GROUP MEDICLAIM SCHEME FOR THE YEAR 2009 FOR

RETIRED EMPLOYEES AND THEIR SPOUSES OF STEEL AUTHORITY OF INDIA LTD.

MDIndia Healthcare Services (TPA) Pvt.Ltd,

HEAD OFFICE S.No-46/1,E-Space,A2-Wing,3rd Floor, Pune Nagar Road, Vadgaonsheri, Pune-411014

Dear Mediclaim Member of SAIL, Welcome to the MDIndia Family. MDIndia Healthcare TPA Services has been appointed by United India Insurance Company, to provide healthcare insurance services to you. These services include ID card issuance, Cashless Hospitalization and Settlement of claims on behalf of the UIIC. This guide book gives a preview of various services provided by MDIndia. The guidebook also contains a list of hospitals/nursing homes in the SAIL/MDIndia network where you can avail OPD and Hospitalization treatment. For any clarifications or information, please contact us on our enquiry numbers as mentioned on the reverse side of your member ID card. You can also visit www.mdindiaonline.com for more information. We, the MDIndians, look forward to a long-lasting relationship with you. It will be our constant endeavor to provide all services to you with high quality and minimum turnaround time. Wishing you a healthy and happy life

Rajnish Sharma

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CONTENTS
1. Objectives 2. Reimbursement Services 3. Cashless Services 4. OPD Services 5. Customer Care services 6. Details of SAIL Plant Officials 7. MD India Branch Details 8. Claim Forms (Annexure A-F) 9. Network Hospitals OPD 10. Network Hospitals IPD 4 8 9 10 11 12 13 14- 21 22 - 31 32 - 46

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MEDICAL SCHEME FOR THE RETIRED EMPLOYEES OF SAIL AND THEIR SPOUSES (2009)
1. 2. OBJECTIVES OF THE SCHEME
To extend the Medical Benefits to the retired employees of SAIL and their spouses

PERSONS COVERED
i) Retired employees of SAIL (including IISCO) and their spouses. ii) The employees who have taken voluntary retirement and their spouses. iii) The employees who cease to be in employment on account of permanent total disablement and their spouses iv) The spouse of an employee who dies in service. This scheme is optional and those who opt for this scheme, will hereinafter be referred to as members"

3.

SCHEME
The members will be covered through Group Insurance Mediclaim Policy of the Insurance Company and will be operated through The United India Insurance Co. Ltd., Divisional Office- XI, E 85, Himalaya House, 8th Floor, K.G. Marg, New Delhi-110001. The period of the policy is 1/1/2009 to 31/12/2009.

MDIndia Healthcare Services (TPA) Pvt. Ltd. (Headquartered at Building A 2, 3rd Floor, E Space, VadgaonSheri, Nagar Road, Pune-411014) has been authorized to offer TPA (Third Party Administrator) services for the Group Mediclaim Policy issued for the retired employees of SAIL and their spouses. MDIndia would work out of 9 locations for the purpose of claim settlement. For the purpose of claim settlement, the bills & other related documents should be directly sent to any of the opted centers of MDIndia (vide page no. 13).

4.

PROCEDURE FOR JOINING THE SCHEME

i) As per the arrangement with SAIL, all retiring employees shall be given an enrolment form by the respective offices of plants/units handling the Mediclaim Scheme. ii) This enrolment form should be filled in by the employee and his spouse desiring to join the scheme. Answer to all columns should be given specifically. No Column should be left blank. iii) All retiring employees should get themselves enrolled under the scheme before their retirement. Under no circumstances applications for enrolment received after the retirement will be entertained. However, a grace period of 30 days will be allowed in case of retirement & 90 days in case of death of employee. iv) The postal address should be mentioned in CAPITAL LETTERS.

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v) The enrolment fee is Rs. 925/- per member for the policy period, who in turn shall send the enrollment data to SAIL Corporate Office for onward transmission to the insurance company. vi) On receipt of complete enrolment form by the plant/Unit of SAIL, the Plant/unit shall allot a Mediclaim Index No. (MIN). Note: Any change of address must be immediately intimated to the concerned Plant/unit and Insurance Company giving the Mediclaim Index No. (MIN).

5.

POLICY COVERAGE
The policy covers reimbursement of Hospitalization (and also Cashless Facility) and/ or OutPatient Department (OPD) expenses within the prescribed limits under the policy for illness/diseases contracted or injury / sustained by the insured person. In the event of any claim becoming admissible under the policy, the company will pay to the insured member the amount of such expenses as reasonably and necessarily incurred anywhere in India, but not exceeding in any one period of insurance of amounts under the respective category in the TABLE OF BENEFITS mentioned at clause 8 of this booklet.

6.

DEFINITIONS

a) Hospital/Nursing Home means any institution in India established for Indoor care and treatment of sickness and injuries and which has been registered either as a Hospital or Nursing Home with the local authorities and is under the Supervision of a registered and qualified Medical Practitioner. Or Hospital/Nursing Home should comply with minimum criteria as under, (i) It should have at least 15 inpatient beds, however, in class 'C' towns, condition of Number of beds be reduced to 10. (ii) Fully equipped operation theatre of its own wherever surgical operations are carried out. (iii) Fully qualified nursing staff under its employment round the clock. (iv) Fully qualified Doctor(s) should be in charge round the clock. For the purpose of O.P.D. treatment, "Hospital" shall mean: 1. 2. 3. 4. 5. A Government Hospital, Dispensaries/Clinics run by local Government authority/Municipalities, SAIL Plant Hospitals/Dispensaries SAIL /Approved Hospitals/Nursing Homes (List of SAIL Hospitals Refer Page 22 to 31 ) Franchisee of major Hospitals viz. Apollo, Max, Escorts, Fortis, etc. anywhere in India. Note:The terms "Hospital" shall not include an establishment which is a place of rest, a place for the aged, a place for drug addicts or alcoholic, a hotel or a similar place. b) Surgical Operation means manual and operative procedures for correction of deformities and defects, repair of injuries, diagnosis and cure of diseases, relief of suffering and prolongation of life.

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Note: 1. when treatment such as Dialysis, Chemotherapy, Cataract and Microsurgery is taken in the Hospital/Nursing Home and the insured is discharged on the same day, the treatment will be considered to be taken under Hospitalisation Benefit Section. 2. While Hospitalization facility can be availed of from any Hospital or Registered Nursing Home in India, OPD facility can only be availed of from any Govt. Hospitals/SAIL Plant Hospitals/Dispensaries or Hospitals listed in this Booklet (Page 22to 31). c) O.P.D.Treatment: Means treatment taken as an out-patient in any Govt. Hospital/SAIL Plant Hospital or SAIL approved Hospital/Nursing Home. The Charges incurred for treatment taken from Registered Medical Practitioners or other than SAIL approved Hospital/Nursing Home will not be reimbursed. The Medicine should be prescribed by the Doctors on the letter heads of the hospital. Even though a medical practitioner is attached to any of the Govt. / SAIL plant hospital or SAIL approved hospital and if the treatment is taken by him/her privately the OPD Claim amount will not be reimbursed, under any circumstances. d) Anyone Illness: Anyone illness will be deemed to mean continuous period of illness and it includes relapse within 105 days from the date of last consultation with the Doctor /Hospital Nursing Home. Occurrence of same illness after lapse of 105 days as stated above will be considered as fresh illness for the purpose of this policy. e) Medical Practitioner: Means a person who holds a degree / diploma of a recognized institution and is registered by Medical Council of respective State of India. The term Medical Practitioner would include Physician, Specialist and Surgeon. f) Qualified Nurse: Means a person who holds a certificate of a recognized Nursing Council and who is employed on recommendations of the attending Medical Practitioners.

7.

IMPORTANT EXCLUSIONS
Under Group Mediclaim Insurance Policy, the Company shall not be liable to make any payment in respect of any expenses whatsoever incurred by the insured person in connection with: 1. Any Disease/complication caused due to alcohol intake. 2. Any disease / injury caused by War/Nuclear Weapons/Radiations / Breach of Criminal law. 3. Circumcision, cosmetic or Plastic Surgery unless necessitated by an accident or as a part of any Disease / illness. 4. All health check - ups, routine eye examinations and cost of glasses and contact lenses. 5. Cost of dentures. 6. Convalescence, general debility, "Run-down" condition or rest cure, congenital diseases or defects, sterility, venereal diseases, intentional self injury and use of intoxicating drugs. 7. Any expenses incurred for diagnosis etc. not consistent with treatment for injury / illness / disease. 8. Expenses on vitamins and tonics unless forming part of treatment for injury or disease as certified by the attending physician.

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9. Treatment traceable to pregnancy / child birth, voluntary medical termination of pregnancy during first 12 weeks of conception. 10. Naturopathy Treatment .

8. 8.1

TABLE OF BENEFITS HOSPITALISATION BENEFIT

Hospitalization benefit, Reimbursement and/or cashless will be paid upto Rs. 1,50,000/- per member (with clubbing facility between the retired employee and his/ her spouse) as per policy terms and conditions. The clubbed ceiling under Hospitalization will be upto Rs. 3,00,000/- (Rs. 1,50,000/- x 2) per policy period. 8.1.1 Reimbursement: Reimbursement of actual charges upto Rs. 1,50,000/- per member per policy (with clubbing facility between retired employee & spouse) period spent on Room, IC Unit, nursing expenses, surgeon, anesthesia, medical practitioner, consultant, specialist fees, anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines & drugs, diagnostic materials, X-ray, dialysis, chemotherapy, radio-therapy, cost of pacemaker, artificial limbs of and similar other expenses. CLAIM UNDER HOSPITALIZATION BENEFIT IS ADMISSABLE ONLY WHEN THE PATIENT IS ADMITTED IN A HOSPITAL FOR A MINIMUM PERIOD OF 24 HOURS. Note: Pre-hospitalisation Relevant medical expenses incurred during the policy period upto 30 days prior to the hospitalisation on disease / illness sustained will be considered as part of claim under hospitalisation. HOWEVER MEDICINES BEING PRESCRIBED UNDER REGULAR OPD TREATMENT DURING PRE-HOSPITALISATION WILL NOT FALL UNDER HOSPITALISATION CLAIMS. Post-hospitalisation Relevant medical expenses incurred during the policy period upto 60 days after hospitalisation on disease / illness / injury sustained will be considered as a part of claim under hospitalisation. However, regular OPD treatment prescribed under post hospitalisation prescription will not fall under Hospitalisation claim. 8.1.2 Cashless: The member can also avail of the Cashless Facility in case of hospitalization in empanelled hospitals.

8.2

OUT-PATIENT DEPARTMENT (OPD)

1) The limit of reimbursement of OPD expenses would be Rs. 4000/- per member for the policy period. 2) The member can take treatment in the out-patient department (OPD) of any of the following Hospitals. i) Government Hospital, ii) SAIL Plant Hospital/Dispensaries, iii) SAIL Approved Hospital/Nursing Homes (List attached), iv) SAIL Doctors /Medical Consultants. 3) Retired employee and spouse will not be permitted under any circumstances to club the individual limit\ of Rs. 4000/- per head per policy period.

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4)

The members can avail of OPD treatment facility in the above Hospitals. In case, the OPD treatment is taken in the SAIL Plant Hospitals the members are not required to pay any expenses. SAIL Plant Hospitals will make claims with the Insurance Co. for the any Treatment given to the member. Para 6 (C) may also be referred to. In case OPD treatment is taken at approved Hospital other than SAIL Plant Hospital, the claim should be submitted to MDINDIA Health Care Services (TPA) Pvt.Ltd. at the opted centre. (Vide page no. page 18) 5) OPD treatment availed from the listed Hospitals should be necessarily claimed on the letterhead of the listed Hospital. Private OPD treatment wherein the prescription is on the letterhead of the doctor shall be treated as private treatment and will not be reimbursed.

9.

CLAIM PROCEDURE A. Reimbursement Hospitalisation

i) Notice of the claim should be sent to the MDIndia at the centre of option, immediately and not later than 7 days of the injury / hospitalisation indicating Mediclaim Index No, Name of the Insured Member, Nature of Injury/illness, Name of the Hospital/Nursing Home. Specimen of claim intimation letter is Annexure- A, at page 14. ii) The claim form should be submitted duly filled in all respects and no column should be left blank. The specimen copy of claim form on pages 15-17, Annexure- B, AnnexureC may be used for the purpose. iii) All bills, Medical Reports, test reports, Pathological test report along with original prescription, Hospital Admission & Discharge Certificates be submitted by Registered Post, to the specified office of MDINDIA Health Care Services (TPA) Pvt. Ltd . as per centre opted at the address given in this booklet in support of the claim along with prescribed claim form (specimen copy on page 15 to 17 ) immediately on completion of the treatment or on expiry of 60 days from the date of discharge from the hospital whichever is earlier. Do ensure that the treatment is taken from a Registered Medical Hospital. However, in case, the treatment is taken in non-registered hospitals on an emergency basis, the insured member should have valid reasons for doing so and should immediately inform the Insurance Company with full details. All claim papers should be submitted in original. No photocopy will be accepted. Further, it may be noted that in case the bills/report enclosed with the hospitalisation claim paper pertain to establishment other than the nursing homes/hospital where the insured was hospitalized and they are not supported by proper prescription/advice of the attending doctor, then such bills/reports must be duly certified by the attending Doctor. iv) On receipt of completed claim form along with relevant document & discharge voucher, MDIndia shall process the claim. If the documents are found to be in order and other relevant information is complete, the claim will be settled and claim cheque would be posted as early as possible, normally within 15 days of the receipt of all claim documents mentioned by the Insurance Company. Cheques valuing more than Rs. 1000/- would be sent by Regd. Post. Cheques can also be collected in person by the claimant or by any person authorized by the claimant.

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B. Cashless Hospitalization MDIndia offers Cashless Service to the Insured, where treatment can be obtained at any of MDIndia network hospitals without payment, subject to the terms and conditions of the policy. MDIndia will settle the hospital bills directly on behalf of insured. A list of network hospitals is attached for reference. (Ref to pages # 31-45). **ID Cards Insured is requested to show the enclosed MDIndia ID card at the time of Cashless hospitalization. Please establish photo identification, as it is a non-photo ID card, by confirming it with a valid identity proof like driving license, Passport, Election Commission Card or Mediclaim Booklet issued by the SAIL plant, etc. The Request for Authorization along with the MDIndia card and a photo ID has to be faxed to MDIndia at Authorization # 1-800-2334505, within 72 hours before the admission. The filled up RAL form is faxed by the hospital authorities. The format of the RAL is attached for reference on Annexure F (ref to Page # 20). The information in this form is to be filled in by the Hospital Authorities and partially by the Insured. When the policyholder is advised admission to one of the network hospitals for treatment: Part I of Request for Authorization to be filled in by SAIL member (Ref page no 20). Part II of the RAL to be filled by the attending doctor/surgeon/hospital RAL to be faxed by the hospital to MDIndia Head Office at 020-25300030/1-8002334505 On receiving the RAL, MDIndia will do one of the following: a. Authorize MDIndia will fax an "Authorization Letter" (AL) directly to the hospital. In case the cost of hospitalization exceeds the sum insured in the policy, the policyholder will have to pay the difference to the hospital. MDIndia will not be liable for any amount in excess of the amount specified in the AL. The AL is valid only for the period of hospitalization as specified on the RAL. b. Request Additional Information In case the information provided in the RAL is incomplete, unclear or insufficient, MDI will request clarification from the policyholder/hospital. RAL maybe approved or rejected subject to obtaining the Additional information and based on the terms and conditions outlined in the policy. c. Denial MDIndia will fax Denial of Authorization Letter (DAL)* directly to the hospital. Cashless facility may be denied in some situations as mentioned below: Any ambiguity in the policy terms and conditions with respect to the present ailment. Insufficient sum insured to cover the hospitalization expenses.

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RAL is not received by MDIndia in time. If the information sent to MDIndia is insufficient to confirm the coverage. The policyholder or his/her relative must sign the claim form and hospital bills at the time of discharge from the hospital. *Please note that DAL is only denial of cashless facility and is no way to be interpreted as denial of treatment. You retain the right to get treated, pay for the services and then submit the bills to us for reimbursement, subject to policy terms and conditions. In case of hospitals/cities not included in the list, call at the Authorization #. Each request would be dealt on a case to case basis. EMERGENCY HOSPITALIZATION In case the insured is admitted to one of our network hospitals in any emergency or accident, the RAL should be faxed to MDIndia Head Office or Branch within 24 hours of admission. MDIndia would authorize or deny the request as mentioned earlier. If the insured gets admitted to a non-network hospital, please refer to non-cashless hospitalization services section.

C. OUT-PATIENT DEPARTMENT (OPD) TREATMENT i) OPD claim should be submitted to the concerned office of MDINDIA Health Care Services (TPA) Pvt.Ltd along with1) OPD claim Form (specimen at page 18) duly filled in. 2) All Doctor's Prescription 3) All Receipts for Drugs/Diagnostic Tests 4) All Diagnostic Reports All the above documents should be submitted in Original, in proper sequence, duly tagged/stapled. ii) Dental Treatment can also be availed of within the existing limit of Rs. 4000/- per member for the policy under O.P.D. treatment. Cost of dentures will not be reimbursed. iii) In case of expenses on Eye Treatment, cost of spectacles/contact lenses shall not be reimbursed. iv) OPD Claims should be submitted by the beneficiary to the concerned office of MDINDIA Health Care Services (TPA) Pvt.Ltd .only when the expenses exceed Rs. 1000 per person per policy period, within 15 days from the date of completion of the treatment. In other words the minimum claim for OPD should be Rs. 1000/- For those members whose OPD expenses do not exceed Rs. 1000/- during the entire policy period, the bills should be forwarded by such members within 15 days from the date of expiry of policy period i.e. latest by 15th January of the succeeding year For claims not lodged within the stipulated time limit. the company shall not be liable for such claims. v) In case of treatment of ear, cost of hearing aid is not reimbursable

C.

In case of any dispute in a claim, a committee of SAIL, UIIC officials and MDIndia Health Care Services (TPA) Pvt Ltd will be constituted to resolve the dispute. The decision of the committee in this regard will be binding on Page 10

the parties. It shall be compulsory for all members of the scheme to first refer any grievance that they may have to the committee and wait for a reasonable time for the decision of the committee. The committee shall give detailed reasons for the decision taken for each and every dispute or grievance referred to it by any member of the scheme.

Customer care services

In case you have any questions or require assistance during hospitalization / claims processing we offer complete support to you, 24/7, through our multi-lingual Customer Care Centre. Toll Free Customer care Number : 1800-233-1166 Customer care Voice (UAN ) Number : 1860-233-4446 Toll Free Authorization Number :1800-233-4505 Authorization Fax Number : 020-25300030 Authorization Voice (UAN ) Number :1860-233-4448 Authorization Fax (UAN ) Number :1860-233-4449

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LIST OF OFFICIALS DEALING WITH SAIL MEDICLAIM SCHEME

PLANT CODE PLANT/ UNIT NAME OF THE OFFICIAL DESIGNATION CONTACT NO. 0788-2854928 0788-2853894 2 DURGAPUR STEEL PLANT Prabir Kr. Das Jr. Mgr (PersWel) SR.MGR (PL)W&ES Asstt. Gen Mgr (Pers-FSC) JR. MGR (PERS) 0343-2562316 EMAIL ADDRESS

BHILAI STEELPLANT

Vijay Kumar Sharma

Sr.Mgr(P)

vijaysharma@sailbhilaisteel.com mddsp3882@dataone.in amarendra.patnaik@sailr sp.co.in bko_fsc@yahoo.co.in a.banerjee94172@gmail. com

ROURKELA STEEL PLANT

A.Patnaik

0661-2448506

4 5 6

BOKARO STEEL PLANT IISCO STEEL PLANT

BP Barnwal Arup Kr. Banerjee

06542-240273 0341-2240313

ALLOY STEELS PLANT

SALEM STEEL PLANT CENTRAL MKTG.OFFICE SAIL CORP .OFFICE CENTRE FOR ENGG & TECH. GROWTH DIVISION KULTI GROWTH DIVISION KOLKATA

A.P. Singh
A.Saifudeen Ambarish Chakraborty Y.P.Manchanda

Sr.Mgr (Pers)
ASSTT.MGR (PERS) Dy.Mgr (Pers)

03432545795
0427-2382210

apsingh_dgp@redif fmail.com
Saif_salem@rediffmail.c om ambarishc@sailsteel.com yp.manchanda@sailex.c om shibajidey@yahoo.com

033-22888825

Dy. Mgr(PERS) DY MGR (PERS) SR.Mgr (PERS) ASSTT.MGR (Law) MANAGER (PERS) Asstt. Gen. Mgr (P&A) SR.MGR(PERS) SR.MGR (PERS)

011-24300329

10

SHIBAJI DEY

0651-2411175

11

BL DHAWAN

12

S.K.SARKAR

033-22263399 08282-271621 Ext. 2011 07172-254368

swapankumar.sarkar@re diffmail.com vislpersworks@yahoo.co m ppchaku@hotmail.com rmd_mediclaim@rediff mail.com

13

VISL, BHADRAWATI

H.S.MANJUNATH

14

MEL CHANDRAPUR RAW MATERIALS DIVISION, KOLKATA RESEARCH & DEVELOPMENT CENTRE, RANCHI

PP Chakrabarty

15

V Kevin Ghose

033-22827603

16

A.K.Sinha

0651-2411128

clc@sail-rdcis.com

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D. Details of dealing officers / office at the Nine centers & MDIndia HO is given below: 1. Kolkata Branch 2. Chennai Branch
MDIndia Healthcare Services (TPA) Pvt. Ltd 169 Sarat Bose Road, 2nd Floor, Kolkata 700 026 Phone: 033-24669429 Fax : 033-24656633 Email : sailkolkata@mdindia.com MDIndia Healthcare Services (TPA) Pvt. Ltd 1402, 15th Main Road, Annanagar, Chennai - 600040 Phone: 044-26162386 044-26160370 Fax: 044-26164000 Email: sailchennai@mdindia.com

3. Delhi Branch
MDIndia Healthcare Services (TPA) Pvt. Ltd E98, 2nd Floor, Lajpat Nagar, Part II, New Delhi 110024 Phone: 011-29811840 Fax : 011-29811838 Email : saildelhi@mdindia.com

4. Bhilai Branch
MDIndia Healthcare Services (TPA) Pvt. Ltd 10th Street, Shanti Nagar, Opp. Dashera Maidan, Bhilai Durg , Pin 490023. Phone: 0788-2291860 Fax: 0788 - 2291860 Email: sailbhilai@mdindia.com

5. Durgapur Branch
MDIndia Healthcare Services (TPA) Pvt. Ltd 22, Kabiguru Sarani, SAIL Co-Op, City Center, Durgapur- 713216 Phone: 0343 - 2605644 Fax: 0343 - 2605644 Email: saildurgapur@mdindia.com

6. Rourkela Branch
MDIndia Healthcare Services (TPA) Pvt. Ltd BM-77, Basanty Colony, Near DL Chowk, Rourkela, Orissa 769 012 Phone: 0661- 2420779 Fax: 0661 - 2420779 Email: sailrourkela@mdindia.com

7. Bokaro Branch
MDIndia Healthcare Services (TPA) Pvt. Ltd 1st floor, Mishra Market, Plot no. 7081, Near Vaibhav Hotel, By-Pass road, Chas, Bokaro, Pin- 827013 Phone:06542-236426 Fax: 06542-236426 Email: sailbokaro@mdindia.com

8. Salem Branch
MDIndia Healthcare Services (TPA) Pvt. Ltd 59 S.K. Nagar, Seelanaickenpatty, Pin Code 636201 Phone: 0427-246686 Fax: 0427-246686 Email: sailsalem@mdindia.com

9. Asansol Branch
MDIndia Healthcare Services (TPA) Pvt. Ltd Room no.3 Shanti Niwas, 1st floor, Besides Income tax office, G.T. Road, Asansol , Pin No.- 713304 Phone: 0341-2250799 Fax: 0341-2250799 Email: sailasansol@mdindia.com

Pune HO Office
MDIndia Healthcare Services (TPA) Pvt. Ltd S.No-46/1,E-Space,A-Wing,3rd Floor, Pune Nagar Road, Vadgaonsheri, Pune-411014 Phone: 020 - 25300030 Fax : 020 -25300003 Email : customercare@mdindia.com authorization@mdindia.com sailops@mdindia.com

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Annexure A
CLAIM INTIMATION LETTER To, MDIndia Healthcare Services (TPA) Pvt.Ltd ...................................................... ...................................................... ...................................................... Dear Sir, Sub: MIN No. . . ......................................... This is to inform you that I have been admitted to Hospital, details of which are as under: 1) Name of Insured Member: ................................................................................ 2) Phone No. : ................................................................................ 3) Nature of Injury/Illness: ................................................................................ 4) Name & Address of Hospital: .............................................................................. ........................................................................................................................................... ... 5) Date of Admission of Hospital: ................................................................................ Thanking You, Yours Faithfully Name: ___________________________ Full Address for Correspondence: _______ __________________________________ Phone No. : ________________________ Page 14 Dated: .........................

Annexure B: HOSPITALISATION BENEFIT POLICY CLAIM FORM

Issuing Office:

Specimen

MDINDIA HEALTHCARE SERVICES (TPA) PVT LTD. HOSPITALISATION BENEFIT POLICY CLAIM FORM Claim No. (For office use only)
Please fill all columns without exception, put N.A, wherever the column is not relevant. 1) Name of the Insured: . . (In Capital Letters) SURNAME NAME 2) Detail of the person Undergoing treatment: a) Name b) Date of Birth : :

c) Residential Address: ... d) Phone Number 3) MIN No. (Self) MIN No. (Spouse) : : :

4) Nature of Disease/ Illness/Injury Suffered : 5) a) Name and Address of the Hospital/Nursing

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Home Registration No. b) Date of Admission c) Date of Discharge

:. :. State/U.Territory.. : :

I have incurred on the treatment of Disease/Illness/Accident referred to above, the expenses as per the details given by me in the Schedule of expenses given overleaf. In support of the above claim I enclose the following documents in Original. 1. Bill, receipt and Discharge Certificate/Card from the Hospital. 2. Cash Memos from the Hospital/Chemist/(s), Supported by the proper prescription. 3. Pathological Test Report. 4. Surgeon's Certificate stating nature of operation performed. 5. Attending Doctor's/Consultant's/Specialist/Anesthetists Report. 6. Discharge Voucher duly signed on Rs. 1/- Revenue Stamp (Specimen given on page 14). I hereby warrant the truth of the foregoing particulars in every respect. I further declare that, in respect of the above treatment, no benefit under any other scheme of insurance or from my present employer's if any, have been claimed by me. I also consent and authorize MDIndia/Insurance Company to seek medical information/collect documents from any hospital/Medical Practitioner who has any time attended on the insured person.

Date:

Signature of Claimant Page 16

Annexure C: SCHEDULE OF EXPENSES INCURRED BY THE CLAIMANT

MIN NUMBER . (If allotted) SCHEDULE OF EXPENSES INCURRED BY THE CLAIMANT (Attach separate Annexure for details of bills) Details of expenses claimed under Hospitalisation (To be supported by Bills/Receipt, Cash Memos etc) 1. Pre Hospitalisation Benefits (Within 30 days prior to admission in the hospital) CLAIM NO

Amount Claimed

2. Hospitalisation Benefits

3. Post- Hospitalisation Benefits (upto 60 days from Date of Discharge)

Total
I also consent and authorize MDINDIA/ united India insurance /SAIL to seek medical information/documents from any hospital /provider who has any time attend on the insured person .

Date:

Place:

Signature of Claima

Page 17

Annexure D: O.P.D TREATMENT CLAIM FORM

MDINDIA HEALTHCARE SERVICES (TPA) PVT. LTD O.P.D TREATMENT CLAIM FORM 1) Name 2) MIN : :

3) Address (IN BLOCK LETTERS): ... 4) Phone Number 5) Nature of Illness 6) Period of Illness 7) Expenses Incurred a) For Consultation b) For Medicines c) For Pathological & Other Diagnostic tests : : : : : : Amount Bill No. Bill Date

I declare that the given information is correct and that I have not claimed reimbursement for the above expenses incurred by from any other source. I also consent and authorize MDINDIA/ united India insurance /SAIL to seek medical information/documents from any hospital /provider who has any time attend on the insured person . Place: Date : (Signature of Insured)

Note : Please enclose the following documents in original along with the claim form : a) OPD Card of SAIL approved / Govt. Hospital. b) Chemist/Nursing Home Bills/Receipts. c) All Pathological & other test report and bills, if any. d) Discharge Voucher duly signed (specimen given on page 14). All the above should be in original. No Photocopies will be accepted.

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Annexure E: Payment Voucher

MDINDIA HEALTHCARE SERVICES (TPA) PVT LTD (Regd Office and H.O., Building A 2, 3rd Floor, E Space, Vadgaon Sheri, Nagar Road, Pune-411014) Payment Voucher : Office: Doc. Code: Pay to Towards : S.L 01. 02. 03. 04. 05. Dept code Policy Yr Number Tr. Code Endt / Ren Yr Number Tp Amount Debit Payment No: Date: Bank A/c Code: MIN NO. : A/C Credi Main Code Sub CL Code Insp Cod e NOL code

Authorised By

AAO

AO

Asst/Dy. MGR

MGR

AGM

GM Please affix Rs. 1/- revenue stamp if amount exceeds Rs. 5000/-

Received with thanks from MDIndia Healthcare Services(TPA) Pvt. Ltd A sum of Rupees (in words)

By Cheque No. Drawn On: Dated Cashier Signature of Recipient

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Annexure F: Request for Authorization (RAL) for Cashless Hospitalization.

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Annexure G Document Acknowledgement Form

MIN: . Name of Patient: .. Date of Submission: .. Branch of Submission: . Type of Document: a. OPD Claim b. Hospitalization Claim c. Additional Document Replies d. Pre/ Post Hospitalization Claim e. Deduction Payment f. Reconsideration Claim

Page 21

LIST OF SAIL APPROVED HOSPITALS FOR OPD TREATMENT UNDER SAIL MEDICLAIM SCHEME ANDHRA PRADESH
City Name Hyderabad Hyderabad Hyderabad Hyderabad Hyderabad Hyderabad Hyderabad Kakinada Kakinada Nellore Vijayawada Vijayawada Vijayawada Vijayawada Vijayawada Visakhapatnam Visakhapatnam Hospital Name Apollo Hospital Aghava Ratna Towers, ChiragAli Lane Care Hospital Jaya Diagnostic & Research Centre Ltd. MEDWIN Hospitals LN Prasad Eye Hospital Yashoda Hospital & Medicity Hospital Maxvision Eye HospitalBegumpet , Hyderabad Apollo Samudra Hospitals Care Hospital Bollineli Ramanaiah Memorial Hospital Global Medical Centre Pinnamaneni Care Hospital Saumya Apollo Hospital St. Ann's Hospital Vijetha Hospital City Care Hospital K.G. Hospital

ASSAM
City Name Guwahati Hospital Name International Hospital

BIHAR AND JHARKHAND

City Name Bokaro Darbhanga Darbhanga Dhanbad Dhanbad Dharbhanga Dhanbad Giridih Hazaribagh Jamshedpur Jamshedpur Jamshedpur Patna Patna Hospital Name Referral Hospital, P.O. Jainamore Ram Janki Hospital R.B. Memorial Hospital BCCL Hospital CCWO Hospital Sariadhella DMCH Patliputra Medical College State Referral Hospital, Dumri Mission Hospital Cancer Hospital Tata Main Hospital Telco Hospital Holy Family, Hospital, Kurji Indira Gandhi Ayur Sansthan,Sekhpur

Page 22

Patna Ranchi Ranchi Ranchi Ranchi Ranchi Ranchi Ranchi Ranchi Ranchi Ranchi Ranchi

Patna Medical College Hospital Apollo Hospital, IRBA Gurunanak Hospital & Research Centre Hospital for Mental Disease Ispat Hospital, MECON Mahadevi Birla TB Sanatorium Marwari Sewa Sadan Mission Hospital, Bariatu Nagar Mal Modi Seva Sadan Rajendra Medical College Hospital R.K. Mission TB Sanatorium Raj Hospital Nidan - Main Road

DELHI
City Name Anand Vihar Ashok Nagar Ashok Vihar, Phase-III Darya Ganj Dwarka Rohini East of Kailash East of Kailash, New Delhi - 24 Greater Kailash, Part-I 23/7 Shakti Nagar,Delhi-7 Rohini Jangapura, New Delhi-14 Madhuban Chowk New Delhi Greater Kailash-II Greater Kailash-II Green Park, Extn Janakpuri Ring Road, Lajpat Nagar-IV Greater Kailash I Delhi Qutab Institutional Area Qutab Institutional Area Pusa Road Panchuian Road, K.G. Marg & Kailash Colony Safadurjang Development Area Lajpat Nagar Lajpat Nagar Laxmi Nagar Mandir Marg, Saket Hospital Name Swastik Medical Centre Tyagi Nursing Home Sunder Lal Jain Charitable Hospital Sanjeevan Hospital Ayushman Hospital Rajiv Gandhi Cancer Institute & Research Centre, National Heart Institute, 49, Community Centre R.G. Stone Clinic Urological Research Centre East West Medical Centre Pvt. Ltd. Parmarth Misson Hospital Saroj Hospital & Heart Institute Sahi Hospital Bhagwan Mahavir Hospital Retina Associates Eye Institute South Point Hospial Mohindra Hospital Mata Chanan Devi Hospital The Heart Centre, Sukdha Hospital, Max Hospitals Sita Ram Bhartia Institute of Science & Research, Rockland Hospital, Jeevan Nursing Home & Hospital, Delhi Heart & Lung Institute, Shroff Eye Centre Orthonova Institute of Advanced Surgery and Research Centre Moolchand Khairati Ram Hospital Dr. Patnaik Laser Eye Institute Walia Nursing Home Gujarmal Modi Hospital & Research Centre For Medical Sciences

Page 23

Mathura Road, Near Sarita Vihar Mayur Vihar Naveen Shahdara Vasant Vihar Lajpat Nagar Okhla Road Okhla Road Okhla Road Pandav Nagar, Naraina road Paschim Vihar Preet Vihar Pusa Road Rajendra Nagar Rajpur Road Rohini Rohini Rohtak Road, Punjabi Bagh Sarita Vihar Sham Nath Marg Sheikh Sarai, Phase-II South Extn Sheikh Sarai Tis Hazari Vasant Kunj Vasant Vihar Vasundhra Enclave Vikas Marg, Extn. Vikas Marg, Extn. Village Khizrabad (Near Friends Colony)

Apollo Indraprastha Hospital Jeevan Anmol Hospital Dr. Gupta Nursing Home & Hospital Vasant Lok Hospital Vidhya Sagar Institute of Mental Health and Neuro Science (VIMHANS) Batra Hospital and Medical Research Centre Escorts Heart Institute and Research Centre Holy Family Hospital Khera Hospital Bhatia Global Hospital Anand Health Care Pvt. Ltd. Kolmet Hospital & Medical Research Centre Sir Ganga Ram Hospital Tirath Ram Shah Hospital Bhagwati Hospital Jaipur Golden Hospital Maharaja Agrasain Charitable Hospital Shri Ram Medical Centre Sant Parmanand Hospital Pushpavati Singhania Research Institute for Liver, Renal & Digestive Diseases, Arya Vaidyashala, (Kottakal) Venu Eye Institute St. Stephans Hospital Indian Spinal Injuries Centre Seth Prabhu Dayal Gupta Charitable Hospital Dharmshila Cancer Hospital & Research Centre Deepak Memorial Hospital & Medical Research Centre Shanti Mukund Hospital Lions Hospital & Research Centre, Lions Service Trust

GOA
City Name Bonapavla Margao Hospital Name Manipal Goa Cancer and General Hospital Apollo Victor Hospital

GUJRAT
City Name Ahmedabad Ahmedabad Ahmedabad Vadodara Vadodara Hospital Name Dr. Jeevraj Mehta Smarak Health Foundation Medical Research Centre M.P. Shah Cancer Hospital R.G. Stone Clinic Bhailal Amin General Hospital Metro Hospital & Research Center

Page 24

HARYANA
City Name Sector-51, Gurgaon Palam Vihar, Gurgaon DLF City -IV Gurgaon Faridabad Gurgaon Gurgaon Gurgaon Gurgaon Gurgaon Gurgaon Hissar Panchkula Panchkula Sonipat Sonipat Sonipat Yamuna Nagar Bahadurgarh Hospital Name Artemis Health Institute Columbia Asia Hospital, Shri Ram Bhartia Clinic Escorts Hospital Centre Ark Hospital MP Heart Research Institute Privat Hospital Paras Hospital Uma Sanjivini Heatlh Centre Pvt. Ltd Umkal Hospital Hospital attached to Jindal Steel Alchemist Hospital Dhawan Hospital Bharat Hospital Janki Das Kapoor Memorial Hospital Sathya OmNethra & Maternity Hospital JP Hospital Delhi Hospital & Nursing Home

KARNATAKA
City Name Bangalore Bangalore Bangalore Bangalore Bangalore Bangalore Bangalore Bangalore Bangalore Bangalore Bangalore Bangalore Bangalore Bangalore Bangalore Bangalore Bangalore Hospital Name Bangalore Institute of Dental Science & Hospital Central Institute of Neuro-Science Chinmaya Mission Hospital Innovative Dental and Medical Poly Care Centre KMC Hospital Mallaya Hospital Manipal Hospital Manipal Heart Foundation Mental Hospital Model Eye Clinic and Nursing Home Nethradhama Superspeciality Eye Hospital Shri Satya Sai Hospital St. Marthas Hospital The Bangalore Hospital Vittala International Institute of Ophthalmology Wochardt Hospital Ramiah Hospital

Page 25

Bangalore Manipal Mysore Mangalore

St. John's Medical College and Hospital Kasturba Hospital Basappa Memorial Hospital A J Hospital & Research Centre

KERALA
City Name Alapuzha Melamur Palakkad-6 Chittur Road, Palakkad-13 Kollam Palakkad Perinthalmanna-679322 Alleppey Calicut Chengannur Kochi Kochi Kochi Kochi Kochi Kochi Kochi Kochi Kochi Kochi Kochi Eraviperoor Irinjalakuda Kannur Kannur Kollam Kottayam Kottayam Kottayam Kottayam, Kollam Kozhencherry Mulakuzha Palakkad Palakkad Palakkad Palakkad Pandalam Parumala Pathanam Thitta Hospital Name VSM Hospital Karuna Hospital Lakshmi Hospital Amrita Ayurveda Medical College Hospital & Research Centre, Diabetic Centre EMS Memorial Co-operative Hospital & Research Centre St. Thomas Mission Hospital Bady Memorial Hospital Christian Mission Hospital Amrita Institute of Medical Science & Research Centre Arya Vaidyasala (Kottakal) Ernakulam Medical Centre Indira Gandhi Co-op. Hospital KPM Eye Hospital Ojus Clinic & Nursing Home PVS Hospital Giridhar Eye Institute Lisie Hospital Lourdes Hospital Medical Trust Hospital Kotakkattu Medicare Hospital Lal Memorial Hospital Cooperative Hospital Indira Gandhi Co-op. Hospital S.S.M. Hospital Karithas Hospital Mar Gee Varghese Dionysius Memorial Hospital S.H. Medical Centre Holy Cross Multispeciality Hospital Muthoot Medical Centre Century Hospital Palana Hospital Palat Memorial Hospital Thangam Hospital of PMRC Welcare Hospital N.S.S. Medical Mission Hospital St. Gregorios Cardio-Vascular Centre Tiruvalla Medical Mission

Page 26

Pathanamthitta Pathanamthitta Perumbavoor Trichur Trichur Trichur Trichur Trichur Trichy Triuvalla Dist, Ernakulam Trivandrum Trivandrum Trivandrum Trivandrum Trivandrum Trivandrum

Marthoma Medical Mission Hospital Muthoot Medical Mission Hospital San Joe, Hospital Amala Cancer Hospital Aswani Hospital Elite Mission Hospital Jublee Mission Hospital Trichur Heart Hospital Maruti Hospital Pushpgiri Hospital General Hospital Mental Hospital Mother Hospital Samaritan Hospital Shreechitra Tirumak Medical Centre Sree Uthradom Thirunal Hospital

MADHYAPRADESH
City Name Bhopal Gwalior Bhopal Indore Indore Indore Jabalpur Raipur Raipur Ujjain Ujjain Vindyanagar Hospital Name Kasturba Hospital (BHEL) G.R. Medical College Ayushman Hospital Centre Bombay Hospital Choitham Hospital & Research Centre M.Y. Hospital Jabalpur Hospital & Research Centre D.K. Hospital Modern Medical Institute PSS Hospital & Research Centre Pushpa Mission Hospital Vindyachal Hospital (NTPC)

MAHARASHTRA
City Name Mumbai Vashi Navi Mumbai Mumbai Mumbai Mumbai Mumbai Mumbai Mumbai Mumbai Hospital Name Bombay Hospital Sterling Wockhardt Hospital Lilavati Hospital & Research Centre B.J. Wadia Hospital G.T. Hospital Hinduja Hospital Jaslok Hospital J.J. Group of Hospital K.E.M. Hospital

Page 27

Mumbai Mumbai Mumbai Mumbai Mumbai Nagpur Nagpur Nagpur Navi Mumbai Navi Mumbai Pune Pune Pune Pune Pune Pune Thane

NAIR Hospital Nanavathi Hospital R.G. Stone Clinic Tata Cancer Research Institute Tata Memorial Hospital Central India Institute of Medical Science Mental Hospital Wockhardt Hospitals Dr. D. Y. Patil Hospital & Research Centre Sterling Hospital Artificial Limb Centre Sadhu Vaswani Mission Medical Complex K.E.M. Hospital Medipoint Hospital N.M. Wadia Institute of Cardiology Jehangir Hospital Lok Hospital

ORISSA
City Name Berhampur Bhubaneshwar Bhubaneshwar Bhubaneshwar Cuttack Sambalpur Hospital Name M.K.C.G. Medical College Apollo Hospital CDR Hospital Kalinga Hospital S.C.B. Medical College V.S.S. Medical College

PUNJAB
City Name Chandigarh Chandigarh Chandigarh Ferozpur Hoshiarpur Jallandhar Ludhiana Rajpura Hospital Name Fortis Hospital Inscol CMC Hospital Anil Baghi Hospital Modern Hospital Patel Hospital Pvt. Ltd. CMC Hospital Soni Hospital

RAJASTHAN
City Name Alwar Alwar Hospital Name Indraprastha Apollo Hospital Sinha Nursing Home

Page 28

Jaipur Jodhpur Vasant Vihar , Alwar

SMS Medical College Goyal Hospital & Research Centre Pvt. Ltd. Seth Prabhir Dayal Gupta Charitable Hospital

TAMIL NADU
City Name Chennai Chennai Chennai Chennai Chennai Chennai Chennai Chennai Chennai Chennai Chennai Chennai Chennai Chennai Chennai Chennai Chennai Chennai. Chennai. Coimbatore Coimbatore Coimbatore Combiatore Coimbatore Coimbatore Coimbatore Coimbatore Coimbatore Coimbatore Madurai Madurai Madurai Madurai Pondicherry R.S. Puram Salem Trichy Trichy Hospital Name Apollo Hospital B.S.S. Hospital Shri. Ramachandra Hospital Cancer Institute General Hospital K.J. Hospital Malar Hospital Madras General Hospital Railway Headquarters Hospital R.S.R's Trinity Acute Care, Hospital Shanker Netralaya Sundaram Medical Foundation Tamil Nadu Hospitals Vijaya Hospital St. Isabel Hospital Dr. Mohans Diabetological Institute Madras Medical Mission Indian Medical Practitioners, Co-operative Society Hospital Ramachandra Medical College & Research Institute Kottakkal Arya Vaidyasala Ganga Medical Centre & Hospital Pvt. Ltd. G Kuppuswamy Naidu Memorial Hospital, Vijaya Hospitals Kennedy Hospital, K.G. Hospital Nataraj Hospital, Kanchi Kamakoti Trust Ram Krishna Hospital The Eye Foundation Coimbatore Aryu Viidyu (Pharmacy) Apollo Hospital Arvind Eye Hospital Bose Hospital Meenakshi Mission Hospital & Research Centre East Coast Hospital Vedanayakam Hospital Sri Gokulam Hospital Sea Horse Hospital Ltd Kavery Medical Centre (KMC) Trichy

Page 29

Vellore

Christian Medical College & Hospital

UTTAR PRADESH
City Name Agra Aligarh Aligarh Allahabad Ghaziabad Ghaziabad Ghaziabad Ghaziabad Ghaziabad Haridwar Kanpur Kaushambi Lucknow Lucknow Lucknow NOIDA NOIDA NOIDA NOIDA NOIDA NOIDA NOIDA Sitapur Varanasi Hospital Name Jalma Insitute of Leprosy Trg. & Research Centre Gandhi Eye Hospital J.N. Medical College MLN Medical College Dr. R.S.G. (Indo German) Medical Centre Ganesh Hospital Narendra Mohan Hospital Sarvodya Hospital Yashoda Hospital Dispensaries run under Divya Yog Mandir (Trust) Regency Hospital Ltd Jashoda Speciality Hospital Vivekanand Polyclinic OP Chaudhar Hospital & Research Centre, Ramakrishnan Mission Aggarwal Eye Hospital & Dental Care Centre Kailash Hospital & Research Centre Ltd Keerti Medical Centre Metro Multi Speciality Hospital Fortis Hospital, Metro Heart Hospital, NOIDA Medical Centre Eye Hospital B.H.U. Hospital

UTTARAKHAND
Dehradun Jolly Grant Himalaya Institute of Medical Sciences

WEST BENGAL
Barrakpore Hooghly Howrah Burdwan Kolkata Kolkata Kolkatta Kolkatta Kolkatta Disha Eye Hospital & Research CentreAroga Niketan West Bank Hospital Burdwan Medical College & Hospital Zenith Superspeciality Hospital, Nightingle Digonostic & Medicare Centre Pvt. Ltd, Advance Medicare and Research Institute Anandlok Hospital Assembly of God Church Hospital

Page 30

Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Kolkatta Purulia Raniganj

Aurobindo Seva Kendra B. P. Poddar Hospital & Medical Research Ltd B.M. Birla Heart Research Insitute Bangur Institute of Neurology Behala Balananda Brahmachari Hospital & Research Centre Calcutta Medical & Research Insitute Cancer Centre and Welfare Home Calcutta Heart Clinic & Hospital Chittaranjan Cancer Hospital Dr. Rafi Ahmed Dental College & Hospital Dr. Sudarsan Chakarborti Memorial Centre for Research and Treatment Apollo Gleneagles Hospital Eskag-Sanjeevani Eye Care & Research Centre Harmoni Nursing Home ILS Multi Speciality Clinic Jitendra Narayan Ray Sishu Seva Bhawan Kothari Medical Centre K.P.C. Medical College & Hospital Microlap Nursing Home Paramount Hospital Pvt. Ltd Park Clinic North Bank Diagnostic Centre North City Hospital & Neuro Institute Peerless Hospital Ramakrishna Mission Seba Pratishthan Ruby General Hospital Rabindra Tagore International Institue of Cardiac Sciences SEBA Hospital Sahid Khudiram Bose Institute & Research Centre Silver Line Hospital & Research Institute Subodh Mitra Cancer Hospital & Research Centre Suraksha Hospital Susrut Eye Foundation & Research Centre Wockhard Medical Centre West Bengal Spastics Society Wockhard Hospital & Kidney Institute IIIA Woodland Nursing Home Netaji Eye Hospital Anandlok Hospital

Page 31

LIST OF EMPANELED HOSPITALS FOR CASHLESS UNDER TPA

AHMEDABAD
Location Dr Jivraj Mehta Marg Memnagar S.G. Highway Shahibag Hospital Name Dr Jivraj Mehta Smarak Health Foundation Sterling Hospital Shalby Hospitals Ltd The Gujarat Research & Medical Institute (rajasthan Hospitals)

ASANSOL
Location G T Road G T Road G T Road G T Road (W) Lower chelidanga Ranigung NH 2 Sen raligelh road Sen raligelh road Sen raligelh road Hospital Name Asansol Metropolitan Nursing home City Nursing Home Kamalya Nursing Home Asansol Mecdial center Life linemedicare AnandalokHospital Dodadil nursing HLG Hsopital (tertiary) Lion Hospital

BALLABGARH
Location Ballabgarh Hospital Name Akash Hospital

BANGALORE
Location 2nd Main Road Agrahara Dasarahalli Ashok nagar Indira nagar Sonde koppa Circle Vittal Mallya Road Bommasandra Industrial Area Mahalaxmi Layout Airport Whitefield Rd Hospital Name Chiranjeevi Hospital and Maternity Home Sarvodaya Hospital St Philomena Hospital Chinmaya Mission Hospital Harsha Hospital Mallya Hospital Narayana Hrudayalaya Sangolli Nursing Home Sankara Eye Hospital

Page 32

Bannergatta Road Bannerghatta road Basavanagudi Basavesharanagar Below Railway Bridge Hanumantha Nagar Hebbal Hosakerehalli Jayanagar Jayanagar (Near Vivekanand School) Kalyananagar Kanakapura Main Road Kanakpura Main Rd Looft Ring Road Magadi Main Road Mahalakshmipuram Malleshwaram Malleshwaram MSR Ngr Near Cantonment Rly Station Near Ulsoor Lake Tumkur Rd Vidyalaya Rd Vijaynagar

Wockhardt Hospitals Limited Apollo Hospitals Bangalore Avadhani Nethralaya Panacea Hospitals (P) Ltd Sundar Hospital Vishwabharathi Hospital Pvt Ltd Bangalore Baptist Hospital Vittala International Institute of Ophthalmology Sagar Hospitals Jayanagar Orthopaedic Centre Lokhande Hospital Bharath Nursing Home Deepak Hospital Pulse Diagnostics & Specialist Care Centre Padmavathi Hospital Sneha Nursing Home Columbia Asia Hospitals Pvt Ltd Jupiter Hospital M S Ramaiah Memorial Hospital Church Of South India Lakeside Medical Centre & Hospital Sri Raghavendra Hospital The Bangalore Hospital Vidya Eye Hospital

BHILAI
Location Mayura Talkies Nehru Nagar Nehru Nagar Nehru Nagar Nehru Nagar Nehru Nagar Opp Mayura Talkies Supela Supela Hospital Name Revival Nursing BSR Apollo BSR Cancer Hospital C M Hospital KGH Hospital(Cardiac) Suraj Hospital Bhilai Nursing Home Gayathri Hospital Sparsh Hospital

BHOPAL
Location Kolar Road M P Ngr Hospital Name Harsiddhi Hospital N M R Hospital

Page 33

Opp Dushehra Maidan Opp Nermal Meera School Shahpura

Career Institute Of Medical Sciences Chirayu Health & Medicare Pvt Ltd Ayushman Hospitial

BHUBANESHWAR
Location BBSR Kharelnagar Near BBSR Rly Station Ekamra Marg Nr. Muncipal Kalyan Mandap Saheednagar Hospital Name Panda Nursing Home (P) Ltd Neelachal Hospital Pvt Ltd Maa Shakti Hospital Aditya Care Hospital Deepak Clinic - N - Nursing Home

BOKARO
Location Bokaro B.S. City City Centre, Sec-4 Birla Dental College Campus Doctor's Clony Chas Chas Chas Hospital Name Dr K K Das Mother Care Sri Sai Hospital Om Sri Sai Hospital & Research Centre Shanti nursing hospital K M memorial hospital MuskanHospital Nilam hospital

CHANDIGARH
Location Bhind grudwara Chandigarh Chandigarh Sec - 34 A Sector 15-c Hospital Name Oxford heart & Multispeciality Hospital Kapoor's Kidney And Urostone Centre Pvt. Ltd Omni Hospital Inscol Hospital Dharam Hospital

CHENNAI
Location 19,Cathedral Road, 21, Greams Lane 45, G A Road Adayar Alwarpet Anna Nagar Hospital Name Dr.Agarwal Eye Hospital Ltd. Apollo Hospitals Enterprise Ltd CSI Rainy Multispeciality Hospital Malar Hospitals Limited Harvey Healthcare Ltd KHM Hospital

Page 34

Baracks road 58 LB Road Naid Colony Aminjika Poonamallee High Road Valasaravakkam Opp Chromepet College Road Jaganathan Street Kaladipet Kattankuluthur Kelampakkam Kilpauk Kilpauk Kilpauk Medavakkam Mogappair Mogappair Mount Poonamallee Road Mylapore Mylapore Mylapore Mylapore Nandanam Nandanam Nanganallur Near Valluvarkottam Nungambakkam Pallikaranai Peravallur (Perambur) Porur Purasawalkam Raja Annamalaipuram Raja Annamalaipuram Saidapet Shenoy Nagar Sowcarpet St Thomas Mount T.Nagar Tambaram (W) Thiruvotriyur Tondiarpet Vadapalani Vadapalani

GKM Hospital Pvt. Ltd. Adyar P M Hospital & Research Ctr P Ltd. M R Hospital New Hope Medical Centre Rakshit Hospital Royal Balaaji Hospital Medical Research Foundation Balaji Hospitals (P) Ltd. Rohit Hospital SRM Medical College Hospital & Research Centre Chettinad Hospital & Research Institute Apollo First Med Deepam Eye Hospital The Guest Hospital Global Hospitals & Health City Frontier Lifeline Pvt Ltd Madras Medical Mission Miot Hospitals Limited Sampat Nursing Home Chennai Meenakshi Multispeciality Hospital Ltd RSR Trinity Acute Care Hospital St Isabel Hospital Apollo Specialty Hospital Venkataeswara Hospitals Hindu Mission Health Services Rajan Eye Care Hospital Kanchi Kamakoti Childs Trust Hospital Dr Kamakshi Memorial Hospital Abhijay Hospital (P) Ltd Sri Ramachandra Medical Centre Noble Hospital Andhra Mahila Sabha Chennai Kaliappa Hospital Vasan Eye Care Hospital Billroth Hospitals Apollo Hospitals Sowcarpet St Thomas Hospital Bharathi rajaa speciality Hospital Bethesda Medical Mission Sugam Hospital Apollo Hospitals Tondiarpet Vijaya health centre Vijaya Heart Foundation

Page 35

Vadapalani West road

Vijaya Hospital Vijais Nursing home

COCHIN
Location Alwave Diwans Road Ernakulam KMK Jn M.G.Road Pachalam Hospital Name Carmel Hoapital Lakshmi Hospital Don Bosco Hospital Kochi Hospital Lourdes Hospital

COIMBATORE
Location Alam Nagar Road Avinashi Road Mettupalayam Road Peelamedu Sundarapurah Hospital Name Ashwin Hospital Lotus Eye Care Hospital Ltd V G Hospital Psg Hospital Sree Abirami Hospital (P) Ltd

CUTTACK
Location Telengapenth N H - 5 Hospital Name Panda Curie Cancer Centre

DELHI
Location Adjacent to Moolchand Flyores Anand Vihar Bali Nagar Budh Vihar Darya Ganj Daryaganj Delhi Mathura Road East of Kailash G. T Karnal Highway Greater Kailash - II Janakpuri Janakpuri Jeewan Nagar Hospital Name Moolchand Khairati Ram Hospital Swasthik Medical Centre Khetarpal Hospital Brahm Shakti Hospital & Research Centre Pvt Sanjeevan Medical Research Centre (P)Ltd Dr Shroffs Charity Eye Hospital Indraprastha Apollo Hospitals National Heart Institute Bhatia Hospital Talwar Medical Centre Mata Chanan Devi Hospital Hemraj Jain Hospital & Maternity Home Jeewan Hospital & Nursing Home

Page 36

Kailash Colony Kailash Colony Kalkaji Kirti Nagar Krishna Nagar Lajpat Nagar Madhuban Chowk, Rohini Main Panchkul Geetanjali Road Malviya Nagar Mayur Vihar Mayur Vihar Najafgarh Nangloi Near Janak Puri West Metro Near Keshnopur Bus Depo Near Popular Apt & Mother Dairy Near Sir Ganga Ram Hospital Near Sunlight Colony Okhala Rd Panchkulan Rd Paschim Vihar Patparganj Phase-3 Preet Vihar Priyadarshini Vihar Punjabi Bagh Punjabi Bagh Pusa Road Rajinder Nagar Rajouri Garden Rohini Rohini Rohtak Rd Safdarjung Enclave Saket Saket Sarva Priya Vihar Sec V Sec-16 Rohini Sector - 14 Rohini

Dr Sharma Nursing Home Shroff Eye Centre Banarsidas Chandiwala Institute Of Medical Sciences Kalra Hospital Ganesh Ortho Trauma & Medical Centre Vimhans Hospital Saroj Hospital & Heart Institute Sunil Hospital and Nursing Home Aakash Hospital Jeevan Anmol Hospital Kukreja Hospital Ortho Plus Hospital Bimal Hospital Anand Hospital Park Hospital Bhagwati Hospital Mohan Eye Institute Jeewan Nursing Home Escorts Heart Institute & Research Centre Delhi Heart & Lung Institute Sri Balaji Action Medical Institite Max Balaji Hospital Sunder Lal Jain Hospital Metro Hospital & Cancer Institute Makkar Medical Centre Maharaja Agrasen Hospital MGS Hospital Jeewan Nursing Home & Hospital Sir Ganga Ram Hospital Kukreja Hospital And Heart Centre Family Hospital (P) Ltd Jaipur Golden Hospital Shree Jeewan Hospital Centre For Sight Max Devki Devi Heart & Vascular Institute Sawan Neelu Angels Nursing Home Healing Touch Hospital Rajiv Gandhi Cancer Institute and Research Centre Satyam Hospital Pvt Ltd Santom Hospital Pvt Ltd

Page 37

Shalimar Bagh Tughlabad Uttam Nagar Uttam Nagar Vikas Marg Vikas Marg Vikas Marg Yamuna Vihar

Kesar Hospital Batra Hospital & Medical Research Centre Gandhi Nursing Home Mata Roop Rani Maggo Mahindru Hospital Malik Radix Healthcare Pvt Ltd Pushpanjali Medical Centre Sharp Sight Centre Panchsheel Hospital (P) Ltd

DURGAPUR
Location A/1 Nandal Bishti Aldrin Path B-120 Aldrin Path CENTRAL PARK Dr Zakir Hossain Avenue G T ROAD Manora Das Market N1 Doctor's Colony Near Durgapur Station Nera DurgapurStaion Nera DurgapurStaion Sector 2C Hospital Name Presidnecy Nursing Home West Midland Nursing Home Bidhan Niramoy Hospital City Clinc and Nursing Home Pvt Ltd Vivekanad Hospital ( Secondary Care) west end Nursing Home Amader Nursing Home Dr B C Roy Hospital JeevanDeep Nursing Home Dollar Nursing Home Dr Vivek Nursing home Mission Hosiptal (tertairty Care)

FARIDABAD
Location 5R/5 ,NIT Near Neelam Bata Flyover Neelam Flyover, Ajronda Chowk Sector 16 Sector 19, Gopi Colony YMCA Road Hospital Name Surya Ortho & Trauma Centre Escorts Hospital & Research Centre QRG Central Hospital Metro Heart Institute Sarvodaya Hospital & Research Centre Sarvodaya Hospital & Research Centre

GAZIABAD
Location H-1, Kaushambi Indirapuram Mohan Nagar Nehru Nagar Hospital Name Yashoda Hospital & Research Centre Ltd Shanti Gopal Narendra Mohan Hospital Yashoda Hospital & Research Centre Ltd

Page 38

Plot No 481, Friend Society, Sector 12, Vasundra Rajnagar

Param Jyoti Eye Care Shivam Hospital & Heart Centre Pvt Ltd.

GURGAON
Location 380, City Centre, Sector 29 877/12, Mata Road B Block, Sushant Lok 1 Mehrauli Road Near Mayfield Garden Near Shalom School Hospital Name Doctor Kares Health Care Pvt Ltd Mamta Hospital Max Hospital Kalyani Hospital Pvt Ltd Artemis Medicare Services Pvt Ltd Paras Hospital

HYDERABAD
Location Banjara Hills Secretariat Road Jubilee Hills L.B.Nagar Malakpet Nampally Railway Station Sanath Nagar Somajiguda Hospital Name Care Hospitals MediCiti Hospitals Apollo Hospitals Kamineni Hospitals Yashoda Super Speciality Hospital Medwin Hospital St Therasa Hospital Yashoda Super Speciality Hospital

INDORE
Location A B Road Dr Sarju Prasad Marg Mainak Bagh Road Ring Rd Ujjain Road Hospital Name CHL Apollo Hospitals Gokuldas Hospitals Ltd Choithram Hospital & Research Centre Mayur Hospital & Research Centre Sri Aurobindo Institute Of Medical Sciences

JABALPUR
Location Damoh naka Gol bazar Jabalpur Near Gate No 3 Opp. Wright town stadium Hospital Name Metro Hospital & Cancer Research Centre National Hospital City Hospital &Research Centre Anant Institute Of Medical Sciences Mahakoshal Hospital

Page 39

JAIPUR
Location Ashok Marg Jaipur Jawaharlal Nehru Marg Malviya Nagar Malviya Ngr Mansarovar Mansarovar Sector 5 Vidhyadhar Nagar Vidhyadhar Nagar Hospital Name Liberty Hospital Sahai Hospital &Research Centre Bhagwan Mahaveer Cancer Hospital & Research Centre Fortis Escorts Hospital Apex Hospital (P) Ltd Dhanvantri Hospital & R Centre Saket Medicare & Reasearch Centre Pvt.ltd S K Soni Hospital Ganadhipati Purushottam Shekhawati Hospital& Research Centre Shekhawati Hospital And Research Centre

JAMSHEDPUR
Location Main Road Bistapur Hospital Name Life Line Hospital

JODHPUR
Location Residency Road Hospital Name Goyal Hospital & Research Centre(p) Ltd.

KOCHI
Location Chittor road, Opp Adam Pillykadu Temple Panayappilly Ravipuram Vellikulam Rd Hospital Name Sree Sudheendra Medical Mission Vijaya Kumara Menon Hospital Gautham Hospital V. G. Saraf Memorial Hospital (P) Ltd. Ccmk Hospital

KOLKATA
Location Albert Road Andul Road APC Road Barsat Belgharia Hospital Name Gamma Centauri Healthcare Pvt Ltd West Bank Hospital Capitol Nursing Home Pvt Ltd Care & Cure Nursing Home Sahid Khudiram bose Hospital

Page 40

Beliaghata Bose Road Bose Road Deshpran Sasmal Road E M Bypass Gariahat Kasba Golpark Canal Circular Road National Library Avenue 1/3 Dover Place Rajdanga Main Road Rajarhat Road Diamond Harbour Road Alipore Road Dimond Harbour Road Gorky Terrace Loudon Street Mallick Square, Mukandapur Music World Park Street,Mocambo Restaurant Nagaland House Near Alipore Zoo Near Vandoan Market Near WBSEB Office New Alipore, Block-G Nr Kamarhati Opp to Club Town Opp Triangular Park Opp. Medical College Opp.Traingular Park,Near Priya Cinema Panchasayar Panchasayar Park Street Paul Road Prannath Pandit Street S C Mullick Rd Salt Lake Salt Lake Salt Lake city Salt Lake Stadium Saltlake

Divine Nursing Home Pvt.ltd., Lansdowne Nursing Home Ramakrishna Mission Seva Pratishthan Rsv Nursing Home & Speciality Diagnostic Centre Ruby General Hospital AMRI Hospitals Desun Hospital & Heart Institute Apollo Gleneagles Hospitals B M Birla Heart Research Centre Dr. Nihar Munshi Eye Foundation Genesis Hospital Swasti Eye &Super Speciality Nursing Home The Calcutta Medical Research Institute Woodlands Medical Centre Limited Behala Balananda Brahmachari Hospital & Research Centre Park Clinic Priyamvada Birla Aravind Eye Hospital Sankar Netralaya Rabindranath Tagore International Institute Of Cardiac Sciences & Armenian Church Trauma Ctr Royd Nursing Home & Health Care Ltd Nightingale Diagnostic & Medicare Centre Pvt Ltd Kothari Medical Centre Life Line Nursing Home Hindustan Health Point Pvt Ltd B.P Poddar Hospital & Medical Research Ltd Zenith Super Speciality Hospital Charnock Hospital Pvt Ltd N G Medicare & Calcutta Hope Infertility Clinic The Sherwood Nursing Home Wockhardt Hospital &Kidney Institute National Neurosciences Centre Peerless Hospitex Hospital And Research Centre Ltd. Mission of Mercy Hospital & Research Centre Microlap Health Point K P C Medical College & Hospital Jadavpur Columbia Asia Hospital Rotary Narayana Nethralaya Ils Hospital Susruta Clinic &Research Institute For Advance Medical Pvt Ltd Subodh Mitra Cancer Hospital & Research Centre

Page 41

Saltlake City Sinthee More (Binayak Enclave) Sukanta Sadan VIP Road VIP Road

Anandalok Hospital Binayak Multispeciality Hospital Disha Eye Hospitals & Research Centre Pvt Ltd Uma Medical Related Institute (P) Ltd Vip Apex Medical Centre Private Limited

KOTTAYAM
Location Azad Lane Azad Lane Kollam Thellakom Ponkunnam Hospital Name Bharath Charitable Hospital Society Bharath Hospital Holy Cross Hospital Matha Hospital P N P Memorial K V M S Hindu Medical Mission Hospital

LUDHIANA
Location Field Ganj Market G T Road Model Town Hospital Name Christion Medical college & Hospital Sps Apollo Hospitals Deep Nursing Home and Children Hospital

LUCKNOW
Location 37 Cantt Road Aliganj Crossing Indiranagar River Bank Colony Seva Nagar Sitapur Road Hospital Name F I Hospital Neera Hospital Shekhar Hospital Pvt Ltd K K Hospital Sewa Hospital & Research Centre

MADURAI
Location Chokkikulam K K Nagar Anna Nagar Melur Rd Narimedu Hospital Name Vadamalayan Hospital Apollo Speciality Hospitals Aravind Eye Hospital Meenakshi Misson Hospital and Research Centre Saravana Hospitals

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MUMBAI
Location Andheri (E) Andheri (W) Andheri (W) Bandra - Kurla Complex Chembur Chembur Chembur Chembur Gandhi Market Ghatkopar (E) Ghatkopar (E) Ghatkopar (W) Ghtakopar (E) Govardhanbapa Chowk Jogeswari (W) Kandivli (E) Kandivli (E) Koparkhairane Kurla (W) Malad (W) Malad (W) Marin Lines Mulund (W) Mulund Goregaon Link Rd Mulund(W) Near dahisar Near Kemp's Corner flyover Next to Maitri Park Best Bus Stop Panvel Panvel Panvel Panvel Panvel Peddar Rd Powai Santacruz (E) Vasai Vikhroli (W) Hospital Name Ashirwad Child & Surgical Hospital BSES MG Hospital Criticare Hospital & Research Centre Asian Heart Institute Inlaks General Hospital Joy Hospital Pvt Ltd Joy Hospital Pvt Ltd Surana Sethia Hospital & Research Centre Smt S R Mehta & Sir K P Cardiac Institute Advanced Orthopaedic & Superspeciality Centre Parakh Hospital Pvt Ltd Kedia Nursing Home Bakul Parekh Children Hospital Sir Hurkisindas Nurrotumdas Hospital & Research Centre Mallika Hospital Asha Hospital Nupur Nursing Home Satyam Multi Speciality Hospital & Trauma Centre City Hospital & Recearch Centre Life Line Hospital Riddhi Vinayak Critical Care And Cardiac Centre Bombay Hospital & Medical Research Centre Holy Trinity Hospital Wockhardt Hospital Limited Hira Mongi Navneet Hospital Shraddha Hospital Cumballa Hills Hospital and Heart Institute Niramaya General Hospital Ashtavinayak Hospital Dr Patil Hospital Dr Patil Hospital Gandhi Hospital Life Line Hospital Jaslok Hospital And Research Centre L H Hiranandani Hospital R.K.Hospital Cardinal Gracias Memorial Hospital Trust (Dir Mailer) Godrej Memorial Hospital

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Vile Parrle(W) Ville Parle(w)

Bhartiya Arogya Nidhi Shet Kantilal C Parikh General Hospital Dr Balabhai Nanavati Hospital

MYSORE
Location Jayalakshmipuram Kuvempunagar Kuvempunagar Nr Nazarbad Police Station Siddalingapura post Hospital Name Basappa Memorial Hospital B. G. S.Apollo Hospitals Kamakshi Hospital Gopal Gowda Shanthaveri Memorial Hospital Bhagwan Mahaveer Darshan eye Hospital

NOIDA
Location E-3A, Sector 26 NH -1, Sector 27 Sector 11 Sec-18, Near Aatta Market Sector 27 Sector 35, Golf Course Road Hospital Name Icare Eye Hospital & Post Graduate Institute Vinayak Hospital Metro Multispeciality Hospital Max Health Care Institute Kailash Hospital & Heart Indistitute Ltd (a Unit Of Kailash Health Care Ltd) Surbhi Hospital

PATNA
Location Rajendra Nagar Hospital Name Magadh Hospital

PUNE
Location Chinchwad Chincwad Erandawane Hadapsar Karve Road Nigdi Rasta Peth Sadashiv Peth Sassoon Road Sassoon Road Hospital Name Aditya Birla Memorial Hospital Lokmanya Care Hospital Deenanath Mangeshkar Hospital & Research Centre Noble Hospital Sahyadri Speciality Hospital Lokmanya Hospital K E M Hospital Poona Hospital & Research Centre Jehangir Hospital Ruby Hall Clinic

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RANCHI
Location Booty Road Main Road Ranchi Hospital Name Alam Hospital & Reasearch Centre Pvt Ltd Raj Hospital & Reasearch Centre Abdur Razzaque Ansari Memorial Weavers Hospital(Apollo Hospital)

ROURKELA
Location Civil town Jagatha Civil town Udit nagar Civil town Civil town Udit nagar Civil town Hospital Name City ClincHsopital CSW Hospital Life Linehsopital Meher Eye Hsopital OM Appollo Hsopital Rourkela Lifeline Pvt Ltd Shanti Memorial Hsopital Veagase Patel hospital

SALEM
Location Agraharam Alagapuram Ammapet Annathanapatti Ashram road, Behind Sarada College Hasthampatty Dadagapatty Five Roads Hasthampatti Main Road Meyyanur Road Near Gandhi Steadium Near Jothi Theatre bus stop Hospital Name Sri Raam Hospital S K S Hospital Pvt. Ltd S. Palaniandi Mudaliar Memorial Hospital Sri Bharathi Nursing Home Nathan super speciality Hospital Thambi Medical Surgical Eye Hospital Shanthi Nursing Home Kurinji Hospital Salem Medical Center Hospital Pvt Ltd Arokya Hospital Sri Gokulam Hospitals (P) Ltd Shri Shellapha Hospital Rajammal Hospital

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Near Old Bus Stand Omalur Road Opp DSP Office Opp New Bus Stand Opp. New Bus Stand Rajaji Road Rajaji road Ramakrishna Road S.K.Nagar Raghavachari Road Seelanaickanpatty Bye-pass Cheery Road Ramakrishna Park Second Agraharam Salem - Bangalore - Highway Sardar College Rd Shankar Nagar Sree Krishna Complex Valapady Veerapandi

A C Hospital Nagarajan Nursing Home Sree Vasantham Hospital Vasan Eye Care Hospital Pranav Hospitals Pvt. Ltd. CKR Hospital Kiruba hospital Salem Gopi Hospital (P) Ltd R P S Hospital Chellam Hospital Dharan Hospital Dr.Haneefa Polyclinic and Nursing Home Ganesan Hospital Mohanraj Childrens Hospital Manipal Hospital Shanmuga Hospital & Salem Cancer Institute M/s. Vidya Hospital Kamala Hospital Deepam Hospital Vinayaka Mission Hospital

TRIVANDRUM
Location Anayara Post Peroorkada Anayara P.D.Tvm Fort, Venjara Moody Hospital Name Kerala Institute of Medical Sciences Punarjani Institute Of Medical Science Lords Hospital SP Fort Hospital Sree Gokulam Medical College & Research Foundation

VELLORE
Location IDA Scurrer Road Hospital Name Christian Medical College

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