Mediclaim Policy Proffers Medical Care without Disbursement (Cash Less)

Mediclaim Policy of General Insurance proffers Cash Less Medical Treatment ...

Cash less Treatment Mediclaim Policy entails without defrayment for medical care to the insured can be provided by the Hospital / Rest home while the individual establishes valid insurance company’s health card to the hospital. Entire hospital invoices adequate to amount insured are finalized outright by an insurance company in which insured individual has acquired the policy.

General Insurance sectors also avail without defrayment for medical care policy in Group Mediclaim Policy and this policy readiness is facilitated merely in few specific hospitals ordained from TPA (third party administrator) of General insurance company. Third party administrator implies affiliation of insurance company with other companies engaged in claiming.

In few special circumstances in case the insured did not preferred this policy of medical care without defrayment, premium will be 5% rebated by the insurance company. Medical care is effectual for solely Hospitals/ Rest home availing care for inpatients suffering from physical harm due to injury/ malady/disease/sickness, Hospital/ Rest home should be recognized or be a member of Medical council of India and Consulting physician or Medical practitioner must hold valid eligibility certificates from a valid medical university and with registered hospital authorities.

In regard to insurance language Nursing/ rest home connotes a place which accommodates at least 15 inpatient beds in a Metro city (A and B class cities). Under C class city accommodates 10 inpatient beds. Completely equipped with medical and surgical facilities infra structure implies pathological tests, X-ray, ECG likewise related departments.

The hospital/ nursing home entirely equipped with surgical equipment of its own operation theater are the terms for compensation of insurance. Hospital /nursing / rest home should assign qualified nursing staff day-and- night. Amply qualified physicians should supervise for 24 hours.

The medical care defrayment is inapplicable to drug addicts, substance abuse cases, and alcoholics. And the Group Mediclaim Policy excluded some institutions like old age homes, rehabilitation centers, hotels and restaurants. In case of Ayurvedic/ Unani/ Homeopathy medical care, the hospital disbursals are liable solely when admitted in the recognized hospital for which surgery/ disease are covered under Mediclaim Policy within 24 hours of hospitalization.