Importance of Group Health Insurance for Cement Industry

Workers in the cement industry are prone to get sick due to the chemicals that are released during the production of cement. Since these chemicals can really harm a human body from the inside, it becomes necessary for the owner of the cement factory to provide group health insurance coverage to the workers.

Group Health Insurance for Cement Factory: Inclusions

Group medical insurance for cement industry provides coverage for the following:

• Pre-existing diseases are covered
• Pre & post hospitalisation expenses are covered
• Infant of the insured worker is covered from the day of delivery
• Maternity coverage
• Doctor’s fee 
• Room rent charges 
• Ambulance charges as specified in the policy
• Medical tests as per specified in the policy
• Day care treatment charged are covered
• Domiciliary charges are covered
• Extended coverage for oxygen, blood, medicines, etc. are covered

Group Health Insurance for Cement Factory: Exclusions

Group medical insurance for cement factory does not provide coverage for the following:

• Several insurance companies does not provide cover for parents
• Non-allopathic treatments are not covered
• If the insured is suffering from a diseases since birth, the insurance plan does not provide coverage
• Health related complications due to alcohol or drug abuse is not covered
• Expenses incurred in diseases like AIDS is not covered

Claiming Process under Group Medical Insurance for Cement Factory

Follow the steps mentioned below to raise claim through third-party administrator:

• Fill in pre-authorisation form at the TPA desk
• Third-party administrator contact the insurer for pre-approval
• You get approval from insurer with initial amount
• Post treatment the claim gets settled

To get re-imbursement:

• Inform the insurer within 24 hours of getting hospitalised
• Keep original bills, discharge documents and reports handy
• Submit the claim form within 7 days of discharge
• The insurer will check the T&C of the policy and process the claim
• Provide cancelled cheque so that the insurer can begin the claim settlement process
• Once everything is done, the insurer will reimburse the amount within 15 days

Documents Required to Raise Claim under Group Medical Cover for Cement Industry

Keep the following documents ready to submit along with the claim form to raise the claim:

• Filled up claim form with concerned Doctor’s signature
• FIR, if any
• Final Hospital Bill 
• Prescription of the Doctor
• Discharge summary with treatments listed
• Cash memo
• Any other docs as per the requirement of the insurer