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THE ADVOCATES’ MUTUALLY AIDED CO-OP. SOCIETY LTD., HYDERABAD MEDICLAIM POLICY TERMS & CONDITIONS
The present Policy No. 62030034190400000014  -  From 02-02-2020 to 01-02-2021

The Members of The Advocates’ Mutually Aided Co-op. Society Ltd., Hyderabad., are requested to note the following Policy Conditions before availing Medi claim facility.

Policy has the following conditions:

  1. Room Rent / Boarding/ Nursing Expenses as provided by the Hospital/nursing home not exceeding 1.0 % of sum insured per day or actual amount whichever is less
  2. Intensive care unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses not exceeding 2% of Sum Insured per day or actual amount whichever is less.
  3. Pre-Hospitalization medical charges up to 30 days period immediately before the Insured’s admission to hospital for that illness or injury.
  4. Post -Hospitalization mediclaim charges up to 60 days period immediately after the Insured’s discharge from the hospital for that illness or injury.

The amounts payable under Surgeon ,Medical Practitioner, Consultants Specialist fees, Anesthesia, Blood, Oxygen, Operation Theatre Charges, surgical appliances, Medicines & Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Artificial Limbs, cost of prosthetic devices implanted during surgical procedure like Pacemaker, relevant laboratory /diagnostic tests, X-Ray and other medical expenses related to the treatment shall be at the rate applicable to the entitled room category. Policy has the following caps for all categories of Members opted with a Floater Sum Insured of Rs.1.50 lac under the policy NO. 62030034190400000014  -  From 02-02-2020 to 01-02-2021

REIMBURSEMENT CHECK LIST

  • Copy of the Intimation Letter
  • Duly Filled & signed IRDA Claim Form (part-A & part-B by the hospital)
  • Original Discharge Card / Summary with sign & stamp of the hospital.
  • Original Final Bill of the Hospital with sign & stamp of the hospital.
  • Original Bill Paid Receipt with sign & stamp of the hospital.
  • Original Investigation Reports signed by MD.Pathologist as per IRDA guidelines.
  • All Imaging Films along with reports sign & stamp, ECG Strips, Doppler / Angiogram CD etc.
  • Original Prescriptions and corresponding Medicine bills,
  • Hospital Registration Certificate.(if required query will be raised)
  • Any other original documents related to the claim.
  • MLC/FIR in case of Accident cases.
  • Patient photo id proof name should match with the name provided in the policy .
  • The copy of the cancelled cheque with printed name (or) front page of Bank passbook of the policy holder should be clear & need to submit along with the claim documents. PLS NOTE ITS MANDATORY.
  • Required IPD Papers Xerox with sign & stamp.

NOTE: AFTER MEDICAL SCURTINY 2ND LEVEL QUERIES MAY BE MAY NOT BE RAISED BASED ON CASE STUDY….

Address : HEALTH INDIA INSURANCE TPA SERVICES PVT.LTD..

H.NO:7-1-28/9 A,1st Floor, Sai Towers,DK Road,

Ameer pet ,Hyderabad – 500016

Office  Contact No’s  :7207022632 & 8019022617 

Mr  B.SRinath  Sr.CRM     Cell No:-       8247650675

Mr.Santosh kumar manthri  Cell No:-   7400037518