. Cashless e-cards will be provided for each family covered under the policy. Cashless Facility only to employees and not to dependants. Dental treatment as per policy conditions ie only in case of accident No Individual (Employee or Dependant) can be covered more than once in a policy. Mid term additions allowed for newly wed spouse & newly born children only. Any additions for new employee, spouse or children would be allowed within 30 days of date of joining, marriage or birth respectively. Any endorsements will be from the date of joining if float is maintained.

5. Group Mediclaim - Standard Exclusions Treatment for injuries arising out of an act of War. Circumcision unless necessary for treatment of a disease due to an accident or as a part of any illness. Routine eye examinations and cost of glasses, contact lenses and hearing aids and all external aids. Dental treatment or surgery of any kind unless requiring hospitalisation arising out of an accident. Convalescence, general debility, "Run-down" condition or rest cure Congenital external disease Venereal diseases, AIDs/HIV Intentional self-injury and use of intoxicating drugs/alcohol. Any fertility, infertility, sub-fertility or assisted conception operation, treatment for sterility. Charges incurred in the hospital purely for diagnostic purpose. Injury or Disease directly or indirectly caused by or contributed to by nuclear weapons/materials or radioactive contamination. Dental treatment or surgery of any kind unless requiring hospitalisation arising out of an accident. Convalescence, general debility, "Run-down" condition or rest cure Congenital external disease Venereal diseases, AIDs/HIV

6. Group Mediclaim - Standard Exclusions Intentional self-injury and use of intoxicating drugs/alcohol. Any fertility, infertility, sub-fertility or assisted conception operation, treatment for sterility. Charges incurred in the hospital purely for diagnostic purpose. Injury or Disease directly or indirectly caused by or contributed to by nuclear weapons/materials or radioactive contamination. Expenses on vitamins and tonics unless forming part of treatment for injury or disease as certified by the attending Physician. Treatment arising from or traceable to pregnancy Voluntary termination of pregnancy Any routine or preventative examinations, vaccinations, inoculation or screening. Outpatient treatment charges Change of Sex. Any cosmetic, plastic surgery, or aesthetic procedure. Any treatment received outside India. Naturopathy treatment. Use of intoxicating drugs / alcohol and the treatment of alcoholism, solvent abuse, drug abuse or any addiction and medical conditions resulting from, or related to, such abuse or addiction. Any stay in hospital for any domestic reason or where there is no active regular treatment by a specialist.

7. Group Mediclaim - Claims Process In case of treatment at empanelled hospital across India, intimate Bajaj Allianz to avail cashless facility. In case of treatment at non empanelled hospital, submit claim form along with all the necessary documents for reimbursement immediately or within 3 days for registration.of claims. The updated list of network hospitals is also available on our website under quick links section (refer below link) and check the same by updating State and City https://www.bajajallianz.com/BagicNxt/hm/hmSearchState.do https://www.bajajallianz.com/BagicNxt/hm/hmSearchState.do Attached is the claim form along with the NEFT form and pre-authorisation form

8. Policy issued by BAGIC Health card and hospital list & Mediclaim forms will be available on the link.. Planned admission Hospital verifies the card Emergency admission Pre-authorization sent to BAGIC callcentre by hospital HAT Medical team at HO reviews details of pre-authorization Cashless granted Patient avails treatment and is discharged Hospital sends claim to HAT Claim documents are verified by HAT team Insured approaches hospital Patient avails treatment and is discharged Insured intimates and send claim form and required documents to HAT for reimbursement Claim payable, payment send to insured or hospital Cashless HospitalizationReimbursement claims Get hospitalized Pay deposit, which will be refunded after cashless approval Network HospitalNon Network Hospital Claim Process

9. Necessary Documents for claim submission Bajaj Allianz claim form duly signed by insured with a copy of the E-card Reimbursement check list Bill detail sheet First Consultation Letter Original Discharge Summary Original Final Hospital Bill giving detailed break up of all expense heads mentioned in the bill Stamped receipt for final hospital bill Pharmacy cash receipts/ cash bills along with supporting prescription Reports towards investigations done, Pathology/ Radiology/ Cardiology Original paid receipt towards the investigation charges In case of a Cataract Operation, the IOL Sticker ( Each bill with prescription pasted & numbered on separate paper)

10. Claims Procedure & Health Helpline Insured intimates BAGICL regarding Accident / Hospitalization BAGICL Register claim & intimate requirements to insured Process claim after receipt of complete documents Dispatch Cheques along with discharge vouchers are sent to Insured Health Helpline Exclusive Health Call Centre to service our cardholders 24 X 7 helpline available for emergencies Facility to send online requests / queries Response Turn Around Time of 20 minutes Follow up with member for complaints received Information on special discounts / packages / schemes Information on hospitals, doctors, diagnostic centres, ambulance services and health products

11. How we are different………  HAT services only Bajaj Allianz clients (HAT is our own inhouse TPA)  No Third Party Administrator (TPA) involved between the insurer and HAT  Exclusive Network with special benefits and Faster claim settlement due to centralized operations  Preferred services extended as HAT services only clients insured by Bajaj Allianz A HEALTH CARD is issued to all members This card entitles the member for identification ONLY as a Bajaj Allianz member Photo ID identification is necessary for admission Exclusive discounts / schemes at network hospitals Admissions without deposits at network hospitals

12. Claim Documents Claim Documents may be sent directly to: Health Claims Team, Bajaj Allianz General Insurance Company Limited, Rustomjee Aspire, 3rd Floor, Everard Nagar – 2, Near APEX Honda, Priyadarshini Circle, Off Eastern Express Highway, Chunabhatti-Sion, Mumbai- 400022 Email: healthclaims.mumbai@bajajallianz.co.in Once the claim is registered the status of the claim may be checked also under the below link by updating the card No: https://general.bajajallianz.com/BagicNxt/InHouseSP/hm/externalUserCC.jsp https://general.bajajallianz.com/BagicNxt/InHouseSP/hm/externalUserCC.jsp or under our Website : www.bajajallianz.comwww.bajajallianz.com (Under Quick links – General Insurance – On the left side drop down Menu)

13. Escalation Matrix LevelsContact PersonContact nosEmail ids First point Saveena Hegde 022-66197508 healthclaims.mumbai@bajajallia nz.co.in Escalation Dr. Rashmi Sachdev 7738395815 rashmi.sachdev@bajajallianz.co. in Ajay Kurup 7738257002 ajay.kurup@bajajallianz.co.in All other queries: jayesh.kadam@bajajallianz.co.in Tel: 022 -67402418/ 419 / 420 Cell: 918451914209 For any other issues/queries please call on the below Nos: Cashless: 020 -30305858 or send an emai to: preauth@bajajallianz.co.in General queries on e-cards – email to: health@bajajallianz.co.in