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JIO SUPER TOPUP MEDICLAIM POLICY PART-2

ENROLLMENT HAS BEEN CLOSED Presented by Aditya Birla Health Insurance Ltd.

PAYMENT FOR POLICY PREMIUM IS ACCEPTED ONLY THROUGH ONLINE PAYMENT ONLY
CASH/ CHEQUE/ DEMAND DRAFT / PAYORDER / NEFT & RTGS WILL NOT BE ACCEPTED

Salient Features

of

JIO SUPER TOP UP MEDICLAIM PART-2

 

SUPER TOP UP: UNIQUE TYPE OF MEDICLAIM

 

An ADDITIONAL COVERAGE of Mediclaim BEYOND a Chosen Specified Limit,

SO IT ACTS as a Cushion & Comes in to Action When Such Limit Is Exhausted.

  1. Available for All JAIN Shravak-Shravika Members of JIO .
  2. ENHANCE Your MEDICLAIM Sum Insured UPTO Rs.20 Lakh at very Nominal Premium.
  3. Available SUPER TOP-UP Sum Insured of Rs.2 Lakh, Rs.5 Lakh and Rs.10 Lakh
  4. Family Floater for Maximum 6 Members (1 + 5).

Proposer + Spouse ( Husband/wife)

+ 2 Dependent Children Up to 25 years of age

+ 2 Dependent Parents OR Parents In-Laws Up to 85 years

( Any one set of parents to be covered, combination not allowed).

  1. Maximum entry age: – Up to 85 Years. Once enrolled LIFE TIME renewal possible.
  2. NO Medical Checkup required.
  3. PRE-EXISTING Diseases are covered from DAY ONE.
  4. NO Waiting Period. (Waiting period for 1st year, 2nd year and 4th year disease are Not Applicable.)
  5. NO Capping ( Sub-Limit) applicable on any disease & on any family member.
  6. NO Co-Payment applicable on any type of claims.
  7. Opportunity to Avoid Heavy Deduction due to ROOM RENT LIMITS.
  8. HIGHER of the ROOM RENT is applicable,

                                           1% and 2% of SUPER TOP-UP Sum Insured

                                                                                      OR

                                           1% and 2% of BASE POLICY Sum Insured.

  1. Pre-Hospitalization Medical Expenses up to 30 DAYS are also
  2. Post-Hospitalization Medical Expenses up to 60 DAY are also
  3. 562 Types of DAY CARE Procedures are covered.
  4. Claims Payable on REIMBURSEMENT Basis only.
  5. AYUSH TREATMENT is also covered up to limits defined by IRDA.
  6. Proposer will be eligible for Deduction Under SEC. 80 D of Income Tax Act.
  7. ADDITIONAL POLICY : Accidental Relief Cover for PROPOSER is also attached of Rs.10 Lakh and Rs.5 Lakh Sum Insured with extra ordinary features.

## POINTS TO BE NOTED FORSUPER TOP UP”

Some more important information about this policy

(Please read it carefully)

 

  1. It ENHANCES your Existing Mediclaim Sum Insured.
  2. This plan is ALSO AVAILABLE for members WITHOUT any Existing Mediclaim
  3. You can TOP UP ANY TYPE of your existing MEDICLAIM issued by any insurance company Like Retail Personal Mediclaim, Family Floater Mediclaim, Group Mediclaim, JIO Mediclaim etc.
  4. IRRESPECTIVE of your Existing MEDICLAIM Sum Insured, You Can Choose ANY AMOUNT as DEDUCTIBLE LIMIT (from the available option- Rs.2 lakh, Rs.3 lakh, Rs.5 lakh and Rs.10 lakh).
  5. DEDUCTIBLE LIMIT: The chosen amount up to which the AGGREGATE Medical CLAIMS of FAMILY, Incurred During The Policy Period WILL NOT Be Payable by this Super Top Up Mediclaim AND The SAME AMOUNT shall be PAYABLE BY Member’s BASE POLICY OR the EXPENSES will be BORNE BY THE FAMILY.
  6. Hospitalization CLAIMS incurred During the Super Top Up Policy Period for the WHOLE Family in ONE OR MORE Occasions will be Considered TO CALCULATE THE DEDUCTIBLE LIMIT.
  7. JIO Super Top Up Mediclaim PREMIUM CHART (2018-19) :

JIO Super Top Up Mediclaim Part-2 PREMIUM CHART (2018-19)
Super TopUp SUM Insured Family Floater Premium amount ( Incl. Tax) Aggregate Deductible Limit Medical Expenses Payable beyond Deductible Limit
under Super Top Up Policy
Upto 60 years 61-85 years
Rs 2 Lakh Rs 8,485 Rs 14,088 Rs 2 Lakh
Rs 2
Lakh
Rs 2
Lakh
 
Rs 5 Lakh Rs 12,727 Rs 21,336
Rs 2
Lakh
Rs 5
Lakh
 
 
Rs 10 Lakh Rs 15,567 Rs 25,849 Rs 3 Lakh
Rs 3
Lakh
Rs 10
Lakh
 
 
Rs 5 Lakh Rs 7,059 Rs 11,833 Rs 5 Lakh
Rs 5
Lakh
Rs 5
Lakh
 
Rs 10 Lakh Rs 10,588 Rs 17,750
Rs 5
Lakh
Rs 10
Lakh
 
 
Rs 10 Lakh Rs 6,353 Rs 10,650 Rs 10 Lakh
Rs 10
Lakh
Rs 10
Lakh
  Deductible – Not Payable under Super Top Up Plan but may be payable under existing policy, if any
  Super Top Up Sum Insured
(Amount Payable)

 

The Member who DOES NOT HAVE BASE POLICY (Existing Mediclaim) their deductible limit starts from Rs 3 Lakh and more.

They can also choose the following option apart from the table above.

More options for members WITHOUT ANY EXISTING MEDICLAIM 
Super TopUp SUM Insured Family Floater Premium amount ( Incl. Tax) Aggregate Deductible Limit Medical Expenses Payable beyond Deductible Limit
under Super Top Up Policy
Upto 60 years 61-85 years
Rs 2 Lakh Rs 6,983 Rs 11,707 Rs 3 Lakh
Rs 3
Lakh
Rs 2
Lakh
 
Rs 5 Lakh Rs 10,476 Rs 17,562
Rs 3
Lakh
Rs 5
Lakh
 

 

  1. Deductible Limit for Proposer WITHOUT ANY EXISTING MEDICLAIM has to be Minimum of 3 Lakh.
  2. Deductible limit of Minimum3 Lakh is also Applicable for that Particular Member of family Who Does Not Have Any Base Policy AT THE TIME OF CLAIM.
  3. After The INCEPTION of Super Top Up Mediclaim, the Expenses incurred thereafter shall only be considered TO CALCULATE THE DEDUCTIBLE LIMIT.
  4. After CROSSING the Chosen Deductible LIMIT, Due To Aggregate Claims falling WITHIN POLICY PERIOD of super top-up Mediclaim Shall Be Payable under this policy Up to the Sum Insured.
  5. IF Base Policy Sum Insured is exhausted or partially Exhausted Before Inception of Super Top Up Mediclaim then the same WILL NOT BE Considered IN CALCULATION OF DEDUCTIBLE LIMIT.
  6. Portability Available for the policy After a Year AT THE TIME OF RENEWAL.

 

PARTNERS for JIO Super Top Up Mediclaim Part-2:

 

Insurance Company: ADITYA BIRLA HEALTH INSURANCE CO.LTD.

Insurance Brokers: EDELWEISS INSURANCE BROKERS LTD.

Third Party Administrator: Vidal Healthcare TPA Pvt.Ltd.

 

Terms & Conditions

of

JIO SUPER TOP UP MEDICLAIM PART-2

 

 

 

SUPER TOP UP: UNIQUE TYPE OF MEDICLAIM

 

An ADDITIONAL COVERAGE of Mediclaim BEYOND a Chosen Specified Limit,

 

SO IT ACTS as a Cushion & Comes in to Action When Such Limit Is Exhausted.

 

  1. Available for All JAIN </Shravak-Shravika Members of JIO.
  2. ENHANCE Your MEDICLAIM Sum Insured UPTO Rs.20 Lakh at very Nominal Premium.
  3. Available SUPER TOP-UP Sum Insured of Rs.2 Lakh, Rs.5 Lakh and Rs.10 Lakh
  4. Family Floater for Maximum 6 Members (1 + 5).

Proposer + Spouse ( Husband/wife)+ 2 Dependent Children Up to 25 years of age

+ 2 Dependent Parents OR Parents In-Laws Up to 85 years

( Any one set of parents to be covered, combination not allowed).

  1. Maximum entry age: – Up to 85 Years. Once enrolled LIFE TIME renewal possible.
  2. NO Medical Checkup </required
  3. PRE-EXISTING Diseases are covered from DAY ONE.
  4. NO Waiting Period. (Waiting period for 1st year, 2nd year and 4th year disease are Not Applicable.)
  5. NO Capping ( Sub-Limit) </applicable on any disease & on any family member.
  6. NO Co-Payment </applicable on any type of claims.
  7. Opportunity to Avoid Heavy Deduction </due to ROOM RENT LIMITS.
  8. The Policy offers In-Patient HOSPITALIZATION Cover
  9. The policy benefit are covered WITHIN INDIA only .
  10. Pre-Hospitalization Medical Expenses up to 30 DAYS are also
  11. Post-Hospitalization Medical Expenses up to 60 DAY are also COVERED.
  12. 562 Types of DAY CARE Procedures are covered
  13. Claims Payable on REIMBURSEMENT </Basis only
  14. AYUSH TREATMENT is also covered up to limits defined by IRDA.
  15. Portability Available for the policy After a Year AT THE TIME OF RENEWAL .
  16. PORTABILITY CONDITIONS : </Upon the Insured Person ceasing to be a member of the Policyholder, such Insured Person shall have   the option to migrate to an available retail health insurance policy available with Aditya Birla Health Insurance </in accordance with the Portability guidelines issued by the IRDA, provided that :
  • Continuity of benefits will be provided for the period based on the number of years of continuous coverage under this Policy with Us.
  • We should have received the application for Portability with complete documentation at least 45 days before ceasing to be an Employee of the Policyholder.
  • We may subject such proposal to our medical underwriting and decide the terms and conditions upon which We may offer cover, the decision as to which shall be in Our sole and absolute discretion.
  1. Proposer will be eligible for Deduction Under SEC. 80 D of Income Tax Act.
  2. Midterm Additions will NOT be allowed under the policy EXCEPT Newly Married Spouse and New Born Baby.
  3. INCREASE in PLAN / SUM INSURED will NOT be allowed for Next Three Years. But PROPOSER CAN REDUCE the Sum Insured. Deletion will be only on account of death of primary insured/self. No deletion in between the policy tenure.

ADDITIONAL POLICY : Accidental Relief Cover for PROPOSER is also attached of Rs.10 Lakh and Rs.5 Lakh Sum Insured with extra ordinary features.

## POINTS TO BE NOTED FORSUPER TOP UP”

Some more important information about this policy

(Please read it carefully)

  1. It ENHANCES your Existing Mediclaim Sum Insured.
  2. This plan is ALSO AVAILABLE for members WITHOUT any Existing Mediclaim
  3. You can TOP UP ANY TYPE of your existing MEDICLAIM issued by any insurance company like Retail Personal Mediclaim, Family Floater Mediclaim, Group Mediclaim, JIO Mediclaim etc.
  4. IRRESPECTIVE of your Existing MEDICLAIM Sum Insured, You Can Choose ANY AMOUNT as DEDUCTIBLE LIMIT (from the available option- Rs.2 lakh, Rs.3 lakh, Rs.5 lakh and Rs.10 lakh).
  5. DEDUCTIBLE LIMIT: The chosen amount up to which the AGGREGATE Medical CLAIMS of FAMILY, Incurred During The Policy Period WILL NOT Be Payable by this Super Top Up Mediclaim AND The SAME AMOUNT shall be PAYABLE BY Member’s BASE POLICY OR the EXPENSES will be BORNE BY THE
  6. Hospitalization CLAIMS incurred During the Super Top Up Policy Period for the WHOLE Family in ONE OR MORE Occasions will be Considered TO CALCULATE THE DEDUCTIBLE LIMIT.
  7. FOR CLAIMS where Base Policy Is AVAILABLE : All Claims will be settled on basis of Settlement Letter of TPA/Insurer & all the claim Documents Attested By Existing Insurer / TPA.
  8. FOR CLAIMS where Member DON’T HAVE Base Policy : Need to Submit ORIGINAL Claim Documents to TPA within document submission period (30days from discharge date).
  9. Super top up policy are also DOESN’T PAY Non-Medical expense like any other Mediclaim policy as per IRDA rule.
  10. JIO Super Top Up Mediclaim Part-2 PREMIUM CHART (2018-19):
JIO Super Top Up Mediclaim Part-2 PREMIUM CHART (2018-19)
Super TopUp SUM Insured Family Floater Premium amount ( Incl. Tax) Aggregate Deductible Limit Medical Expenses Payable beyond Deductible Limit
under Super Top Up Policy
Upto 60 years 61-85 years
Rs 2 Lakh Rs 8,485 Rs 14,088 Rs 2 Lakh
Rs 2
Lakh
Rs 2
Lakh
 
Rs 5 Lakh Rs 12,727 Rs 21,336
Rs 2
Lakh
Rs 5
Lakh
 
 
Rs 10 Lakh Rs 15,567 Rs 25,849 Rs 3 Lakh
Rs 3
Lakh
Rs 10
Lakh
 
 
Rs 5 Lakh Rs 7,059 Rs 11,833 Rs 5 Lakh
Rs 5
Lakh
Rs 5
Lakh
 
Rs 10 Lakh Rs 10,588 Rs 17,750
Rs 5
Lakh
Rs 10
Lakh
 
 
Rs 10 Lakh Rs 6,353 Rs 10,650 Rs 10 Lakh
Rs 10
Lakh
Rs 10
Lakh
  Deductible – Not Payable under Super Top Up Plan but may be payable under existing policy, if any
  Super Top Up Sum Insured
(Amount Payable)

 

The Member who DOES NOT HAVE BASE POLICY (Existing Mediclaim) their deductible limit starts from Rs 3 Lakh and more.

They can also choose following option apart from the table above.

More options for members WITHOUT ANY EXISTING MEDICLAIM 
Super TopUp SUM Insured Family Floater Premium amount ( Incl. Tax) Aggregate Deductible Limit Medical Expenses Payable beyond Deductible Limit
under Super Top Up Policy
Upto 60 years 61-85 years
Rs 2 Lakh Rs 6,983 Rs 11,707 Rs 3 Lakh
Rs 3
Lakh
Rs 2
Lakh
 
Rs 5 Lakh Rs 10,476 Rs 17,562
Rs 3
Lakh
Rs 5
Lakh
 
  1. Deductible Limit for Proposer WITHOUT ANY EXISTING MEDICLAIM has to be Minimum of 3 Lakh.
  2. Deductible limit of Minimum3 Lakh is also Applicable for that Particular Member of family Who Does Not Have Any Base Policy AT THE TIME OF CLAIM.
  3. HIGHER of the ROOM RENT is applicable,
    1.          1% and 2% of SUPER TOP-UP Sum Insured
    1.                                            OR
    1.          1% and 2% of BASE POLICY Sum Insured
      • Member with Base Policy : As per Base Policy or 1% for Normal Room & 2 % for ICU Room per day on Base Policy SI or 1% for Normal Room and 2 % for ICU per day on Super top up sum insured, whichever is higher.
      • Member without Base Policy : 1% for Normal Room and 2 % for ICU per day on Super top up deductible limit for the First year and 1% for Normal and 2% for ICU of Super top-up Sum-Insured from second year.
      • If the Insured occupies a room with a room rent limit higher than his eligibility, then all the other charges except medicine, implants etc. shall be processed on proportionate basis.
  1. After the INCEPTION of Super Top Up Mediclaim, the Expenses incurred thereafter shall only be considered TO CALCULATE THE DEDUCTIBLE LIMIT.
  2. After CROSSING the Chosen Deductible LIMIT, Due To Aggregate Claims falling WITHIN POLICY PERIOD of super top up Mediclaim Shall Be Payable under this policy Upto the Sum Insured.
  3. IF Base Policy Sum Insured is exhausted or partially Exhausted Before Inception of Super Top Up Mediclaim then the same WILL NOT BE Considered IN CALCULATION OF DEDUCTIBLE LIMIT.
  4. Organ Donor Expenses :-
  • Policy will cover the Medical Expenses incurred for an organ donor’s treatment for the harvesting of the organ donated up to the limit as specified in the Policy Schedule or Certificate of Insurance provided that the donation confirms to The Transplantation of HUMAN ORGANS ACT 1994 and the organ is FOR THE USE OF THE INSURED PERSON.
  • Policy will NOT cover the Pre-hospitalization Medical Expenses or Post-hospitalization Medical Expenses of the organ donor; Screening expenses of the organ donor; Any other Medical Expenses as a result of the harvesting from the organ donor; Costs directly or indirectly associated with the acquisition of the donor’s organ; Transplant of any organ/tissue where the transplant is experimental or investigational; Expenses related to organ transportation or preservation; Any other medical treatment or complication in respect of the donor, consequent to harvesting.

Terms and Condition of ACCIDENTAL RELIEF COVER

  1. This is an INDIVIDUAL Basis POLICY.
  2. This additional policy is COMPULSORY for all PROPOSER of Super Top-Up Mediclaim with nominal additional premium.
  3. Cover is available on optional basis for OTHER FAMILY MEMBERS on Individual basis with additional premium.
  4. Premium Table for Accidental Relief Cover ( 2018-19 ) for JIO Members
Type of Plan Sum Insured Premium (incl.TAX)
Plan A Rs.5 Lakh Rs.472/-
Plan B Rs.10 Lakh Rs.944/-
  1. Accidental Relief Cover AVAILABLE to members between 5 Years to 85 years of age.
  2. Accidental Relief Coverage details :-
S.N. Benefit Sum Insured
Plan 1 Plan 2
1 Accidental In-patient Hospitalization (limited to India) Upto 1,00,000 Upto 2,00,000
2 Recovery Benefit 10,000 20,000
3 Permanent Partial Disablement Upto 5,00,000 Upto 10,00,000
4 Permanent Total Disablement 5,00,000 10,00,000
5 Accidental Death 5,00,000 10,00,000
6 Funeral Expenses 10,000 20,000
7 Education Fund for Children 1,00,000 2,00,000
8 Marriage Fund for Children 1,00,000 2,00,000
9 Orphan Benefit for Children 3,00,000 5,00,000
Per Life Premium –  Including Tax Rs. 472 Rs. 944

Spouse and other Dependents can be covered on Individual Basis for all benefits except benefit Number 7,8 & 9 which is applicable only for Primary Insured Person.

  1. 106. Details of Coverage
    1. 106.1 Accidental In-patient Hospitalization (limited to India)If an Insured Person suffers an Injury due to an Accident and such Injury requires the Insured Person to be Hospitalized as an In-patient in a Hospital room ( Shared/ Twin Sharing AC), then policy will cover the costs incurred on Medical Expenses up to the limit specified in the Policy Schedule or Certificate of Insurance provided that:
      1. The Insured Person is Hospitalized in India;
      2. The Hospitalization is for Medically Necessary Treatment and is on the written advice of a Medical Practitioner.
      3. The Insured Person is admitted to Hospital within 7 days of the occurrence of the Accident.
    1. 106.2. Recovery BenefitIf the Insured Person suffers an Injury due to an Accident and such Injury results in the Hospitalization of the Insured Person during the Policy Period for at least 10 consecutive days ( Minimum continuous 10 days), then policy will pay the lump sum amount as specified in the Policy Schedule or Certificate of Insurance.
    1. 106.3. Permanent Partial DisablementIf the Insured Person suffers an Injury due to an Accident that that results in the permanent partial disablement of the Insured Person of the nature as specified in the table below, then policy will pay the percentage of the Sum Insured as specified in the table below.
  1. Table of Benefits Percentage of the Sum Insured payable
    Type of Permanent Partial Disablement
    i)    Total and irrecoverable loss of sight of one eye 50%
    ii)   Loss of one hand or one foot 50%
    iii)  Loss of all toes – any one foot 10%
    iv)  Loss of toe great – any one foot 5%
    v)  Loss of toes other than great, if more than one toe lost, each 2%
    vi) Total and irrecoverable loss of hearing in both ears 50%
    vii)  Total and irrecoverable loss of hearing in one ear 15%
    viii)  Total and irrecoverable loss of speech 50%
    ix)   Loss of four fingers and thumb of one hand 40%
    x)  Loss of four fingers 35%
    xi) Loss of thumb –both phalanges 25%
    xii)  Loss of thumb – one phalanx 10%
    xiii) Loss of index finger-three phalanges 10%
    – two phalanges 8%
    – one phalanx 4%
    xiv)Loss of middle/ring/little finger-three phalanges 6%
    – two phalanges 4%
    – one phalanx 2%
  1. In case the Insured Person suffers a loss not mentioned in the table above, then an external medical advisor will determine the degree of disablement and the amount payable, if any. 
  1. 106.4. Permanent Total DisablementIf the Insured Person suffers an Injury due to an Accident that results in the permanent total disablement of the Insured Person of the nature as specified in the table below, policy will pay 100% of the Sum Insured.
  1. Table of Benefits
    Type of Permanent Total Disablement
    1) Total and irrecoverable loss of sight of both eyes
    2) Loss by physical separation or total and permanent loss of use of both hands or both feet
    3) Loss by physical separation or total and permanent loss of use of one hand and one foot
    4) Total and irrecoverable loss of sight of one eye and loss of a Limb
    5) Total and irrecoverable loss of hearing of both ears and loss of one Limb/loss of sight of one eye
    6) Total and irrecoverable loss of hearing of both ears and loss of speech
    7) Total and irrecoverable loss of speech and loss of one Limb/loss of sight of one eye
    8) Permanent total and absolute disablement (not falling under the above) disabling the Insured Person from engaging in any employment or occupation or business for remuneration or profit, of any description whatsoever which results in Loss of Independent Living
  1. For the purpose of this Benefit,– Limb means a hand at or above the wrist or a foot above the ankle;– Physical separation of one hand or foot means separation at or above wrist and/or at or above ankle, respectively.Once a claim has been accepted and paid under this Benefit then cover under this Benefit shall immediately and automatically cease in respect of that Insured Person.
  1. 106.5. Accidental DeathIf the Insured Person suffers an Injury due to an Accident that results in the death of the Insured Person, Policy will pay 100% of the Sum Insured provided that:
    1. Once a claim has been accepted and paid under this Benefit then cover under this Policy shall immediately and automatically cease in respect of that Insured Person.
  1. 106.6. Funeral ExpensesIf We have accepted a claim under Accidental Death in accordance with Sections II.1 then in addition to the amount payable under that Section, POLICY WILL PAY A LUMPSUM AMOUNT as specified in the Policy Schedule or Certificate of Insurance towards funeral, cremation/ or burial and transportation of the body to the place of the funeral ceremony for the Insured Person.
  1. 106.7. Education Fund for ChildrenIf We have accepted a CLAIM UNDER ACCIDENTAL DEATH OR PERMANENT TOTAL DISABLEMENT, then in addition to the amount payable under that Section, Policy will PAY A LUMP SUM AMOUNT as specified in the Policy Schedule or Certificate of Insurance in respect of each surviving Dependent Child, UP TO 2 DEPENDENT CHILDREN, if specified in the Policy Schedule or Certificate of Insurance irrespective of whether the child is an Insured Person under this Policy.
    This Benefit shall be payable subject to the Dependent Child being up to 25 years of Age as on date of occurrence of the event irrespective of whether the child is an Insured Person under this Policy and PROVIDED THAT THE DEPENDENT CHILD DOES NOT HAVE ANY INDEPENDENT SOURCE OF INCOME.
  1. 106.8. Marriage Fund for ChildrenIf We have accepted a CLAIM UNDER ACCIDENTAL DEATH OR PERMANENT TOTAL DISABLEMENT, then in addition to the amount payable under that Section, We will PAY A LUMP SUM AMOUNT as specified in the Policy Schedule or Certificate of Insurance in respect of the Dependent Child that is UNMARRIED, UP TO 2 DEPENDENT CHILDREN, if specified in the Policy Schedule or Certificate of Insurance, irrespective of whether the child is an Insured Person under this Policy.
  1. 106.9. Orphan Benefit for ChildrenIf We have accepted a CLAIM UNDER ACCIDENTAL DEATH for the INSURED PERSON and that INSURED PERSON’S SPOUSE (who may or may not be an Insured Person) is also deceased in the SAME POLICY YEAR at the time of death of the Insured Person, and the CHILD BECOMES ORPHAN, then in addition to the amount payable under that Section, POLICY WILL PAY A LUMP SUM AMOUNT as specified in the Policy Schedule or Certificate of Insurance in respect of the DEPENDENT CHILD, up to 2 Dependent Children, if specified in the Policy Schedule or Certificate of Insurance, irrespective of the whether the child is an Insured Person under this Policy.This Benefit shall be payable subject to the DEPENDENT CHILD BEING UP TO 25 YEARS OF AGE as on date of occurrence of the event and provided that the Dependent Child does not have any independent source of income.Any claim towards Orphan Benefit where the Dependent Child is a minor, shall be payable to the legal guardian of the Dependent Child.

PERMANENT EXCLUSIONS

  1. PERMANENT EXCLUSIONS (Not Payable) FOR JIO SUPER TOP UP MEDICLAIM As Per Insurance Company Under IRDA Guidelines

We shall not be liable to make any payment for any claim under any Benefit in respect of any Insured Person directly or indirectly caused by, based on, arising out of, relating to or howsoever attributable to any of the following:

  1. 41.1. Injury/Disease contracted due to war and allied perils
  1. Treatment directly or indirectly arising from or consequent upon war or any act of war, invasion, act of foreign enemy, war like operations (whether war be declared or not or caused during service in the armed forces of any country), civil war, public defense, rebellion, uprising, revolution, insurrection, military or usurped acts, nuclear weapons / materials, chemical and biological weapons, ionizing radiation, contamination by radioactive material or radiation of any kind, nuclear fuel, nuclear waste.
  1. 41.2. Injury while attempting suicide or criminal activity
  1. Committing or attempting to commit a breach of law with criminal intent, intentional self- Injury or attempted suicide while Insured Person is sane or insane.
  1. 41.3. Participation in hazardous activity and military operation
  1. Willful or deliberate exposure to danger, intentional self- Injury, non- adherence to Medical Advice, participation or involvement in naval, military or air force operation, circus personnel, racing in wheels or horseback, diving, aviation, scuba diving, parachuting, hang-gliding, rock or mountain climbing, bungee jumping, parasailing, ballooning, skydiving, river rafting, polo, snow and ice sports in a professional or semi- professional nature.
    Insured Person whilst flying or taking part in aerial activities except as a fare-paying passenger in a regular scheduled airline or air charter company.

 

  1. 41.4. Treatment due to intoxication of drug and alcohol
  1. Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol, including smoking cessation programs and the treatment of nicotine addiction or any other substance abuse treatment or services, or supplies.

 

  1. 41.5. Weight management programme and treatment of obesity
  1. Weight management programs or treatment in relation to the same including vitamins and tonics, treatment of obesity (including morbid obesity).

 

  1. 41.6. Lasik treatment of Eye
  1. Treatment for correction of eye sight due to refractive error including routine examination.
  1. 41.7. Health Check-up and Evaluation
  1. All routine examinations and preventive health check-ups.
    Admission primarily for diagnostic purposes not related to Illness for which Hospitalization has been done.
    Preventive care, vaccination including inoculation and immunizations (except in case of post-bite treatment); any physical, psychiatric or psychological examinations or testing .
    Cost incurred for any health check-up or for the purpose of issuance of medical certificates and examinations required for employment or travel or any other such purpose.

 

  1. 41.8. Plastic Surgery or Cosmetic Surgery
  1. Cosmetic, aesthetic and re-shaping treatments and Surgeries:
    Plastic Surgery or cosmetic Surgery or treatments to change appearance unless medically required and certified by the attending Medical Practitioner for reconstruction following an Accident, cancer or burns.
    Treatment for alopecia, baldness, wigs, or toupees, and all treatment related to the same.
  1. 41.9. Circumcision
  1. Circumcisions (unless necessitated by Illness or Injury and forming part of treatment); aesthetic or change-of-life treatments of any description such as sex transformation operations.
    Non- allopathic treatment, except as per coverage of AYUSH Treatment.

 

  1. 41.10. OPD claims
  1. Conditions for which treatment could have been done on an out-patient basis without any Hospitalization.

 

  1. 41.11. Unproven and Experimental treatment
  1. Unproven/Experimental treatment, investigational treatment, devices and pharmacological regimens.Treatment for Age Related Macular Degeneration (ARMD) , treatments such as Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), Hyperbaric Oxygen Therapy.
  1. 41.12. Convalescence and Old age condition
  1. Convalescence (except as per the coverage as coverage defined in Section 11 – Recovery Benefit), cure, rest cure, sanatorium treatment, rehabilitation measures, private duty nursing, respite care, long-term nursing care or custodial care.
  1. 41.13. Enteral feeding
  1. Admission for enteral feedings (infusion formulas via a tube into the upper gastrointestinal tract) and other nutritional and electrolyte supplements unless certified to be required by the attending Medical Practitioner as a direct consequence of an otherwise covered claim.
  1. 41.14. Hearing aids, Spectacles and multifocal lens
  1. Hearing aids, spectacles or contact lenses including optometric therapy, multifocal lens.
  1. 41.15. External device and Non Medical items
  1. Medical supplies including elastic stockings, diabetic test strips, and similar products.Any expenses incurred on prosthesis, corrective devices external durable medical equipment of any kind, like wheelchairs crutches, instruments used in treatment of sleep apnea syndrome or continuous ambulatory peritoneal dialysis (C.A.P.D.) and oxygen concentrator for bronchial asthmatic condition, cost of cochlear implant(s) unless necessitated by an Accident or required intra-operatively. Cost of artificial limbs, crutches or any other external appliance and/or device used for diagnosis or treatment (except when used intra-operatively).Expenses which are medically not required such as items of personal comfort and convenience including but not limited to television (if specifically charged), charges for access to telephone and telephone calls (if specifically charged), food stuffs (save for patient’s diet), cosmetics, hygiene articles, body care products and bath additives, barber expenses, beauty service, guest service as well as similar incidental services and supplies, vitamins and tonics unless certified to be required by the attending Medical Practitioner as a direct consequence of an otherwise covered claim.Charges related to a Hospital stay not expressly mentioned as being covered, including but not limited to charges for admission, discharge, administration, registration, documentation and filing, including MRD charges (medical records department charges).Non-medical expenses including but not limited to RMO charges, surcharges, night charges, service charges levied by the Hospital under any head and as specified in the Annexure V for non- medical expenses.
  1. 41.16. Mental Disease and Parkinsonism
  1. Psychiatric or psychological disorders, mental disorders (including mental health treatments), Parkinson and Alzheimer’s disease, general debility or exhaustion (“rundown condition”), sleep-apnea, stress.
  1. 41.17. External Congenital Disease and Genetic Disease
  1. External Congenital Anomalies, diseases or defects, genetic disorders.
  1. 41.18. Stem Cell therapy or surgery
  1. Stem cell therapy or surgery, or growth hormone therapy
  1. 41.19. Sexually transmitted disease & AIDS
  1. Venereal disease, all sexually transmitted disease or Illness including but not limited to genital warts, Syphilis, Gonorrhea, Genital Herpes, Chlamydia, Pubic Lice and Trichomoniasis.“AIDS” (Acquired Immune Deficiency Syndrome) and/or infection with HIV (Human Immunodeficiency Virus) including but not limited to conditions related to or arising out of HIV/AIDS such as ARC (AIDS Related Complex), Lymphomas in brain, Kaposi’s sarcoma, tuberculosis.
  1. 41.20. Maternity
  1. Complications arising out of pregnancy (including voluntary termination), miscarriage (except as a result of an Accident or Illness), maternity or birth (including caesarean section) except in the case of ectopic pregnancy for In-patient only.
  1. 41.21. Family Planning and Surrogacy
  1. Treatment for sterility, infertility, sub-fertility or other related conditions and complications arising out of the same, assisted conception, surrogate or vicarious pregnancy, birth control, and similar procedures contraceptive supplies or services including complications arising due to supplying services.
  1. 41.22. Illegal Organ Transplant Surgery
  1. Admission for Organ Transplant but not compliant under the Transplantation of Human Organs Act, 1994 (amended).
  1. 41.23. Surgery of dislocation
  1. Treatment and supplies for analysis and adjustments of spinal subluxation, diagnosis and treatment by manipulation of the skeletal structure; muscle stimulation by any means except treatment of fractures (excluding hairline fractures) and dislocations of the mandible and extremities.
  1. 41.24. Dental treatment
  1. Dentures and artificial teeth, Dental Treatment and Surgery of any kind, unless requiring Hospitalization due to an Accident.
  1. 41.25. After Brain death treatment
  1. Artificial life maintenance, including life support machine used to sustain a person, who has been declared brain dead, as demonstrated by:Deep coma and unresponsiveness to all forms of stimulation; orAbsent pupillary light reaction; orAbsent oculovestibular and corneal reflexes; or Complete apnea.
  1. 41.26. Developmental Issue
  1. Treatment for developmental problems, learning difficulties eg. Dyslexia, behavioral problems including attention deficit hyperactivity disorder (ADHD).
  1. 41.27. Medical Practitioner
  1. Treatment taken from a person not falling within the scope of definition of Medical Practitioner.Treatment charges or fees charged by any Medical Practitioner acting outside the scope of license or registration granted to him by any medical council.Treatments rendered by a Medical Practitioner who is a member of the Insured Person’s family or stays with him, save for the proven material costs are eligible for reimbursement as per the applicable cover.Any treatment or part of a treatment that is not of a reasonable charge, is not a Medically Necessary Treatment; drugs or treatments which are not supported by a prescription.
  1. 41.28. Treatment taken Out of India
  1. Treatment taken outside India not covered in the policy.

 

 

PARTNERS for JIO Super Top Up Mediclaim Part-2:

 

Insurance Company: ADITYA BIRLA HEALTH INSURANCE CO.LTD.

 

Insurance Brokers: EDELWEISS INSURANCE BROKERS LTD.

 

Third Party Administrator: Vidal Healthcare TPA Pvt.Ltd.

 

FAQ of JIO SUPER TOP UP MEDICLAIM

Super Top Up policy brought to you by JIO is family floater policy which offers you coverage of Mediclaim above your chosen deductible limit along with extra ordinary features.
It offers you financial relaxation in the event when your hospitalisation claim bill crosses your sum insured under any other Mediclaim policy. Thus it acts as cushion & comes in to action when you have exhausted the chosen limit.

Mediclaim policy pay the claim from Rs. 1/- till maximum Sum Insured under your base policy.
Whereas Super top-up policy cover hospitalization expenses beyond the chosen Deductible limit. The deductible limit is chosen by you. In other word it is a Mediclaim policy which triggers after a certain pre-decided limit of expense has crossed.
Further mediclaim and super top up policy can work along with one another. That is, if you have a mediclaim you can also purchase a super top up policy to get an enhance cover.
Insert Half Pie chart here
Admissible Claim Bill Super top up sum insured Deductible SI Policy SI 1 lakh 2 lakh 3 lakh 4 lakh 5 lakh 6 lakh 7 lakh 8 lakh 9 lakh 10 lakh
Mediclaim   Not required 1 lakh                    
  2 Lakh Not required 2 lakh                    
  3 Lakh Not required 3 lakh                    
  5 Lakh Not required 4 lakh                    
  10 Lakh Not required 5 lakh                    
Super topup   2lakh 2 lakh                    
    2lakh 5 lakh                    
    3lakh 5 lakh                    
    5lakh 5 lakh                    
    5lakh 2 lakh                    

a. It increase your sum insured at very reasonable premium
b. No capping , NO Co-Pay , No waiting period.
c. Pre-existing Disease are also covered from Day One.
d. Opportunity to avoid heavy deduction due to Room Rent limits.
e. JIO Super Top Up plan is cheapest super top up plan available in the market.
f. For higher age person above 55 years of age it is very difficult to increase the sum insured hence JIO super top up policy is advisable where we are offering sum insured of Rs.10 lakh up to 85 years of age.

Whenever any one hospitalisaion exceed your base policy sum insured then claim is payable under top up policy. It is rare incident that single hospitalisation can arise where total hospitalisation bill will cross Rs.2 lakh or deductible selected by you. Whereas under Super Top Up Policy aggregate of all claims made by your family members once crosses the base policy sum insured then your super top policy will start making the claim payment.

In floater Mediclaim policy the base sum insured will be for all the members of the family. Hence either the claim amount should exceed the deductible amount or sum insured should be exhausted for super top up policy to respond. Under floater policy claims of one or more member of the family or one or more claim of one of the family member should exceed the deductible amount chosen under super top up sum insured.

In individual Mediclaim policy every family member will have his own sum insured under base policy. Hence for super top up policy to respond his claim amount should cross the deductible limit under super top up policy. His / her other family members sum insured still remaining balance under base policy.

All sharavak & shravika members of JIO can covered under Super top up policy.

Your entire family can be covered under the policy maximum up to 6 members. Yourself, Spouse, 2 dependent Children up to the age of 25 years of age and two parents/Parents In-Laws Up-to 85years can be covered under the policy.

85 years is the age limit for policy holder.  Once join then they will be covered life long on renewal of policies.

Base policy is your Mediclaim policy.  It can be your JIO mediclaim policyindividual Mediclaim policy or family floater Mediclaim policy.  It can also be your group Mediclaim policy offered by your employer.  The sum insured under your base policy is base policy sum insured.

Higher the better.  You can select sum insured from Rs.2 Lakh, Rs.5 Lakh or Rs.10 Lakh  option.  However it is better you select Rs.10 lakh as sum insured because sum-Insured cannot be enhanced for 3years once chosen. However it can be reduced at renewal.

Deductible limit is a pre-decided limit chosen in super top-up Policy by you.  Super Top-up policy gets triggered and starts paying claim once the aggregate expense crosses this deductible limit.
Example-1: Single Claim in a policy year
  Base Policy Sum Insured Super Top Up Sum Insured Opted Claim Amount eligible Base policy will pay (Rs.) Super Top Up Policy will pay
At Inception 200,000 500,000 0 0 0
Claim 200,000 500,000 350,000 200,000 150,000


Example-2: Multiple Claims in a policy year
  Base Policy Sum Insured Super Top Up Sum Insured Opted Claim Amount eligible Base policy will pay (Rs.) Super Top Up Policy will pay
At Inception 200,000 500,000 0 0 0
Claim 1 200,000 500,000 350,000 200,000 150,000
Claim 2 200,000 500,000 200,000 0 200,000
Claim 3 200,000 500,000 200,000 0 150,000
Claim 4 200,000 500,000 100,000 0 0
Total Paid     850,000 200,000 500,000

Ideally we should choose deductible limit which is equal to your Mediclaim policy sum insured so you should get optimum cover.  However it is not compulsory to choose only the same.  You can choose lower than/ Higher then your base policy sum insured.  We have option of Rs.2 lakh, Rs.3 lakh, 5 Lakh or Rs.10 Lakh as deductible sum insured.  You can choose any of the above

Member with Base Policy : Deductible 2lakh, 3lakh , 5lakh and 10 lakh
Member without base Policy :  Deductible 3lakh , 5lakh and 10lakh .

If you or your family member does not have Mediclaim policy then you can still get super top up policy.

Yes. Still you will get super top up policy and cover these members also in super top up policy.  However for those members who do not have any other mediclaim policy their deductible under super top up policy will be minimum Rs.3 Lakh.

It is not necessary that in single hospitalisation your sum insured should be exhausted.  Even in aggregate of multiple hospitalisation of smaller claims, cross your  base policy sum insured then super top up policy will come to your rescue and pay the balance hospitalisation bills.  All the hospitalisation bills for more than one member of your family can also be accumulated to claim under super top up policy.

In super top up policy, all the hospitalisation claims of all the members covered under the policy can be accumulated.  So super top up policy will trigger once multiple hospitalisation claims of your all family members crosses the deductible limit.

You can claim all the bills for which hospitalization has occured during super top up policy period.  If your base policy period is 1st Jan, 2018 to 31st December, 2018.  Super top up policy period is 1st April, 2018 to 30th March, 2019 and If you have claims paid under base policy before inception of super top up policy i.e. 1st April 2018  then the same will not be considered for exhaustion of  deductible limit of super top up policy.

Super top up policy will continue with minimum period of three years.  Premium is payable on annual term.   As per the table mentioned below if JIO super top up policy has claim ratio then you will enjoy discount or loading for next year.  This table has been agreed and approved between insurance company and JIO.
Claim Ratio Discount/ Loading on Premium
  Discount Medical Inflation Final discount/loading on existing premium
Up to 75% 25% Discount 10% 17.50% Discount
76-80% 20% Discount 10% 12% Discount
81%-90% Same Rate 10% 10% loading
91% to 100% Same Rate 10% 10% loading
101 % to 110% 5 % loading 10% 15.50% loading
Above 110% 20% loading 10% 32% loading
Above 125% To be revived 10% To be revived

*By Default Medical Inflation @ 10% will be added on renewal irrespective of claim Ratio

If a group policy is issued for the first time then the general claim ratio of individual policies is considered. Further the fact that the company receives huge number of policy holders at one time, the reduced advertisement costs can be passed on by way of discount on premium.
For renewal of group policy, the premiums are decided on the basis of past claim ratio, age composition of the policy holders, types of claims made earlier and assumptions made for future claims.

Super top up policy covers all hospitalisation expenses covered under your base policy.  In addition whether your base policy is covering Pre- existing disease or not it covers Pre existing disease from Day 1 under the policy.  If your base policy has waiting period for PED cover then you opt for deductible more than Rs.3 lakh in which case your PED claims will also be paid under Super Top Up Policy.

Hospitalisation expenses covered Pan India occurred either due to accident or natural diseases
In patient hospitalisation expenses will be covered in reimbursement basis.
No Medical test to be done prior taking this policy.
No waiting period is applicable under the policy for hospitalization claims.
30 days pre hospitalization expenses are included: Medical expenses incurred 30 days prior to the hospitalization are reimbursed.
Post Hospitalization expenses up to 60 days are covered.
Internal congenital diseases covered.
Minimum Hospitalization of 24 hours required for the treatment, which cannot be taken at home.
The minimum hospitalization clause is not applicable for Cataract, Chemotherapy & fracture or any Day Care treatment.

The list of exclusions are mentioned in Terms and condition applicable to super top up policy.  All the exclusions are common between your base policy and super top up policy.  However under super top up policy  exclusions like Pre-existing diseases , Waiting period of special disease & 30days are not applicable

Premium Table For Benefit Table A All Ready Insured Member
Super TopUp SUM Insured Family Floater Premium amount ( Incl. Tax) Aggregate Deductible Limit Medical Expenses Payable beyond Deductible Limit
under Super Top Up Policy
Upto 60 years 61-85 years
Rs 2 Lacs Rs 8485 Rs 14088 Rs 2 Lacs
Rs 2 Lacs Rs 2 Lacs  
Rs 5 Lacs Rs 12727 Rs 21336
Rs 2 Lacs Rs 5 Lacs  
Rs 10 Lacs Rs 15567 Rs 25849 Rs 3 Lacs
Rs 3 Lacs Rs 10 Lacs  
Rs 5 Lacs Rs 7059 Rs 11833 Rs 5 LacsRs 5 Lacs
Rs 5 Lacs Rs 5 Lacs  
Rs 10 Lacs Rs 10588 Rs 17750
Rs 5 Lacs Rs 10 Lacs  
Rs 10 Lacs Rs 6353 Rs 10650 Rs 10 Lacs
Rs 10 Lacs Rs 10 Lacs
  Deductible – Not Payable under Super Top Up Plan but may be payable under existing policy, if any
  Super Top Up Sum Insured
(Amount Payable)


ENTAL RELIEF COVER  for sum insured of Rs.5,00,000/-
COMPULSORY FOR PROPOSER additional premium of Rs.472/- including 18% Tax.
Cover is available on optional basis forOTHER FAMILY MEMBERS on Individual basis at following premium :
Sum Insured Rs.5 Lakh per insured  – Rs.472/- including Tax
Sum Insured Rs.10 Lakh per insured – Rs.944/- including Tax

In mediclaim completed age is counted.  Hence to consider where the premium of upto 85 years slab will be charged you or not, no one in your family should be borne before 1st April, 1957.

Since maximum age of the one of the family member is above 61 years you will be charged premium of 61 – 85 years of age.

Yes, you will get Tax benefit under section 80D

No.  There is no co-payment applicable to Super Top Up Policy.

No, this is Super Top Up Policy need not to undergo any medical test.

The policy would be for one year from the date of inception

Aditya Birla Insurance Company

Edelweiss Insurance Brokers Limited ( EIBL )

Your Super Top Up policy certificate will be available on groupinsurance.bluebox.com.  The TPA I-cards will be made available to each customer and their dependents on groupinsurance.bluebox.com.  E-cards are also available at TPA site and JIO site as well.

The policy period will be 1st April, 2018 to 31st March, 2019

Policy would be issued within 15 days and the card would be issued after 10 days of policy issuance.

Please follow the below mentioned steps
  • Please go on jiojac.com

  • Select “JIO HEALTH PLAN” Scheme

  • Read revise Terms & Conditions carefully

  • Enter JIOJAC ID

  • Fill your enrolment details

  • Make payment ONLINE .
  • No, You can’t opt for Super top-up plan . JIOJAC ID is compulsory. Please register online for JIOJAC ID.

    NO , You can only claim through reimbursement. But in all cases immediate intimation shall be given to our Call Center within 24 hours of Hospitalization.

    Yes , under section 80 D you can claim TAX Rebat

    No, you will not get Policy Number. However you will receive Health ID card thorough which you can come for reimbursement claim

    No, as this is a Group scheme you will not get NO Claim Bonus

    Third Party Administrator (TPA) in Health Insurance Sector servicing all insurance companies. Health Insurance policies for individuals are basic products of Insurance Companies on which TPA adds value and facilitates smooth operation through its value‐addition like network of healthcare service providers, medical care standardization, Claims management, Client servicing, expert opinion etc. Thus TPA administers a `healthcare package’ for its clients with customized healthcare delivery.

    No, Loction does not affect the operational activities, main member or the dependent member can avail same and equal benefits irrespective of their location.  In other words if few members covered under the policy is staying at Native place or some other cities than of the self under the policy.  They can raise their claim under the policy and submit the attested copies of the document in the nearest city in vidal TPA office.

    Yes, According to the Insurance Company the claim will not be settled (unless prior intimation to Insurance company) if there is any alterations in the name It has to be intimated to your respective Insurance Co. within 15 days on receipt of your cards & requisite Endorsement for the change in name needs to be passed by Insurance co. This has to be done first hand and not only if any claim arises.  The window period will close for change in name on 15th May, 2018.

    You can claim medical expenses incurred 30 days before and 60 days after hospitalization (as specified in your policy), provided they are related to the ailment/treatment for which you were hospitalized. Such expenses are termed as pre and post hospitalization, except for Maternity Claims.

    Yes, your health insurance policy is valid all over INDIA

    Under the family floater policy you can cover your wife as long as the proposer is Jain and because now she is a part of the Jain family.

    Family Floater Policy is available for family size ranging between 2 to 6 members i.e. Proposer + Spouse + 2 Dependent Children up to 25 years of Age + Parents/or Parents or Laws.

    Yes you can but any person can’t be covered more than once under whole group in JIO Policy. If declared more than once, benefit would be payable under one Sum Insured only

    No. One person can be covered only once in a JIO policy.

    No. As she is now not part of your family.

    Yes this policy is for Pan India Jain population only.

    Yes , NRI Jain can take the policy but hospitalization should happen in India and the proposer should have Bank account in India.

    Pre‐Existing Diseases are covered since day 1.Also there is no waiting period in any illness.

    Please get a confirmation from your Sangh / Gyati that you are a Jain.

    No, You can’t opt for MEDICLAIM Policy.

    Yes only is she is a Jain by birth.

    The Jain certification has to be from Gyati / Samaj / Sang only.

    In mediclaim completed age is counted.  Hence to consider where the premium of upto 85 years slab will be charged you or not, no one in your family should be borne before 1st April, 1957.


    FAQ of Accidental Relief Cover Policy

    In mediclaim completed age is counted.  Hence to consider where the premium of upto 85 years slab will be charged you or not, no one in your family should be borne before 1st April, 1957.

    In mediclaim completed age is counted.  Hence to consider where the premium of upto 85 years slab will be charged you or not, no one in your family should be borne before 1st April, 1957.
  • An accident may include events like:

  • Rail / Road / Air Accident.

  • Injury due to any collision/fall.

  • Injury due to Bursting of gas cylinder etc.

  • Snake-bite, Frost bite/Dog bite/ or any other animal bite etc.

  • Burn Injury, Drowning, Poisoning etc.

  • Rite/Strike/Malicious damage/terrorism etc.

  • Injury due to electrical current.

  • These are only illustrative and not an exhaustive list of type of accidents
  • Accidental Relief Cover policy covers accidental death, permanent total & partial disablement, Recovery Benefit for admission above 10days , In-patient treatment cost arising out of accident, Education fund , Marriage Fund , Orphan benefit for children as selected and granted by the insurance companies based on the underwriting norms.

    Yes. Policy cover In-patient Hospitalisation on reimbursement basis

    This Policy is available to persons between the age of 5 and 85 years (Male & Female).

    No, the coverage under this policy is WORLDWIDE however, claims, if any, will be paid in  Indian currency only

    Generally Accidental Relief Cover policies are maximum for one year only. Hence this policy is also remain valid for one year.

    When an insured person sustains accidental injuries resulting in loss of limb and is certified by a medical specialist that the injury is of a permanent total or permanent partial nature, then only the insured shall deemed to be permanently totally/partially disabled.
    These are general interpretation for easy understanding & not legal wording

    Accidental hospitalization benefit is applicable to one or multiple hospitalization subject to exhaustion of prescribed limit of 1lkah and 2 lakh.

    Yes , even if your claim gets paid in PPD benefit you can take benefit under PTD cover with the full 100% Sum-Insured.

    Yes we can offer this benefit to even non earning individual

    No .

    Under normal circumstances where war and or warlike situation prevails PA cover is not offered.

    If the insured person does not prefer any claim in the expiring policy, he is entitled to 5% cumulative bonus for every such claim free year subject to maximum of 50% cumulative bonus that means the sum insured under the renewed policy will be increased by 5% every year without charging any additional premium. But in our policy that is not possible .

    Assignment means that in the event of fatal accident of the insured person, the compensation is made to the assignee on the basis of his full and final discharge. In case the assignment is not made under Accidental Relief Cover Policy, the insurance company insist for SUCESSION CERTIFICATE from the Court for settlement of claim compensation, which is a time consuming, lengthy & cumbersome procedure.

    There is NO TAX BENEFITS for the premium paid under these types of cover.


    Myths and Facts about JIO Insurance Policies.

    NO , JIO is not an insurance company and does not give any type of insurance policy. JIO has ONLY played the role of a negotiator for benefits of its Shravak / Shravika members.

    The Policy is serviced by the following three entities: a. Insurance Brokers (Like Prudent, Alliance, Almonds, Edelweiss Insurance Brokers ltd ( EIBL)) Insurance brokers are the mediators and communicator between JIO and Insurance Company to receive best terms. The responsibility of compiling the enrolment data, getting the policy endorsed, overview on claims process and resolving the queries of members is to be executed by the Insurance brokers. The Insurance brokers are the working hand of JIO for overall assistance for Group Policies. b. Insurance Company (Like Govt. companies – National Insurance, Oriental Insurance & Pvt. Companies – ICICI Lombard, Star Health , Aditya Birla Health) The Mediclaim policy is issued by the government approved Insurance Companies under the regulation of IRDAI. Means, the premium collected from members is transferred to the Insurance Company. The Insurance Company bears the risks of the policy and pays claims to the members as per terms of the policy. c. Third Party Administrators – TPA (Like Paramount, Vipul TPA, Vidal TPA, Health India etc) The TPA’s are appointed by the Insurance Companies for issuing members Medi-claim card, communicate terms to policy holders, prepare panel of hospitals for cashless, receiving claim documents, evaluating the documents and sanctioning the claim amount .

    NO,
    JIO is not a profit making organization and is formed with a noble objective of serving its Shravak / Shravika members as well as society at large. Under the medical insurance scheme, the premiums are collected individually from the members and then full amount is transferred as a group premium to the insurance company.
    In-fact, Gurudev has inspired several Jain Shravaks to donate partly towards the premiums for members of their respective Samaj / Gnyati, who are financially troubled. Hence the health security could be availed by members of their Samaj at further discounted premiums. This will immensely help such families to face the additional financial burden of medical expenses, if any.

    NO,
    The enrolment process requires registering accurate details of the member and their family so that they do not face any trouble during the full year or at time of claim. The forms have been designed in a way to get the important details only and no un-necessary details are to filled. Taking into consideration feedback of member’s , JIO always try to make the process more user friendly .

    NO,
    JIO has not appointed/authorized any retail agents for selling / marketing its policies. But, when the enrolment for policy is started, JIO chapters and volunteers across India assist in the policy and enrolment process and spreading information of policy.
    Because of the dedicated service of its volunteers, JIO has been able to reach huge number of Shravaks across India easily, without additional cost of hiring huge number of professionals.
    Members can take help / advice from helpline number of the insurance company/TPA/Insurance Broker for detailed enquiry regarding enrollment or claim . Alternatively, at the time of claim, members can also take help from any insurance agent because the process of claim is same as retail insurance policies.

    JIO has pioneered in adopting to the latest technologies and online tool for your convenience and better service. The online enrolment process has the following major advantages:

    The data entry and processing time is saved.
    Accuracy of the data entered. This will also help in hassle free claims to the members.
    Speedy Enrollment anytime from anywhere
    Immediate confirmation of enrolment completion.

    This is an exclusive insurance policy for Sharvak and Shravika members of Jain International Organisation(A Known worldwide organization of Jain’s ). For effective control and to maintain exclusivity of policy , JIO has linked all processes with JAC ID . Jain Advantage Card (JAC) is a unique & permanent identification issued by JIO to all its member’s .
    Members can easily participate in the programme’s of JIO without having to provide various details everytime & they can also easily connect with fellow Shravaks.

    JIO Group Policy is negotiated with Insurance Company for the Best TERMS and Lowest PREMIUM based on a commitment of certain Minimum NUMBERS of enrollment.
    For enrolling the members, messages are sent to Shravaks residing all over India. An enrolment window period is kept open for members to fill forms and make premium payment.In case the numbers fall short of the minimum target, then the enrolment period is extended for few days.
    After the closure of enrolment period, any errors found at the stage of validation and verification are corrected by contacting the members.
    JIO pays the insurance premium to the Insurance Company through a single payment for all the members together for commencing policy. Upon payment, the Insurance cover period starts on common date for all the members.
    A single group policy document is issued in the name of JIO with the list of enrolled members and their families. On the basis of this TPA’s issue Health Cards to all members with unique enrolment number for taking benefits of the policy.The above process takes lot of time and efforts, hence the commencement of policy is after necessary period from the date of payment.

    NO
    The process of filling claim for cashless or reimbursement with the Insurance Company is the same for JIO policy like any other retail Mediclaim policy’s and in accordance with IRDA guideline. The timeline of intimation is 24 hour and after intimation you can submit the claim paper’s within 30days .

    No
    The deduction from claim are as per the terms of the policy and no add –hoc deduction’s are made by the TPA or insurance company. The TPA and Insurance company are bound by the guidelines of IRDA .
    However , in case any claim’s are wrongly deducted or disallowed , than the members can approach greviance department of insurance company or Ombudsmen department of IRDA.
    These actions are within the rights of every policy holders.

    As clarified above JIO is neither the insurance broker/agent to the policy nor the company undertaking the insurance . JIO has played a role of group leader to the policy issuance
    All the queries regarding the claim process , status of claim, reasons of deduction from claim etc. are handled by the concern TPA .
    In cases where the greviances of policy members remain unresolved by the TPA the member can escalate such urgent/important issues with the servicing brokers or JIO officials.JIO in turn will take up these issues with the concern authority through Brokers.
    However the claims will be decided on merits of the case and within the terms of the policy.

    For any queries and complaint in regard to Super Top-Up plan , please contact Edelweiss Insurance Brokers over Toll Free No. 1800-3100-3360 , email id gmc.claims@edelweissfin.com .
    As you are aware , the responsibility for coordination of enrollment and claims has been assigned to the brokers by JIO. The brokers are required to maintain appropriate number of contact points in the form of helpline numbers and email id for helping members and resolving their queries.
    For any help or assistance at the time of enrollment the members can contact the brokers helpline numbers.
    For any assistance at the time of claim, the members can contact the TPA helpline. The details of contact numbers and emails of service provider are available on JIO’s website.

    The JIO group policy is NOT a temporary affair and will continue in future like all other insurance policies.
    However, as discussed earlier, the terms of the policies and the premiums are subject to change at the time of each renewal based on previous year experience & analysis.
    JIO group Mediclaim policy was started with a noble vision of giving financial security in medical emergency to all the Shravak / Shravika families. Therefore JIO will never think about discontinuing the scheme.
    JIO has signed a MOU with ABHI, the current insurer with 3years contract for Super Top-up policy. The loading/discount table on given below will be applied as per claim ratio at next two renewals.
    The loading/discount pattern shall be like this :-
    Claim Ratio Discount/ Loading on Premium
     DiscountMedical InflationFinal discount/loading on existing premium
    Up to 75%25% Discount10%17.50% Discount
    76-80%20% Discount10%12% Discount
    81%-90%Same Rate10%10% loading
    91% to 100%Same Rate10%10% loading
    101 % to 110%5 % loading10%15.50% loading
    Above 110%20% loading10%32% loading
    Above 125%To be revived10%To be revived


    *By Default Medical Inflation @ 10% will be added on renewal irrespective of claim Ratio
    Group Claim Ratio : – Premium paid per year Vs Claim Paid and Outstanding per year

    Your super top up policy will pay claim on reimbursement basis. Once your base policy has paid the claim either under cashless or reimbursement basis, you need to submit attested copy of entire claim file under Super top Up policy. The attested claim file from your base policy TPA should have settlement voucher which will show details of claim payment. Only you should not forget to intimate claim under your Super Top Up Policy during hospitalisation. Once your claim under base policy is paid you should submit the attested claim file within 30 days under Super Top Up Policy.

    Claim need to be settled under Base Policy. Base policy Sum Insured should get exhausted. In case of base policy having individual sum insured the Top Up policy will come in picture when his individual sum insured is exhausted of the respective patient.

    No till the time your basic Policy Sum Insured is balance.

    Your health insurance policy pays for reasonable and necessary medical expenditure. There are several items that do not classify as medical expenses during hospitalization. These items will not be payable and expenditure towards such items will have to be borne by you.

    No. You can do so only in cases arising from Road Accidents

    No. Maternity benefit is not their in this scheme.

    No. Non medical expenses as per list prepared by IRDAI like hand gloves, savlon, apron, registration fees, service charges are not payable under any Mediclaim policy.

    No.

    The expenses that are reimbursed under Mediclaim policy are –
    a. 30 days prior to hospitalization all the expenses related to disease for which hospitalization is done like doctors bill, medical cost, test and report cost etc.
    b. Hospitalization bill which will include Room charges, doctors fees, surgeon fees, operation theatre cost, nursing charges, medicine charges and internal implant cost.
    c. After discharge all doctors bill, medical cost, test and report cost till 60 days from date of discharge from hospital. Cost of Prosthetic devices implanted during surgical procedure like pacemaker.

    Expenses incurred at a hospital or a nursing home for diagnostic purposes such as X‐rays, blood analysis, ECG, etc. will be reimbursed if they are consistent with or incidental to the diagnosis and treatment of the ailment for which the policy holder has been hospitalized. In any other scenario, these expenses will not be reimbursed.

    Typically, the insured can make a claim if her/his hospitalized stay is for over 24 hours. However, for certain treatments, such as dialysis, chemotherapy, eye surgery, etc. the stay could be less than 24 hours.

    Pre‐Existing Diseases are covered since day 1 or inception of the policy. However for policy to start paying claims your deductible Sum insured should exhaust.

    The claim amount would be transferred to CUSTOMER’s Bank account made available with claim file by NEFT.

    The claim amount is paid to the nominee of the insured. If no nominee has been assigned under the policy, the insurance company will insist upon a succession certificate from a court of law for disbursing the claim amount. Alternatively, the insurers can deposit the claim amount in the court for disbursement to the legal heirs of the deceased

    Any institution established for indoor care and treatment of sickness and/or injuries, which is duly registered and supervised actively by a registered medical practitioner registered with local government body.

    OR

    Any establishment that satisfies the following criteria can qualify as a hospital:

    . with at least 15 patient beds
    . With a fully equipped operation theatre of its own if surgical procedures need to be carried out
    . Employing fully qualified nursing staff around the clock
    . Having fully qualified doctors in charge around the clock Note: For Class ‘C’ towns, the number of beds relaxed to ten.

    An instance where the insured individual is hospitalized for a minimum period of 24 hours can be termed as hospitalization. Specific treatments like dialysis, chemotherapy, radiotherapy, laser eye surgery, dental surgery, etc. when the patient is discharged on the same day are also considered hospitalization.

    No. Maternity benefit is not payable under Individual Health Insurance Plan.

    Room Rent Limit :
    Member with Base Policy : As per Base Policy or 1% for Normal Room & 2 % for ICU Room per day on Base Policy SI or 1% for Normal Room and 2 % for ICU per day on Super top up sum insured whichever is higher.
    Member without Base Policy : 1% for Normal Room and 2 % for ICU per day on Super top up deductible sum insured.
    (If the Insured occupies a room with a room rent limit other than his eligibility, then all the other charges except medicine shall be limited to the charges applicable for the eligible room rent or actual).

    The process of filing claims for Reimbursement with the Insurance Company is the same for JIO policy like any other retail mediclaim policies and in accordance with IRDA guidelines. In-fact, the norms for intimation of claim are relaxed in super top up Policy.

    Physical forms will not be accepted at all for the renewal of policy. All the information has to be provided online for easy processing of claims.

    The members have to make payment of premium amount online through our Website only from following options
    1. Credit / debit card.
    2. UPI
    3. Netbanking

    In this age of digitization, internet and computer facility is easily available. The members who are not very conversant with use of computers are advised to approach young members in their family for help in completing the online process.

    At the time of hospitalization the person should intimate TPA and Edelweiss Insurance Brokers (EIBL) on claims.gmc@edelweissfin.com (call on 022 67133791 (Mon- Friday 10am till 6pm) & Toll free 1800-3100-3360 within 24hrs. One can use either the TOLL FREE number or on email or by fax to the numbers mentioned on Cashless cards or policy document.

    It takes around 21 working days to get the claim settled on reimbursement basis

    Attested hospital final bill
    Attested photocopy of numbered receipts for payments made to the hospital
    Attested photocopy of Complete breakup of the hospital bill
    Attested photocopy of Discharge Card/Summary
    Attested photocopy of investigation reports
    Attested photocopy of medicine bills with relevant prescriptions
    Original Settlement voucher of Base Policy in case of Option A.
    Original signed claim form
    Photo ID card copy of claimant
    TPA Card copy
    Intimation mail copy/ Claim Registration no.
    Attested photocopy of FIR/MLC copy incase of Road accidents. If MLC is not applicable then written confirmation from Doctor/Hospital that the patient was not under influence of alcohol ordrugs.
    Any further document which claim assessor feel necessary to adjudicate the claim.

    Claim-1
    Star Health SI1,000,000
    DiagnosisCancer of Blood
    Total claim Amt2,389,008
    Claim Paid by Star170,000
    Super topup SI1,000,000
    Deductible SI200,000
    Claim payable in Super top up policy1000,000
    Insured has to bear1189008

    Claim-2
    Star health SI500,000
    DiagnosisBrain stroke
    Total claim Amt1,001,528
    Claim Paid by Star (Major surgery)120,000
    Super topup SI500,000
    Deductible SI300,000
    Non Medical items20,000
    Claim payable in Super top up policy500,000
    Insured has to bear381,528

    Claim-3
    Star health SI5lakh
    Super topup SI10 lakh
    Deductible SI3lakh
    DiagnosisSepticemia
    Total claim Amt1,491,722
    Claim Paid by Star180,000
    Non Medical items20,000
    Claim payable in Super top up policy980,000
    Insured has to bear391,722

    Claim-4
    Star health SI1,000,000
    Super topup SI500,000
    Deductible SI200,000
    DiagnosisHeart Disease
    Total claim Amt943,481
    Claim Paid by Star110,000
    Non Medical items20,000
    Claim payable in Super top up policy500,000
    Insured has to bear333,481

    Claim-5
    Base Policy SI500,000
    Super topup SI1,000,000
    Deductible SI200,000
    Eligible RR2,500
    Utilsed7,000
    Total stay 4 days28,000
    DiagnosisCABG
    Total claim Amt1,000,000
    Claim Paid by Basic(proportionate deduction)339,286
    Non Medical items50,000
    Claim payable in Super top up policy610,714
    Insured has to bear50,000

    Claim-6
    Period of Topup Insurance1/4/2018 till 31/03/2019
    Super topup SI(member without any base policy)500,000
    Deductible SI3,00,000
    First claim admissible bill (02/04/2018 till 09/04/2018)100,000
    Second claim admissible bill (01/06/2018 to 10/06/2018)200,000
    Third claim (07/11/2018 to 11/11/2018)500,000
    Payable under Top-up policy500,000

    Claim-7
    Base policy SI – Retail – (First Year)300,000
    DiagnosisHeart Disease with HTN since 10years
    Total claim Amt600,000
    Claim DecisionRejected under PED
    Super topup SI500,000
    Deductible SI200,000
    Non Medical items30,000
    Claim payable in Super top up policy370,000
    Insured has to bear30,000

    Claim-8
    Base Policy100,000
    Super topup SI200,000
    Deductible SI200,000
    DiagnosisKnee Replacement
    Total claim Amt250,000
    Claim Paid by Base100,000
    Non Medical items20,000
    Claim payable in Super top up policy30,000
    Insured has to bear120,000

    Claim-9
    Base policy Period1/11/2017 to 31/10/2018
    Super Top Up Period1.4.2018 to 31.3.2019
    Base policy is not renewed on11/1/2018
    Super topup SI500,000
    Deductible SI200,000
    Date of Hospitalisation12/1/2018
    Claim Bill500000
    Non Medical10000
    Claim payable in Super top up policy190000


    Claim Procedure of Accidental Relief CoverPolicy



    At the time of accident or death the claimant should intimate Edelweiss Insurance( EIBL) Brokers on claims.gmc@edelweissfin.com (call on 022 67122791 ) within 48hrs. One can use either the TOLL FREE number or on email or by fax to the numbers mentioned on policy certificate .

    It takes around 45days to 60days working days to get the claim settled on reimbursement basis .

    Yes. Edelweiss Insurance Brokers (EIBL) and respective TPA, would assist you in your claim settlement . You may write to us on pa.claims@edelweissfin.com or call us on 022-67133791 (Mon-Friday 10a m till 6pm) and Toll Free 1800-3010-3360.

    IN THE EVENT OF ACCIDENTAL INJURIES Fore most duty of the insured or nominee is to inform the insurer/Edelweiss about the event in 7 working days with all particulars.

    a. Death claim checklist

    1. Duly filled original Claim Form.
    2. Policy certificate.
    3. Claim intimation No.
    4. FIR – Attested or Original.
    5. Death Certificate.
    6. Form IV certificate containing cause of death.
    7. Post Mortem report.
    8. Inquest/Coroner’s Report
    9. Final Police Report / Original Panchnama
    10. Legal Heir certificate.
    11. KYC documents.
    12. Any other documents as and when requested by the claim settling authority.

    b. List of Documents for Permanent Total Disability

    1. Duly filled original Claim Form with Medical part of claim form need to be filled by treating doctor.
    2. Policy certificate
    3. Claim Intimation No.
    4. FIR – Attested or Original
    5. Final Police Report / Original Panchnama
    6. Certificate of from government hospital doctor confirming the nature and degree of disability
    7. Discharge summary of the treating hospital clearly indicating the Hospital Registration No.
    8. Diagnostic reports with Xray film and report.
    9. Copy of appointment letter.
    10. Photograph of the injured with reflecting disablement
    11. Any other documents as and when requested by the claim settling authority

    c. List of Documents for Permanent Partial Disability

    1. Duly filled original Claim Form with Medical part of claim form need to be filled by treating doctor.
    2. Policy certificate .
    3. Claim Intimation No.
    4. FIR – Attested or Original
    5. Final Police Report / Original Panchnama
    6. Certificate of from government hospital doctor confirming the nature and degree of disability
    7. Discharge summary of the treating hospital clearly indicating the Hospital Registration No.
    8. Diagnostic reports with X-ray film and report.
    9. A copy of appointment letter.
    10. Photograph of the injured with reflecting disablement.
    11. Any other documents as and when requested by the claim settling authority.

    d. Accidental Hospitalisation claim checklist

    1. Duly filled original Claim Form
    2. Policy certificate
    3. Claim Intimation No.
    4. Discharge card/certificate/ death certificate in original.
    5. Itemized hospital bill in original.
    6. Original hospital payment receipt with receipt number.
    7. Hospital registration number/ the number of beds available with the hospital verified by the authorized signatory of the Hospital
    8. Original pharmacy and investigation bills.
    9. Copies of prescription for diagnostic test, treatment advise, medical references etc
    10. Investigation reports in original.
    11. Police FIR/MLC copy .
    12. X-ray films.
    13. Details of the implants including the sticker indicating the type as well as invoice towards the cost of implant
    14. Copy of cancelled cheque.

    If you are having claim under Accidental In- Patient Hospitalisation, you are eligible for Recovery benefit claim provided your stay in hospital as per discharge card is above 10 Consecutive Nights ( Days ). You need to only submit discharge card copy for the claiming claim under the policy.

    In case of death claim under the policy, you can claim Funeral Expenses of the deceased member. You need to submit the original bills of expenses such as
    a. Morgue bill
    b. Crematam expenses receipt
    c. Transportation bill for carrying the dead body
    d. Funeral Expenses bill receipt.

    In case of death claim under the policy, you can claim for education fund for two dependent children below 25 years of age. Please note the child should not have his/her independent source of income. You need to submit the following documents.

    a. Adhar Card Copy of the children
    b. Bonafide certificate from the education institute
    c. Certificate of unemployment from Tahsildar office

    In case of death claim under the policy, you can claim for Marriage fund for two dependent children below 25 years of age. Please note the child should not have his/her independent source of income. You need to submit the following documents.

    a. Adhar Card Copy of the children
    b. Bonafide certificate from the education institute

    In case of death claim under the policy, and in the same year if insured person’s spouse (who may or may not be an Insured Person) is also deceased at the time of death of the Insured Person the children will become Orphan. In this event claim can be made for the above benefits and the documents for the same will be

    a. Adhar Card Copy of the children
    b. Bonafide certificate from the education institute

    As you aware we will ONLY provide ONLINE ENROLLMENT process for JIO Super Top Up Mediclaim, as this will help both of us for ERROR & HASSEL FREE with QUALITY DATA (spelling error in the name or error in the birth date) and also this is most important for Insurance Company & TPA for better and quick services in case of Hospitalization.

    We know this decision might be hard for some members but as per our previous experience the ISSUES faced in by member’s 90% of which were DUE to OFFLINE enrollment only.

     

    1. Any person CAN’T BEcovered MORE THAN ONCE under whole group in JIO super Top Up Mediclaim Policy. If declared more than once, benefit would be payable under one Family Sum Insured only.
    2. You CAN’Tenrolled any person out of the FAMILY DEFINITION given in the policy (As per define in form) For  BROTHER AND SISTER, Because at the time of claim RELATIONSHIP PROOF will be required and claim will get REJECTED if enrollment is NOT as per the POLICY GUIDELINE. As well as your policy will CANCEL and premium will NOT BE REFUNDABLE .
    3. Kindly mention your PERMANENTand accessible MOBILE NUMBER and E-MAIL Id for EASY and FAST Communication and to SHARE all important UPDATES with you.
    4. Kindly note we can DISPATCHyour cards only if we will get your COMPLETE POSTAL ADDRESS in this enrollment form
    5. Due to any unavoidable circumstances if you want refund then also you have to apply online only. Once you apply for policy and it has been issued than it cannot be refunded.

    *** It is advisable that you verify your data to avoid issues related to information mismatch at the time of claim processing.

     
     

    CONTACT FOR MORE DETAILS Toll Free 1800-3010-3360

    Enquiry Points Name Of Company Name of Person City Office Address
    Enrollment & Health ID Card & kit Edelweiss Insurance Brokers Limited Vasant Mahadik Mumbai Unit No.1201/1202, 12th Floor, ‘C’ Wing, Godrej Coliseum, Everard Nagar, Chunabhatti, Mumbai – 400022
    Enrollment & Health ID Card & kit Vidal TPA Narendra Yadav Mumbai 413-422, 4th Floor, Chintamani Plaza, Mohan Studio compound, Chakala Andheri Mumbai 400099
    Claim Intimation Edelweiss Insurance Brokers Limited Vasant Mahadik Mumbai Unit No.1201/1202, 12th Floor, ‘C’ Wing, Godrej Coliseum, Everard Nagar, Chunabhatti, Mumbai – 400022
    Claim Intimation Vidal TPA Narendra Yadav Mumbai 413-422, 4th Floor, Chintamani Plaza, Mohan Studio compound, Chakala Andheri Mumbai 400099
    Claim Status & other Enquiry Edelweiss Insurance Brokers Limited Vasant Mahadik Mumbai Unit No.1201/1202, 12th Floor, ‘C’ Wing, Godrej Coliseum, Everard Nagar, Chunabhatti, Mumbai – 400022
    Claim Status & other Enquiry Vidal TPA Narendra Yadav Mumbai 413-422, 4th Floor, Chintamani Plaza, Mohan Studio compound, Chakala Andheri Mumbai 400099

     

    Contact for Claim Submission & Enquiries Vidal TPA offices

    Registered Branch office – Visit & Enquiry of Vidal TPA
    Name Of CompanyName of PersonCityOffice Address
    Vidal TPAJom GeorgeBanglore (HO)Tower 2, 1st Floor,SJRI park, EPIP Zone Whitefield, Bangalore 560066
    Vidal TPAPremnathMangaloreNo 201-203,2nd Floor,CityPlaza,Shedigudda,Mangalore 575003
    Vidal TPAAshwiniHubliBhagyalakshmi Complex, CTS No873B/57B, Bhuvaneshwari Nagar, Opp to Ramesh Bhavan, Keshwapur,Hubli-580023
    Vidal TPANanda KishoreHyderabadNo. 303, VC Plaza, Opp to BJP Office, Kukatpally, Hyderabad-500072
    Vidal TPAJaya HariharanVishakapatnamNear Gurudwara Circle next lane of positive homeopathy clinic Vishakaptnam 16
    Vidal TPASachin SadafulePune1187/22, 4th Floor, Venkatesh Meher | Opp National Institute of Opthalmology Ghole Road pune 411005
    Vidal TPAAshish SaxenaMumbai413-422, 4th Floor, Chintamani Plaza, Mohan Studio compound, Chakala Andheri Mumbai 400099
    Vidal TPASheenu MathurNoidaB-25, Sector one, Noida
    Vidal TPAPrabir AdhikaryKolkataChatterjee International Centre, 6th Floor, Flat- A/12, 33A, Jawaharlal Neharu Road, Kolkata- 700071
    Vidal TPARashmi DineshCochin39/4131B Mareena Buildings|Ravipuram, MG Road, Kochin Kerala682016
    Vidal TPARashmi DineshTrivandrum27/2343,Vanchiyoor,Cobvent school Road,Thiruvananthapuram-595001
    Vidal TPASavitha. RCoimbatore#146, Sai Baba Towers, Coimbatore
    Vidal TPAMurali. RChennaiT Nagar- Anmol Palani,#88,GN Chetty Road,T. Nagar,Chennai-600017
    Vidal TPATapash PaulRaipurShop No-103, 1st Floor, Maruti Arcade, Main road, Avanti Vihar, Raipur.
    Vidal TPABala Murali KrishnaChennai- TN SchemeNo.226, Kilpauk Garden Road, Kilpauk, Chennai-600010
    Vidal TPASiddharth MohapatraBhubaneswarNo. 43, 4th Floor, Janpath Tower,Ashok Nagar,Bhubaneswar-751009
    Vidal TPAJaspreet SinghMohaliS.C.O.661, II Floor,Sector 70, Mohali, Punjab- 160070
    Vidal TPAOdangNagalandHighschool area, New Secretariat road, Adjacent agency, IOC Petrol Pump, Kohima, Nagaland-797001

    Aditya Birla Health
    Name of CompanyName of personCityOffice address
    Aditya Birla HealthSunny ChandelMumbaiR tech Park, 10th Floor, Nirlon Compound, Off Western Express Highway, Goregaon East, 400063
    Aditya Birla HealthShilpi AgarwalMumbaiR tech Park, 10th Floor, Nirlon Compound, Off Western Express Highway, Goregaon East, 400063
    Aditya Birla HealthGaurav JainPune1st Floor, Pradeep Chambers,, Bhandarkar Rd, Pune, Maharashtra
    Aditya Birla HealthYogesh ( Zone West )Mumbai/WestR tech Park, 10th Floor, Nirlon Compound, Off Western Express Highway, Goregaon East, 400063
    Aditya Birla HealthChirag DewanDelhi605, 6 Floor, Mahatta Tower, B1, Janakpuri, C-Block, Janakpuri, C-Block Community Center, Janakpuri, New Delhi, Delhi 110058
    Aditya Birla HealthKriti JainDelhi605, 6 Floor, Mahatta Tower, B1, Janakpuri, C-Block, Janakpuri, C-Block Community Center, Janakpuri, New Delhi, Delhi 110058
    Aditya Birla HealthChandrashekarBengaluru#19/4, “SAIR BAGH”, 1st Floor, Above Axis Bank, Cunnigham Road,
    Aditya Birla HealthDibyajyoti KarBengaluru#19/4, “SAIR BAGH”, 1st Floor, Above Axis Bank, Cunnigham Road,
    Aditya Birla HealthRam Kumar Singh (Zone South)Bengaluru/South#19/4, “SAIR BAGH”, 1st Floor, Above Axis Bank, Cunnigham Road,
    Aditya Birla HealthRyan MichaelChennaiGr Floor Rain Tree Palace, Mc Nicholas Road, Chetpet, Chennai, Tamil Nadu 600034
    Aditya Birla HealthVenuHyderabad# 209, WHITE HOUSE, BLOCK II, 6-3-1192,, Panjagutta Road, Kundanbagh Colony, Begumpet, Hyderabad, Telangana 500016
    Aditya Birla HealthAnujan KrishnamoorthyMumbaiR tech Park, 10th Floor, Nirlon Compound, Off Western Express Highway, Goregaon East, 400063

    Edelweiss Insurance Brokers Limited
    Name of CompanyName of personCityOffice address
    Edelweiss Insurance Brokers LimitedVasant MahadikMumbaiUnit No.1201/1202, 12th Floor, ‘C’ Wing, Godrej Coliseum, Everard Nagar, Chunabhatti, Mumbai – 400022