Lic Club Member Agents Group Mediclaim Insurance Scheme Review

Group Mediclaim Insurance Scheme (Policy Year 2014-15) for Club Member Agents (Membership Year 2013-14)

Club Member Agents Group Mediclaim Insurance Scheme has been renewed for the Policy Year 2014 – 2015 (from 01-09-2014 to 31-08-2015) with the New India Assurance Corporation Limited, Cooperage Road, Mumbai. Group Mediclaim Insurance Scheme for Club Member Agents is renewed with some additional facilities. Club Member Agents Group Mediclaim Policy number is 12030034140500000001.

Key Features of the Scheme

• The cover for different Club Member Agent Groups are as follows,
  

  Club	Cover (Rs.)
  Corporate Club	1,25,0001/-
  Chairman’s Club	1,25,0001/-
  Zonal Manager’s Club	75,0001/-
  Divisional Manager’s Club	55,0001/-
  Branch Manager’s Club	40,0001/-

• Group Mediclaim Policy for Club Member Agents, will be served by the New India Assurance Co. Ltd.
• The reimbursement of claim will be provided to the insured by the insurer through Medi Assist India Pvt. Ltd.
• Maximum age limit for coverage under the Group Mediclaim Insurance scheme has been increased to 85 years.

Inclusions and Exclusions under Lic Club Member Agents Group Mediclaim Insurance Scheme

1. Pre-existing diseases will be included from the 1st year itself subject to clauses.
2. Any disease (other than those stated in the clause), existed during the first 30 days from the commencement the policy will be excluded.
3. Diseases like Cataract, Hernia, Hydrocele, piles, Fistula in anus, Sinusitis and related disorders are not payable.
4. Maternity Benefit has also been included under this policy.

Claim Procedure for Club Member Agents Group Mediclaim Policy

To Avail Cashless Benefit

• Cashless Benefit is available in network hospitals only.
• Prior authorization from the TPA (Third Party Administrator) is a must.
• The list of network hospitals is available on the website of Medi Assist India Private Limited at www.mediassistindia.com.
• At the time of admission in the hospital, the Lic agent should carry the I-card issued by TPA (Third Party Administrator).
• He should submit the duly signed and stamped Nodal Officer’s certificate to the hospital before discharge.

Reimbursement of Mediclaim

If the beneficiary does not avail the cashless facility for any reason, he/she has the option of claiming reimbursement of medical expenses.

Premiums for Group Mediclaim Insurance Scheme

The premium to be recovered for the Club Member Agents Group Mediclaim Insurance Scheme is mentioned in below table.