Strictly Confidential

Group Health Insurance By:

Manish Agarwal Senior Risk Manager

Group Health Insurance By:

Manish Agarwal Senior Risk Manager

We are independent intermediaries who represent the client and not the insurance company, unlike an insurance agent who

normally represents the company 

We are independent intermediaries who represent the client and not the insurance company, unlike an insurance agent who

normally represents the company 

What do we do…

We market Insurance Solutions for

“ALL INSURANCE COMPANIES”

Life & General Public & Private

“Product Range”

ALL TYPES OF INSURANCE

And advice the best to our Valuable Client

We market Insurance Solutions for

“ALL INSURANCE COMPANIES”

Life & General Public & Private

“Product Range”

ALL TYPES OF INSURANCE

And advice the best to our Valuable Client

Identify and evaluate your needs Design your Insurance Portfolio

Choose the Right Product Negotiate with the Companies for the most competitive rates

Assist in documentation

Claims Management- After all money matters

Claims Handling

Legal Representation

And what do we do for you…

Advantages of Group Health

Floater cover for Entire Family so higher cover at lower cost

Lower Premiums than Individual Plans

Easy Claims Settlement

Pro Rate Premium if people leave

Maternity Benefit

Pre Existing Diseases Covered so all disease covered from day one*

Parents can be covered too without any Medical Tests upto age 80

some exclusions are there

Advantages of Group Health

Floater cover for Entire Family so higher cover at lower cost

Lower Premiums than Individual Plans

Easy Claims Settlement

Pro Rate Premium if people leave

Maternity Benefit

Pre Existing Diseases Covered so all disease covered from day one*

Parents can be covered too without any Medical Tests upto age 80

some exclusions are there

We take complete responsibility of any service/claims/other issues during the policy period.

Your employee needs to give us intimation during an unfortunate event of a claim and we take over from there managing all documentation, liasioning with the TPA and Insurer for speedy cashless/recovery and other necessary work.

We will train all your employees about the procedure of claims so that the claim process becomes hassle free for them.

We will provide a 24 hr. Helpline number for any Assistance

We will give you One dedicated Service Manager for day-to-day requirements

We will also provide assistance related to any other type of insurance that your employees might need

We take complete responsibility of any service/claims/other issues during the policy period.

Your employee needs to give us intimation during an unfortunate event of a claim and we take over from there managing all documentation, liasioning with the TPA and Insurer for speedy cashless/recovery and other necessary work.

We will train all your employees about the procedure of claims so that the claim process becomes hassle free for them.

We will provide a 24 hr. Helpline number for any Assistance

We will give you One dedicated Service Manager for day-to-day requirements

We will also provide assistance related to any other type of insurance that your employees might need

Some of Our Group Health Insurance Clientele

1. Keventer Agro2. Tilaknagar Industries3. Zentech Pharma4. Prachar Communications5. Bengal Ambuja Group6. South City Projects 7. Hotel Golden Park 8. Hotel Taj Bengal9. Machino Polymers Ltd 10. Aircon India (Unit of Voltas) 11. Infinity InfoTech Parks Ltd 12. S.P.Jain Institute of Management and Research 13. Purbanchal Cements14. Maithan Group15. Orion Edutech16. N K Realtors17. Raj Bhavna & Associates18. Rebecca Technologies19. JMD Telefilms20. T B Marketing

Some of Our Group Health Insurance Clientele

1. Keventer Agro2. Tilaknagar Industries3. Zentech Pharma4. Prachar Communications5. Bengal Ambuja Group6. South City Projects 7. Hotel Golden Park 8. Hotel Taj Bengal9. Machino Polymers Ltd 10. Aircon India (Unit of Voltas) 11. Infinity InfoTech Parks Ltd 12. S.P.Jain Institute of Management and Research 13. Purbanchal Cements14. Maithan Group15. Orion Edutech16. N K Realtors17. Raj Bhavna & Associates18. Rebecca Technologies19. JMD Telefilms20. T B Marketing

CREDENTIAL’S

We are currently managing more than 20000 lives under Health Insurance

We settle more than one claim every day

We maintain a 100% claims settlement ratio!!

In case of rejection on false grounds, we file the claims with ombudsman and get the claim

We have a strong Claims & Customer Service team which is there 24 hours to support your people

CREDENTIAL’S

We are currently managing more than 20000 lives under Health Insurance

We settle more than one claim every day

We maintain a 100% claims settlement ratio!!

In case of rejection on false grounds, we file the claims with ombudsman and get the claim

We have a strong Claims & Customer Service team which is there 24 hours to support your people

About Your Policy

Enrolment

Guidelines for Hassle-Free Claims

In case of Emergency• Approach Network Hospital on recommendation of Physician & Show Cashless Card at the

Hospital

• Obtain a Pre-Authorization form and get it filled and signed by the treating doctor and submit to Hospital which will then fax it to the TPA along with other necessary reports

• After investigation, TPA will fax the approval for Cashless to Hospital

Cashless can be rejected

• If the Disease is not covered

• Information sent is insufficient

• Request for Cashless is not sent in time

• However, you need to pay the bills which can be reimbursed later

In case of Planned Hospitalization• Go to the Hospital at least 72 Hours before admission and

• Submit the Pre-Authorization Form available with the Hospital

• Show your Cashless Card, Doctor’s Advice Letter, Probable Date of Admission so that

• You will get the Cashless approval even before admission to the Hospital if cashless is

approved by the TPA

In case of Emergency• Approach Network Hospital on recommendation of Physician & Show Cashless Card at the

Hospital

• Obtain a Pre-Authorization form and get it filled and signed by the treating doctor and submit to Hospital which will then fax it to the TPA along with other necessary reports

• After investigation, TPA will fax the approval for Cashless to Hospital

Cashless can be rejected

• If the Disease is not covered

• Information sent is insufficient

• Request for Cashless is not sent in time

• However, you need to pay the bills which can be reimbursed later

In case of Planned Hospitalization• Go to the Hospital at least 72 Hours before admission and

• Submit the Pre-Authorization Form available with the Hospital

• Show your Cashless Card, Doctor’s Advice Letter, Probable Date of Admission so that

• You will get the Cashless approval even before admission to the Hospital if cashless is

approved by the TPA

Claims Reimbursement

If Cashless is not approved or if you visit a Non-Network Hospital

At the time of Discharge, settle the Hospital Bills in full and collect all the original BILLS, DOCUMENTS, REPORTS and DISCHARGE SUMMARY

Lodge your claim with the TPA by filling the CLAIM form and attaching Necessary Documents within 7 Days of Discharge

Documents to be Submitted:

Claims Notification - Within 3 Days of Admission via Letter/Fax/Email Discharge Summary in Original with all Necessary Details Detailed Bill –

Proper Bills with Break-up of all the items/medicines/tests Doctor’s Bills must be stamped, with Doctor’s Reg. No.

All Supporting Prescriptions and Reports Payment Receipt – Must be stamped and signed by Hospital Authorities

Any expenses not pertaining to the Medical Treatment are not covered

If Cashless is not approved or if you visit a Non-Network Hospital

At the time of Discharge, settle the Hospital Bills in full and collect all the original BILLS, DOCUMENTS, REPORTS and DISCHARGE SUMMARY

Lodge your claim with the TPA by filling the CLAIM form and attaching Necessary Documents within 7 Days of Discharge

Documents to be Submitted:

Claims Notification - Within 3 Days of Admission via Letter/Fax/Email Discharge Summary in Original with all Necessary Details Detailed Bill –

Proper Bills with Break-up of all the items/medicines/tests Doctor’s Bills must be stamped, with Doctor’s Reg. No.

All Supporting Prescriptions and Reports Payment Receipt – Must be stamped and signed by Hospital Authorities

Any expenses not pertaining to the Medical Treatment are not covered

Do’s and Don'ts Store our Helpline No’s and Also give it to other Family Members

Find out whether the disease is covered in the policy or not

Always carry Cashless Card while going to the Hospital

Maintain All Bills inc. pre and post Hospitalization

Take the bill also from the family/consulting doctor

Never Disclose the amount of coverage to the Hospital

Do not go for very expensive treatment

Enquire about the Approx. cost of Treatment beforehand

Do not panic. Procedures and Rules have to be followed

No Need to call at Weird Hours

Push the Hospital Authorities to send all papers to TPA and follow up continuously

Store our Helpline No’s and Also give it to other Family Members

Find out whether the disease is covered in the policy or not

Always carry Cashless Card while going to the Hospital

Maintain All Bills inc. pre and post Hospitalization

Take the bill also from the family/consulting doctor

Never Disclose the amount of coverage to the Hospital

Do not go for very expensive treatment

Enquire about the Approx. cost of Treatment beforehand

Do not panic. Procedures and Rules have to be followed

No Need to call at Weird Hours

Push the Hospital Authorities to send all papers to TPA and follow up continuously

Reminders Reminders

Your RiskWe at IDEAL would like to assure you a Seamless Service Experience with

a focus on building a Long Term Relationship.

NEEDLESS TO SAY WE TAKE COMPLETE RESPONSIBILITY OF YOUR CLAIMS SETTLEMENT

We will surely create a Difference both in terms of “Cost & Quality”

With IDEAL