Professional Documents
Culture Documents
Preamble:
As part of the Hospitalization Insurance benefit, all employees and their named
dependents (Spouse and 2 children) are eligible for Medical Insurance cover. The Group
Personal Accident Program covers employees against the financial risk of death / injury
sustained due to an accident caused by violent, visible and external means. The Group
Term Life Insurance covers employees and ensures to reimburse sum Insured to the
nominee of the deceased in case of natural or accidental death. The major
features/benefits under the three policies for employees and their covered dependents
are outlined here.
Applicability
This policy is applicable to all permanent employees on the rolls of Baxter (India) Pvt.
Ltd and any other Baxter managed operation(s) in India (i.e. Commercial,
Manufacturing, Regional, Integrated Delivery Center (IDC), Global Process Center(GPC)
etc.)
Duration of the policy
The Hospitalization and Personal accident policy will be effective for one year from the
date of inception of policy. The current policy is with Bharti Axa General Insurance Co
Ltd. is valid from 1st April 2014 to 31st March 2015.
The Group term Life Insurance policy is with Future Generali India Life Insurance Co
Ltd. and is valid from 1st Nov 13 to 30th Oct 14.
Group Medical (Mediclaim) Policy
The Group Medical policy covers expenses incurred by the insured person on account of
hospitalization due to sickness or an accident. The policy covers expenses incurred on
Policy Benefits
amount has to be borne by the employee in the same proportion as in the Final
Hospital Bill.
Claim must be filed with Medi Assist TPA within 25 days from the date of
discharge from the Hospital / completion of treatment. However, the Company
may at its absolute discretion consider waiver, of this Condition in extreme cases
of hardship where it is proved to the satisfaction of the Company that under the
circumstances in which the insured was placed it was not possible for him or any
other person to give such notice or file claim within the prescribed time-limit.
Reimbursement Claim to be intimated to the TPA within 24 Hours of admission.
Details can be shared on mail with the TPA SPOC.
The above Coverage is subject to the overall policy conditions and exclusions.
Policy Exclusions
The following are deducted / Not Paid under a standard Health insurance policy:
1. Administration charges,Admission / Registration fees, File / Records
Management charges
2. Service / Surcharges. Bed booking / Reserving charges
3. Patients Attendant charges, Special Nurse / Attendant charges, FIR / MLC
charges
4. Telephone / Photocopy / Courier / Insurance Processing Fees, etc.
5. Others (non-insurance, items not related to treatment)
6. Lasik treatment is not covered.
7. Infertility and Male Sterility are not covered.
8. Septoplasty is Excluded from the scope of the policy.
9. Treatment on trial/experimental basis are not covered under the scope of the
policy.
10. Voluntary medical termination of pregnancy during the first 12 weeks from the
date of conception is not covered.
11. Expenses related to a device contributing/replacing function of an organ and
expenses on prosthesis are excluded.
*For complete information refer policy wordings/Benefits PPT uploaded on the link
www.askbaxhr.in.
Diseases Where 24 Hours Hospitalization Is Not Required:
Claims Procedure
a. Cashless Process
Duly filled Claim form (signed by the Insured and the Treating Doctor)
Discharge summary (with details of complaints and the treatment availed)
Final Hospital Bill (detailed break-up) along with interim bills
Payment Receipts.
Doctors consultation papers
All investigation reports (E.g. Original Blood report, X-ray, Sonography, CT Scan,
MRI, etc.)
7. All pharmacy bills supported by doctor prescriptions
8. Implant sticker / invoice, if used (E.g. lens details in cataract case, stent details in
angioplasty)
9. Medico Legal Certificate (MLC) and / or FIR for all accident cases
10. For miscellaneous charges - detailed bills with supporting prescription of the
Treating Doctor
11. Photocopy of MAID Health card
12. Cancelled cheque of the Employee for NEFT Transfer of Funds.
All documents should be in Original.
* This is not an exhaustive list; any other document could be required post assessment
of the case.
Dos and Donts for Availing Reimbursements:
1. Always keep a photocopy of the claim documents submitted to Medi Assist TPA.
2. Kindly ensure that the Claim form is completely filled and signed by the Insured
and the Treating Doctor.
3. Kindly ensure to mention the mobile number on the Claim form.
4. Mention correct and complete communication address with the pin code on the
claim form.
5. All claim documents are to be submitted in original within 25 days from the date
of discharge.
Policy Benefits
Accidental Death is covered upto 100% of Capital Sum Insured (CSI).
Permanent Total Disablement (PTD) is covered upto 150% of Capital Sum Insured
(CSI)
Permanent Partial Disablement (PPD) is covered % of CSI (As per the chart)
Claims Procedure
Documents to be provided
Documents for weekly Benefits Claims
Basic Death Benefit - 2 Times of Annual Base Salary. Pays the Sum Assured in case of
a natural /accidental death to the Nominee.
Critical Illness Benefit Pays the Sum Assured in case an employee develops a critical
illness like Heart Disease, Cancer, stroke etc. This is over and above the Basic Life
Sum Insured. Same as Death Benefit subject to a maximum of INR 10 Lacs.
Terminal Illness BenefitProvides an accelerated benefit whereby a percentage of
death benefit is paid in advance on diagnosis of a terminal disease. Same as Death
Benefit subject to a maximum of INR 50 Lacs.
(Terminal Illness is any condition from which an insured member is diagnosed to
be suffering from a disease which in the opinion of two Registered Medical
Practitioner specializing in the relevant field of medicine, is likely to lead to death
of the life insured within six months from the date of such diagnosis. The insured
member must no longer be receiving treatment other than that for symptomatic
relief.
Claims Procedure
Documents to be provided
Documents to claim accidental death
Sandeep Devgon
Finance Director
Date
Annexure
Contact Points
HR Baxter India Pvt Ltd
Ashima Raju
Assistant Manager, HR
Contact No: 0124-4500242
Email ID: ashima_raju@baxter.com
Insurer Bharti Axa General Insurance Co Ltd
Shivalee Sharma
Relationship Manager
Contact Number: 9810507763
Email ID: Shivalee.Sharma@bharti-axagi.co.in
TPA Medi Assist India TPA Pvt Ltd
1. Rahul Kumar (SPOC For BAXTER Employees)
Contact Number: 09310981166
Email ID:- Rahul.Kumar@Mediassistindia.Com
2. Sarika Bhatia (SPOC For BAXTER Employees)
Contact Number: 08130591191
Email ID:- Sarika.Bhatia@Mediassistindia.Com
For Reimbursement claim:Intimation must be given within 24 hours from admission or prior to Date of Discharge
at rahul.kumar@mediassistindia.com
To submit re-imbursement claims after discharge within 25 days, please send it to this
address:Kind Attention - Mr. RAHUL KUMAR
Medi Assist India TPA P Ltd
B-20, Sector-2, Near Noida Sector-15,
Metro Station. Opp HCL Comnet,
Noida U.P-201301
Ph# 0120 4628200/4628201 ; Fax # 0120-4628250
Please follow the below mentioned steps to download the insurance cards for you and
your family:
LOGON TO WWW.MEDIASSISTINDIA.COM
In the homepage under the "LOGIN" tab click on "Corporate Employee "
User ID would be your "EMP-ID@BAXTER"
Password would be "BAXTER"
Please change the password after your first login. Once you enter you will be able
to view the list of members covered.
Click on the link e cards where you can download & save it.
Claims status can also be viewed similarly.