Edelweiss Insurance Brokers Limited EIBL Super Top Up

Edelweiss Insurance Brokers Limited (EIBL) Super Top Up Policy 2015

Today’s Healthcare Cost Concern Advancement of Medical Technology Corporatisation of Healthcare Advent of new Lifestyle diseases Increasing Awareness Increased Healthcare Cost 2 General Inflation

Current Solutions to the Healthcare Cost Concern Group Mediclaim Policy Advancement of Loan Any other option? ? ? 3

Current Solutions to the Healthcare Cost Concern Any other Solution? ? ? Personal Mediclaim Policy Confusion of abundance Restricted Benefits Pre-policy check up 4 High Premium

Alternative Solution Confusion of abundance Restricted Benefits Pre-policy checkup High Premium Super Top Up Policy for Publicis Employees, specially designed by EIBL with Oriental Insurance Co. Ltd. 5

Highlights of the Policy 1. This policy has coverage for employees and dependants which include spouse, children, parents or parent in laws. The identical family covered under Group Mediclaim will be covered for Super Top Up Policy. 2. No Medical check up / pre policy checkups. 3. The policy can be issued on family floater sum insured basis i. e. Single sum insured would be applicable for entire family and the same can be utilised by any of the insured family member. 4. Single documentation required for processing claims and hence employee need not to arrange any other documents for Super Top Up policy. 5. Paramount Health Services (TPA) Pvt. Ltd. , will service the cashless and reimbursement claims under Super Top Up policy. 6. This policy will trigger only when the aggregate of covered hospitalisation expenses exceeds the Sum Insured under Group Mediclaim policy. 7. Employee has option to select sum insured from the choice of the sum insured from Rs. 1 lakh to 20 Lakh. 8. This policy will be governed by Terms, conditions, exclusions and warranties of the Basic Group Mediclaim Policy. 6

Benefits Claims under this Policy shall be payable only if the aggregate of covered Medical Expenses in respect to Hospitalisation(s) of Insured Person exceeds the Sum Insured under the Group Mediclaim Policy availed by Publicis The benefits covered are as below: 1. All the coverage's available under Publicis Group Mediclaim will be carried forward. 2. In-patient Treatment -Medical expenses for room rent, boarding expenses, nursing, ICU, medical practitioner, anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs and consumables, diagnostic procedures, cost of prosthetic and other devices or equipment if implanted internally during a Surgical Procedure. 3. Waiver of Pre Existing diseases ; 1 st year, 2 nd year exclusion ; first 30 days exclusion. 4. Pre-Post hospitalization 5. Day Care Expenses 6. Claims paid under basic policy in which claim amount exceeds the sum insured of basic policy, super top up policy will pay the balance claim amount. 7

Exclusions under Super Top Up Policy The following expenses will not be covered under the policy: 1. Maternity Expenses, Pre & Post Natal Expenses, Baby Day 1 cover expenses. 2. Co-pay, Capped Diseases and Non admissible expenses deducted under Basic GMC policy of Publicis 3. All Exclusions of Basic GMC Policy like Cosmetic Surgery, Dental and cost of Spectacle, treatment of Obesity. 4. Domiciliary Hospitalization, Naturopathy, Stem Cell Surgery. Please note that all the terms and conditions applied in the Group Base Mediclaim policy will be applicable in the Top-up Policy 8

Special Features 1. TPA : Same TPA (i. e) Paramount Health Services (TPA) Pvt. Ltd. for basic and Top-Up policy. Employee need not to prepare two set of documents. 2. Financial Saving: Financial saving by avoiding dent to your saving when hospitalisation cost exceeds the sum insured of your basic Group Mediclaim. 9

Premium (Excluding Service Tax) Premium Rates applicable Top Up Sum Insured 1 Lakhs 2 Lakhs 3 Lakhs 5 Lakhs 10 Lakhs 15 Lakhs 20 Lakhs Premium 3500 4000 4500 5000 8000 11000 12500 10 Service Tax Total Payable 508 4007 580 4580 653 5153 725 5725 1160 9160 1595 12595 1812 14313

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