swasthya ratna

Group Mediclaim Policy

Terms, Premium & Benefits Liberty General Insurance
(option I)		 United India Insurance Co Ltd
(option II)		 United India Insurance Co Ltd
(option III)
Family Definition
  • Self + Spouse + 2 dep child up to the age of 25 years
  • Self + Spouse + 2 Dep Child up to 25 years + 2 Dep Parents / In laws up to 80 years
  • Self + Spouse + 2 dep child up to the age of 25 years
  • Self + Spouse + 2 Dep Child up to 25 years + 2 Dep Parents / In laws up to 80 years
  • Self + Spouse + 2 dep child up to the age of 25 years
  • Self + Spouse + 2 Dep Child up to 25 years + 2 Dep Parents / In laws up to 80 years
Sum Insured Various as per Slabs mentioned below Various as per Slabs mentioned below Various as per Slabs mentioned below
Cashless Facility Yes Yes Yes
Pre Existing Ailments Covered from Day one without any capping Covered after 6 months  Covered from Day one Covered from Day one
30 Days waiting period and 1st / 2nd / 3rd / 4th year Exclusion  Waived off Waived off Waived off
30 days Pre and 60 days Post Hospitalisation Expenses ( excluding maternity) Covered Covered Covered
Room rent including Nursing Charges capping- per day (If it is applicable, then Consultation Charges / Investigation Fees and all other related expenses will be paid in accordance with the charges applicable for the authorized room rent limit.)
  • 1% of Sum Insured for Room Rent (If a person opts for the higher room category all incidental charges will be applied as per the room rent eligibility)
  • Capping on ICU rent Charges per Day 4% of Sum Insured (If a person opts for the higher room category all incidental charges will be applied as per the room rent eligibility)
  • 1% of Sum Insured for Room Rent (If a person opts for the higher room category all incidental charges will be applied as per the room rent eligibility)
  • Capping on ICU rent Charges per Day 4% of Sum Insured (If a person opts for the higher room category all incidental charges will be applied as per the room rent eligibility)
  • 1% of Sum Insured for Room Rent (If a person opts for the higher room category all incidental charges will be applied as per the room rent eligibility)
  • Capping on ICU rent Charges per Day 4% of Sum Insured (If a person opts for the higher room category all incidental charges will be applied as per the room rent eligibility)
Maternity Covered After 9 Months ( Rs.30,000 for Normal Delivery and Rs.40,000 for C-section) Covered from day one ( Rs.30,000 for Normal Delivery and Rs.40,000 for C-section) Covered from day one ( Rs.30,000 for Normal Delivery and Rs.40,000 for C-section)
9 Months Waiting Period  for Maternity Applicable Not Applicable Not Applicable
Baby Day 1 Cover Covered Covered Covered
Co Pay 10% for Parental Claim (Not applicable for diseases wise capping as per below)  10% for Parental Claim (Not applicable for diseases wise capping as per below)  20% for Parental Claim & 10% for Self, Spouse & 2 child (Not applicable for diseases wise capping as per below) 
Disease wise capping Cataract 30,000/- Per Eye Cataract 30,000/- Per Eye Cataract 21,000/- Per Eye
Day Care Procedure Covered Covered Covered
Congenital internal diseases  Covered Covered Covered
Day Care Procedure Covered Covered Covered
Claim Intimation 7 days from the date of Admission 7 days from the date of Admission 7 days from the date of Admission
Claim submission 30 days from the date of Dischage 30 days from the date of Dischage 30 days from the date of Dischage
Ambulance Charges Covered - Rs. 2,500 Per Case Covered - Rs. 2,500 Per Case Covered - Rs. 2,500 Per Case
Mid Term Addition Only for New Employees, Child Birth, Newly Married Couple Only for New Employees, Child Birth, Newly Married Couple Only for New Employees, Child Birth, Newly Married Couple
TPA Health India TPA MD India / Ericson /  Health India TPA MD India / Ericson /  Health India TPA
Personal Accident Policy Death Only Cover for Employees Only Death Only Cover for Employees Only Death Only Cover for Employees Only