Dear Sir,
Group Mediclaim Policy for the year 2014-15 has been issued. Following changes in benefits and other policy conditions have been incorporated in the policy.
1. Room, Boarding Expenses as provided by the hospital including Nursing charges, should not exceed 1.5% of Compulsory Floater Sum Insured per day, subject to maximum amount of Rs.7500/- per day.
2. Expenses in respect of claim relating to Cataract shall be limited to Actual or maximum of Rs.60000/- for each eye, whichever is less. Old limit was Rs.40000/- for each eye.
3. In case of Maternity Expenses Benefit, the maximum benefit allowable for ‘Normal Delivery’ shall be Rs.65000/- (old limit was Rs.50000/-) and for ‘Cessarian Section’ the medical expenses upto Rs.125000/- (old limit was Rs.100000/-) shall be reimbursed.
4. Four additional Diagnostic Tests, i.e. Gastroscopy, Colonoscopy, EEG and EMG without hospitalization shall be covered.
5. One additional treatment (Organ Transplantation) shall be included for Cashless Facility.
6. The reasonable, customary and Medically Necessary Surgeon fee and Anesthetist fee shall be reimbursed, limited to the maximum of 25% of Sum Insured where bills raised by Surgeon, Anesthetist directly and not included in the hospitalization bill.
7. Fee paid directly to Surgeon/Anesthetist in cash will be reimbursed upto a limit of Rs.10,000/-.
8. Maximum amount payable for Lasik Laser treatment performed to get rid of spectacles and/or contact lenses shall be Rs.35,000/- per eye.
Administrative Officer,
PERSONNEL/ER-A DEPT.,
CENTRAL OFFICE.