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    Insurance Claim Form

    Uploaded by

    Anubhav Vardhan
    This document provides a refresher on three different mediclaim policies for BCG employees - a group policy covering employees and dependents, a policy for parents/in-laws, and an international policy. Key features summarized are a family floater sum insured of Rs. 15 lacs for the group policy, pre-existing illnesses covered, and claims submission deadline of 15 days. The parents/in-laws policy offers a range of sum insureds and has a 6 month wait for pre-existing coverage. The international policy provides worldwide coverage including or excluding the USA and must be renewed annually.

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    Insurance Claim Form

    Uploaded by

    Anubhav Vardhan
    97 views3 pages
    This document provides a refresher on three different mediclaim policies for BCG employees - a group policy covering employees and dependents, a policy for parents/in-laws, and an international policy. Key features summarized are a family floater sum insured of Rs. 15 lacs for the group policy, pre-existing illnesses covered, and claims submission deadline of 15 days. The parents/in-laws policy offers a range of sum insureds and has a 6 month wait for pre-existing coverage. The international policy provides worldwide coverage including or excluding the USA and must be renewed annually.

    Original Description:

    Form template to file health insurance claim

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    This document provides a refresher on three different mediclaim policies for BCG employees - a group policy covering employees and dependents, a policy for parents/in-laws, and an international policy. Key features summarized are a family floater sum insured of Rs. 15 lacs for the group policy, pre-existing illnesses covered, and claims submission deadline of 15 days. The parents/in-laws policy offers a range of sum insureds and has a 6 month wait for pre-existing coverage. The international policy provides worldwide coverage including or excluding the USA and must be renewed annually.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    97 views3 pages

    Insurance Claim Form

    Uploaded by

    Anubhav Vardhan
    This document provides a refresher on three different mediclaim policies for BCG employees - a group policy covering employees and dependents, a policy for parents/in-laws, and an international policy. Key features summarized are a family floater sum insured of Rs. 15 lacs for the group policy, pre-existing illnesses covered, and claims submission deadline of 15 days. The parents/in-laws policy offers a range of sum insureds and has a 6 month wait for pre-existing coverage. The international policy provides worldwide coverage including or excluding the USA and must be renewed annually.

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    Group Mediclaim Policy - Refresher

    (Policy period 28th March 2018 till 27th March 2019)


    Insurer – New India

    Enrolment
    • Insurance enrolment summary can be accessed from below link
    http://portals-
    asp.bcg.com/sites/indiafinance/connect/Shared%20Documents/confirmation_summary.aspx

    • Addition of Dependents (spouse, children) should be intimated within 30 days. Insurer is liable to reject
    any claims of dependents for whom intimation is not received within the 30 day timeline

    Key features of our Group Mediclaim policy – Covers Self, Spouse and Children:
    • Family floater cover of Rs. 15 Lacs
    • Pre Existing illnesses covered from day 1
    • Room rent - Restricted to Single Private Room category
    • Maternity limit of Rs. 1.5 Lacs
    • Annual Health checkup - Rs. 6,000 per person
    • 60 days pre and 90 days post hospitalization expenses covered
    • Dental cover upto Rs. 75,000 per family
    • Vision Care cover upto Rs. 10,000 per family (1 Frame / 1 pair of lenses per year)
    • Infertility, Obesity treatment covered
    • Advanced imaging like MRI, CT angiography covered upto Rs. 10,000 p.a. per family
    • Accident / Injury treatment covered in OPD

    Documents for Health Checkup Claim


    • Claim form – format attached (Part A)
    • Copies of checkup reports
    • Original bill / numbered payment receipt
    • Copy of cancelled cheque

    Documents for Vision Care / Dental OPD (Should be Non-cosmetic in nature) Claim
    • Claim form – format attached (Part A)
    • Doctor’s certificate or computerized test report which mention the vision number.
    • Dentist’s certificate on letter head mentioning the detailed line of treatment given
    • Dental Xray – If any
    • Original bill / numbered payment receipt
    • Copy of cancelled cheque

    Claim process:
    • All claims should be submitted within 15 days of incurring the expense.
    • Claims received post 15 days will be rejected
    • Send all claim documents to the BCG Mumbai office addressed to: BCG India Payroll, Mumbai office

    Name Department Contact Email


    Amit Jethava Cashless & +91 99207 Health@bisonline.in
    Reimbursement 80645
    Management
    Ashish Bhatia Complaints / +91 98201 ashish.b.bhatia@gmail.com
    Escalations – Level 1 57934
    BCG Parents / In-laws Mediclaim Policy – Refresher
    This is a self-sponsored scheme – Employee bears the premium
    Insurer – New India

    Enrolment
    • Insurance enrolment summary can be accessed from below link
    http://portals-
    asp.bcg.com/sites/indiafinance/connect/Shared%20Documents/confirmation_summary.aspx

    • For fresh enrolment please contact Payroll team

    Key features of BCG Parents / In-Laws Mediclaim policy


    • Family floater cover available ranging from 5 lacs to 1 Crore
    • Pre Existing illnesses - Fully covered after 6 months. In first 6 months, coverage is restricted to 75% of
    premium paid
    • Room rent - Restricted to Single Private Room category
    • Annual Health checkup - Rs. 6,000 per person
    • 30 days pre and 60 days post hospitalization expenses covered
    • Dental cover upto 5% of sum insured per family
    • Vision Care - Not applicable
    • Increase/Decrease in Sum insured possible during renewal only assuming No claim made in previous year

    Increase in premium due to claims:


    • Loading is applicable on renewal as per chart shared by New India

    Termination of Cover / portability


    • Mandatory renewal - Policy cannot be terminated during tenure with BCG
    • Fully portable - Post exit from BCG, employee can continue cover

    Claims process:
    • Same as Group mediclaim policy– refer above
    BCG International Mediclaim Policy – Refresher
    This is a self-sponsored scheme – Employee bears the premium
    Insurer – CIGNA TTK

    Enrolment
    • Insurance enrolment summary can be accessed from below link
    http://portals-
    asp.bcg.com/sites/indiafinance/connect/Shared%20Documents/confirmation_summary.aspx

    • For fresh enrolment please contact Payroll team

    Key features of BCG International Mediclaim policy


    • Individual cover of Rs. 9 Crore
    • 2 coverage options
    o Worldwide Including USA
    o Worldwide excluding USA
    • Pre Existing illnesses
    o Covered from Day 1 in WW Excluding USA
    o Covered after 48 months in WW including USA
    • Room rent - Restricted to Single Private Room category
    • Deductible – Rs. 1.2 lacs – expenses above this limit are only payable under this policy
    • Refer CIGNA policy summary deck for details

    Loading of premium due to high claims:


    • Loading is applicable on renewal as per renewal process of CIGNA

    Termination of Cover / portability


    • Mandatory renewal - Policy cannot be terminated during tenure with BCG
    • Portability - Post exit from BCG, employee has option to purchase CGHO plan from CIGNA office in
    Singapore / UK

    Claims process:
    • Refer CIGNA policy summary deck for details

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