BENEFITS MANUAL

CARRIER AIRCONDITIONING &

REFRIGERATION LIMITED

SALIENT FEATURES
Policy Parameters
Insurer
TPA
Insurance Broker
Pre Existing Disease
Family Definition - Unmarried
Employees
Family Definition Married
Employees

Family Floater Sum Insured

ICICI Lombard General Insurance Company Limited

ICICI Lombard Healthcare
Prudent Insurance Brokers Private Limited
-Covered
Self + Dependent Parents

Self + Spouse + Children + Parents

Any One Set of Parents can be covered by the employees
Per Family Sum Insured
INR 225,000 ( G1-G4)
INR 300,000 (G5-G6)
INR 450,000 (G7-G10)
INR 900,000 (U)
2

BOARDING CHARGES, DAY CARE &PRE/POST HOSPITALIZATION

NORMAL ROOM -

ICU

METRO LOCATIONS - INR 4,500 per day for Sum Insured Slab

ICU Hospitalization at Actual

of INR 225,000 & INR 5,500 per day for Sum Insured Slabs of
INR 300,000 & INR 450,000 [In case the patient has to be kept in
isolation as suggested by the treating doctor, the room rent to be
accommodated at actual]
*If insured is admitted in a higher category, then insured will bear
difference of all medical expenses as in final hospital bill in same

proportion

PRE & POST HOSPITALIZATION EXPENSES

NON METRO LOCATIONS - Twin Sharing Room on per day
basis for Sum Insured Slab of INR 225,000 and, INR 4,500 for
Sum Insured Slabs of INR 300,000 & INR 450,000

Day Care treatment is covered for attached disease

30 days

60 days

MATERNITY BENEFIT
Maternity and Infertility Treatment
INR 50,000 FOR NORMAL & CAESAREAN DELIVERY
Maternity Benefit is applicable only for First Two Deliveries
Pre Natal & Post Natal are not covered unless admitted in to
the hospital / Nursing home and treatment is taken there.
Baby is covered from day one under family floater (if the
baby is hospitalized for some ailment)

Treatment related to Infertility will not be covered.

Baby Expenses (for a healthy baby) within the Maternity sub-limit

Pediatrician Visit Charges
Phototherapy Machine Charges for HYPERBILIRUBENEMIA (mild jaundice)

DISEASE SUB LIMITS

Diseases Sub Limit
Appendicitis INR 35,000

Cataract [Per Eye]

INR 37,500

Gall Bladder Stone Removal

INR 60,000

Hydrocele

INR 22,500

Psychiatric Ailments

INR 30,000

Functional Endoscopic Sinus Surgery

INR 35,000

Piles

INR 24,000

Cyber knife treatment/Stem Cell

Transplantation
Cochlear Implant Treatment

50% Co-pay
50% of the Sum Insured

GENERAL EXCLUSIONS
Circumcision unless necessary for treatment of disease

Cosmetic dental treatment (please check with the TPA whether your scheduled dental treatment falls under the category of
cosmetic treatment)
HIV and AIDS
Hospitalization for convalescence, general debility, rest cure, intentional self-injury, use of intoxicating drugs / alcohol.
Venereal diseases
Injury or disease caused directly or indirectly by nuclear weapons
Naturopathy any non-allopathic treatment
Infertility treatment
Congenital external and internal diseases

Any non-medical expenses like registration fees, admission fees, charges for medical records, cafeteria charges, telephone
charges, and disposable items, etc.
Any cosmetic or plastic surgery except for correction of injury caused by accident
Charges incurred primarily for diagnostic, X-Ray or laboratory examinations or other diagnostic studies not consistent with
or incidental to the diagnosis and treatment of any ailment, sickness or injury.
Vitamins and tonics unless used for treatment of injury or disease
Injury or disease directly or indirectly caused by or arising from or attributable to War or War-like situations.

ADD ON COVERS
TOP Up cover for Parents
Based on Employee Nomination on SELF PAY BASIS: Employees can choose to opt for any one option
below ( Company will pay premium and deduct 100% from employees salary)

The Premium Rates are as follows

Sum Insured

Rate per Parent

Rate for Couple

100,000

7,923

13,469

200,000

10,613

18,042

300,000

12,576

21,379

500,000

15,245

25,917

* Service Tax @ 12.36% is additional

Remember this
is over and
above your base
policy, to support
your Parents on
medical
exigencies

NOTE -Selection of either father or mother is not permitted for Parents' TOP Up, if both are covered in
base policy .