SANTOBA Group Medical Insurance Policy (21-22)
Brief Details:
| Insurer | The New India Assurance Co Ltd
|
| Broker | Alliance Insurance Brokers Pvt Ltd |
| Policy Period | 9.8.21 to 8.8.22 |
| Family Definition | Self, Spouse and 2 dependent children upto 25 yrs of age + 2 Dependents Parents/inlawsupto 90 Years (no cross selection) |
| Sum Insured Per Family | Rs. 5,00,000.00 |
| Premium | Rs 14,990/= including GST |
| Type of Cover | Family Floater |
| Age band | 1 day to 90 Years |
| Pre Existing Disease Exclusion | Waived Off (i.e covered from day one) |
| First 30 days waiting period | Waived Off (i.e covered from day one) |
| 1 / 2/ 3 year exclusion | Waived Off (i.e covered from day one) |
| New Born Baby Coverage | Covered from Day 1 within Family Sum Insured |
| Pre & Post Hospitalisation Expenses | Pre & Post Hospitalisation Expenses (30-60 Days respectively) |
| Room Rent Restriction | 1% of Sum Insuredand 2% of Sum Insured for ICU. Proportionate charges applicable |
| Internal Congenital Ailments cover | Covered |
| Lucentis | Not covered |
| External Congenital Ailments cover | Covered in life threatening situation |
| Emergency Ambulance Charges | Rs. 2000/- per hospitalization |
| Sub-limit of Ailment | No sub-limit |
| Special condition | Psychiatric ailments within a limit of Rs. 30,000/= as well as treatment of Functional Endoscopic Sinus Surgery within a limit of Rs. 35,000/=. The coverage for treatment of mental illness is also covered up to Rs. 30,000 within the sum insured. |
| Cyber-knife treatment/Stem Cell Transplantation | 50% Co-Pay |
| Cochlear Implant treatment | Restricted to 50% of the sum insured |
| Lasik Surgery | Covered if correction index is +/- 7.5 D |
| AYUSH treatment | Covered |
| GIPSA Clause | Applicable |
| Terrorism Cover | Covered |
| Day Care Procedures | Covered |
| Dental Treatment | Covered if due to accident and requiring Hospitalization |
| Cashless Facility | Yes |
| Addition/Deletion on pro-rata | After the inception of the Policy, no mid-term inclusion of any member unless he/ she is a new pass out of the school and dependents of the already insured employee unless they are newly married spouse and new born child. Such inclusion is subject to payment of additional premium on pro rata basis and immediate intimation to the broker |
| Maternity Benefit | Covered (35000/- Normal delivery and 60000/- cesarean) |
| Home Quarantine | 20000/- per family. Policy limit is 10L |
| Attendant charges | Not covered |
| Claim intimation | Within 07 Days of Hospitalization |
| Claim submission | Within 30 Days of Discharge From Hospital |
Santoba Group Top-up Medical Policy (21-22)
Sum Insured 5L (Five Lacs)
Minimum participation 35% of those enrolled for Medical policy of SANTOBA
Policy period 9.8.21 to 8.8.22
Premium 7000/- including GST(seven thousand only)
Condition It has to be purchasedtogether with base SANTOBA medical policy
Santoba Group Personal Accident Policy (21-22)
SANTOBA Western Region started this policy four years back and this is running with all success. All Western Region members are covered and their premium is paid by the corpus of west.
Brief Details
| Sum Insured | Rs. 10 Lakhs |
| Premium | Rs. 600/- including GST |
| Death | Covered |
| Permanent Total Disability | Covered |
| Permanent Partial Disability | Covered |
| Temporary Disablement | Covered |
| Medical Treatment | 40% of claim amt or actual medical bill or 10% of individual SI whichever is less |