1. Insurer : Bajaj Allianz General Insurance Co. Ltd
Group Mediclaim Top-Up Policy :
Insurer : Bajaj Allianz General Insurance Co. Ltd

2. Top Up Policy – Features of the policy
  This is a Top up cover over the Group Mediclaim Family Floater Policy for the employees and dependents of United Phosphorous & Tatva Global Group.
The Sum Insured under the Top up cover is on individual basis and will remain the same for the entire family. The cover would trigger after the exhaustion of the limit of sum insured under the base policy vide policy No: OG and
Family definition – As per base policy. Coverage remains the same as the employee policy but this policy can be utilised only when the base policy sum insured gets exhausted
Pre-existing diseases covered and all pre-existing diseases would be covered without any waiting periods under the scheme. Maternity benefit : Maternity limit Rs.35,000/- for normal and Rs.45,000/- for Caesarian
Cashless e-cards will be provided for each family covered under the base policy. Cashless Facility only to employees and not to dependants.
Only addition for new joinees/spouse/new born baby allowed during the policy period subject to getting enrolled to the policy.

3. Premium: Per family premium table inclusive of service tax
Top Up Sum Insured
Premium With Maternity Cover
Premium Without Maternity Cover
Annual
Prorata
01/09/2013
Prorata we.f
100000
8136
5276
7160
4806
150000
8946
5803
7873
5284
200000
9760
6331
8589
5765
300000
11714
7598
10308
6919
500000
16867
10941
14843
9963
29195
18937
25691
17245
Service 12.36% included in the above
Above quote and Premium would be available subject to 30% of the employees getting enrolled under the Additional/Top-UP Cover.

4. Claim Intimation and Escalation Matrix
All reimbursement claim intimation s to be sent directly to:
Escalation Matrix:
Levels
Contact Person
Contact nos
ids
First point
Saveena Hegde
Second Point
Dr. Rashmi Sachdev
Ajay Kurup
Third Point
Jayesh Kadam
For any other issues/queries please call on the below Nos:
Cashless: or send an emai to:
General queries on e-cards – to:
All other queries:

5. 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)

6. Claims Procedure & Health Helpline
In case the claim amount is more than the base sum insured both the card details to be updated.
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 20 Min.
Follow up with member for complaints received
Information on special discounts / packages / schemes
Information on hospitals, doctors, diagnostic centres, ambulance services and health products