Importance of Group Health Insurance for Banking Industry

Majority of the organisation provide group health cover to their employees. Group mediclaim insurance not only provides financial coverage to the employees for medical emergencies but also reflects the employer’s goodwill and helps them retain employees for a longer period of time.

Coverage under Group Mediclaim Insurance for Banking Industry

Group health insurance for banking industry provides coverage for the following:

• Pre-existing diseases
• Doctor’s fee
• Room rent as per specified in the policy
• Consultation charges
• Maternity cover is provided
• Day care treatments
• Pre and post hospitalisation charges are covered
• Medical test expenses
• Domiciliary charges
• Ambulance charges
• X-rays, medicines, etc. are covered
• New born baby is covered from the day of delivery
• Ambulance charges are also covered

Group Mediclaim Insurance for Banking Industry does not Cover

Group health insurance for banking industry does not cover the following:

• Ayurveda and homeopathy treatments
• Any kind of complication caused due to drug abuse or alcohol abuse
• Some insurance companies do not provide coverage to the parents of insured employee
• If any disease is present in the insured employee since birth, the insurance plan does not provide cover for it
• Expense incurred in AIDS treatment or any other similar diseases

Group Medical Insurance for Banking Industry: Claiming Process

To raise claim under group medical insurance for banking industry through third-party administrator:

• Go to the TPA’s desk where the insured is admitted
• Fill the form for pre-authorisation
• Third-party administrator will get the pre-approval from insurer
• Then the insurer will settle the claim

For re-imbursement claiming process

• Inform the insurer within 24 hours of hospitalisation
• Keep all the reports and documents ready
• Fill the claim form and submit with all the required documents within 7 days of discharge
• Insurer will process the claim from their end
• Insurer will ask for a cancelled cheque to get the claim amount processed
• Within 15 days of submission the insurer will settle the claim

Group Mediclaim Insurance for Banking Industry: Documents Required

Keep all the below mentioned documents ready to submit with the claim form to initiate the claim process:

• Medical test reports
• Doctor’s prescriptions
• Medicine bill
• Cash memo
• FIR, if any
• Discharge summary with the list of treatments
• Any other additional documents required by insurer
• Final bill