broad terms of wbmscl employees’ group health insurance ... · broad terms of wbmscl employees’...
TRANSCRIPT
Broad terms of WBMSCL Employees’ Group Health Insurance Coverage
Tenure of Policy1(One) year from 01-01-2017 to 31-12-2017
Sum InsuredRs.5,00,000 (Rs.5 lakh) per employee/family.
‘Family’ includes spouse, two dependent children (upto the age of 23, unmarried and financiallydependent on employee) and dependent parents up to the age of 80 (at the time of entry) and notincluded in any Health Scheme of the State / Central Government.
Corporate BufferCorporate Buffer or Floater of Rs.10 Lakhs in a policy year, at the discretion of the management,after the employee/his family exhausts the sum insured of Rs.5 Lakh.
CoverageHospitalisation in network hospitals including room rent, surgery, doctor’s fees and other relatedmedical expenses under ‘cashless’ system.
For admission in non-empanelled hospital, instead of treatment under cashless system, admissibleclaims, subject to a deduction of 10%, will be reimbursed by the TPA.
Subsequent Inclusion of Member in Policy : New born baby will be free on intimation. Spouse (on marriage) will be covered on intimation.
Intimation for inclusion of Member to be given to WBMSCL in the following format foronward transmission to the SBI General Insurance to take effect from the first day offollowing month:
1. Name / Designation of Primary Member2. Name of Beneficiary (intended for inclusion)3. Relationship with primary Member4. Gender5. Date of Birth6. Whether the beneficiary is included in any Health Scheme of the State/ Central
Government. New employee with spouse, children and dependent parents will be covered.
Pre & Post Hospitalisation expense30 days / 60 days respectively.
Waiver of Pre-existing diseases.
Waiver of 30 days and 1st year general exclusions.
Maternity Benefits Limit Rs.35,000 normal delivery Rs.50,000 /- Caesarians. 9 months period waived.
Exclusions : Congenital diseases Treatment of Homoeopathy Aurvedic, Unani, etc.
Domiciliary treatment Dental Treatment OPD treatment
Cappings: Room Rent in hospitals
Rs.6,500 /- per day for NON-ICU Rs.10,000 /- per day for ICU.
Cataract surgery : Rs.50,000 /- per eye. Ambulance charges :Rs.1500 per family, per admission.
No Capping / sub-limit on: Medical
Practitioner/Anesthetist Consultant fees Surgeon fees Blood Oxygen
OT Surgical appliances Medicines and Drugs Diagnostic material X-ray Dialysis
Chemotherapy Radiotherapy Pacemaker Artificial limbs Cost for replacement of
organs and similar expenses.
Critical illness:There will be no additional limit for critical illness.
Detail of the Insurer :Insurance Company Third Party Administrator (TPA)
SBI General Insurance Company Limited“Apeejay House”, 4th floor,
Block-B,15, Park Street, Kolkata 700 016.Website : www.sbigeneral.in
For any support :Call back to 1800-102-1111 / 1800-22-1111,Write to [email protected]
Further assistance or support, contact to :
Somnath Banerjee, [email protected]
Sayantan Roy, [email protected]
Medi Assist India TPA Private Limited“Premier Court”, 4th Floor,
4, Chandi Chowk Street, Kolkata 700072.Website : www.mediassistindia.com
For any assistance or support , contact to :
Chandranath Biswas, [email protected]
Sanjiv Chatterjee, [email protected]
Mihir Ranjan Parida, [email protected]
If you still have any specific query / clarification or need any other supportcontact Company Secretary, WBMSCL at +91-33-40340316 or write to [email protected]
HospID Hospital Name Address Phone PinCode City(West Bengal)
50093 Arogya Maternity And Nursing HomeNo 71, Toolygunge Circular Road, (NewAlipore Sital Sadan Compound) 033 - 24000684 / 24000681 700053 Kolkata
50142 Bankura Nursing Home Patpur P.O., District Bankura 03242 - 250582 / 255155 722101 Bankura
50148Bellona Nursing Home And DiagonsticCentre Private Limited 51 A Diamond Harbour Road 033 - 30901803 / 24487057 700027 Kolkata
50177 Brws Hospital 10 Kendua Main Road Garia Kolkotta033 - 24300603 / 24239851 /24376732 700084 Kolkata
50179 Capitol Nursing Home Pvt Ltd 288/2. Apc Road 033 - 23507272 / 4913 700009 Kolkata
50204Charring Cross Nursing Home PrivateLimited 2c, Motilal Basak Lane 033 - 23598353 / 56 / 57 / 58 700054 Kolkata
50237 Daffodil Nursing Home Pvt Ltd 276. Canal Street033 - 2534-6649 / 5681 /4581 700048 Kolkata
50257 Dilkush Nursing Home 944, Dilkusha Street033 - 22404067 / 22404318 /22803639 700017 Kolkata
50237 Daffodil Nursing Home Pvt Ltd 276. Canal Street033 - 2534-6649 / 5681 /4581 700048 Kolkata
50257 Dilkush Nursing Home 944, Dilkusha Street033 - 22404067 / 22404318 /22803639 700017 Kolkata
50259 Divine Nursing Home Pvt Ltd 11A, Abinash Ch. Banerjee Lane033 - 28950512 / 23505636 /4765 700010 Kolkata
50317 Ekbalpur Nursing Home P Ltd 9, Ibrahim Road Kolkotta-700023033- 30910909 / 24490455/24494514/ 24495151/ 2449 700023 Kolkata
50321 Eskag Sanjeevani Pvt LtdP-48, Kshirod Vidyavinod Avenue,Baghbazar Near Girish Mancha 033 - 25545252 / 1818 700003 Kolkata
50350 Genesis Hospital 1470 Rajdanga Main Road 033 - 24424242 700107 Kolkata50372 Haldia Seva Sadan Debhog Haldia Purba Medinipur 03224 - 252987 / 252162 721657 Midnapur
50386 Hindusthan Health Point Pvt Ltd2406, Garia Main Road, HindusthanMore, Near Wbseb Office 033 - 4359999 700084 Kolkata
50399 Ils Hospitals Salt LakeJeewan Satya Dd-6, Salt Lake CityKokotta-064 033 - 40206500 700064 Kolkata
50434 Jeevan Deep Nursing Home Khosbagan, Burdwan Dist0342 - 2566935 /09832162367 711201 Burdwan
50483 Kasturi Medical Centre Private Limited
Diamond Harbour Road, 3a Bus Stand,Po- Joka, 24 Paraganas(South), P O Joka 24 Paraganas(South) 033 - 24676870 / 24672609 700104 Kolkata
50509 Kothari Medical Centre 8/3 Alipore Road 033-40127000 700027 Kolkata50614 Maple Nursing Home 17a Bipradas Street Kolkota 033 - 23501682 / 9300 700009 Kolkata50636 Medicare Clinic Pvt Ltd 138. G T Road, Howrah 033 - 26601777 / 78 / 1288 711102 Howrah50643 Mediview Nursing Home Pvt Ltd 74. Broad Steet, Kolkata - 19 033 - 22803991 / 92 700029 Kolkata
50659Mission Of Mercy Hospital And ResearchCentre 125/1, Park Street, Kolkata
033 - 30217710 / 30217703 /30217704 700017 Kolkata
50663 Mohan Clinic 46, Lake Temple Road 033 - 24655841 / 24658225 700029 Kolkata
50677N G Medicare Calcutta Hope InfertilityClinic 123a. Rash Behari Avenue 033 - 24631376 / 24640230 700029 Kolkata
50712 North Bengal Nursing Home 28/33 K J Sanyal Road, Malda 03152 - 252132 732101 Malda
50740 Paramount Nursing Home Private Limited 109/1, Hazra Road033 - 24763173 / 3174 /3175 700026 Kolkata50740 Paramount Nursing Home Private Limited 109/1, Hazra Road033 - 24763173 / 3174 /3175 700026 Kolkata
50756Peerless Hospital And B K Roy ResearchCentre 360, Panchasayar, Kolkata
033 - 24622394 / 0071 / 72 /73 700094 Kolkata
50797Rabindranath Tagore InternationalInstitute Of Cardiac Sciences
124 Mukundapur Em Bypass NearSanthoshpur Connector 033 - 24363000 / 24363401 700099 Kolkata
50835 Royd Nursing Home And Health Care Ltd No. 5 - B, Royd Street, Kolkata 033 - 22271666 / 67 / 68 700016 Kolkata
50836 Ruby General Hospital Limited Kasba Golpark Em Bypass, Kolkata 033 - 2442 6576 / 2442 6091 700107 Kolkata
50851Sab Nursing Home And DiagnosticsCentre Hpl Link Road Basudevpur(W) 03224 - 274718 721602 Haldia
50875 Samaritan Clinic Pvt Ltd#4. Roy Mansion, Elgin Road, (10/4d,Lala Lajpat Rai Sarani) 033 - 32940892 / 22876231 700020 Kolkata
50919 Serampore Surgical Nursing Home P Ltd 8a K M Sha Street Serampore 033 - 26620449 / 26522484 712201 Serampur
50946 Sheshraj Medicare Near Rabindra Bhavan, Nh-34, Malda 0 732101 Malda51057 Amri Hospitals Jc 16 & Jc 17, Sector-3. Salt Lake 033 - 23357710 700091 Kolkata
51078Swasti Eye And Super Speciality NursingHome
Aa-2/2, Taltala, Rajarhat Road,Joramandir, Baguihati 033 - 40123636 700059 Kolkata
51081 Swiss Park Nursing Home Pvt Ltd 48/4 Swiss Park, Tollygunge 033 - 24241884 / 24242216 700033 Kolkata
51180Woodlands Multispeciality HospitalLimited 8/5 Alipore Road 033 - 24567075 / 7089 700027 Kolkata
51188 Apollo Gleneagles Hospital58, Canal Circular Road, (Opp. SaltlakeStadium), Kolkata 033 - 2358-5211 / 5215 700054 Kolkata
51192Bhagirathi Neotia Woman And Child CareCentre (Only For Lexmark, Ibm) 2, Rawdon Street, Kolkatta 33-40405000 700017 Kolkata
51254Uma Medical Related Institute PrivateLimited V.I.P Road, Teghoria, Kolkata-59 033 - 25701956-59 700059 Kolkata
51955 Microlap Hospital 24, Bepin Pal Road, Kolkatta 033 - 24669910 / 24640702 700026 Kolkata
52257B P Poddar Hospital And MedicalResearch Ltd
71/1, Humayun Kabir Srani, NewAlipore, Block-G, Kolkata 033 - 24458901-05 700053 Kolkata
52262Susrut Eye Foundation And ResearchCentre
Hb-36/A/1, Sector Iii, Salt Lake City ,Kolkata
033 - 23580201 / 23341628 /1632 / 1648 700106 Kolkata52262
Susrut Eye Foundation And ResearchCentre
Hb-36/A/1, Sector Iii, Salt Lake City ,Kolkata
033 - 23580201 / 23341628 /1632 / 1648 700106 Kolkata
52931 The Calcutta Medical Research Institute 7/2, Diamond Harbour Road, Kolkata 033 - 24567700 / 02 / 03 / 04 700027 Kolkata52932 B M Birla Heart Research Centre 1/1, National Library Avenue 033 - 24567777 / 24567890 700027 Kolkata
53934 Alpha Medical Services13, Lala Lajpat Rai Sarani, (Elgin Road),Kolkata
033 - 22892530 33 /9830049510 700020 Kolkata
53935 Alpha Medical Services21/1, M.A.K. Azad Road, (Dobson Road),Howrah
033 - 26667494 / 26667495 /26667197 711101 Howrah
55033 The Mayfair Hospital 34/1a, B.T. Road, Kolkata, West Bangal 033 - 25328622 700002 Kolkata
56562 Paramount Hospital Pvt Ltd
Mangal Pandey Road, Khalpara, P.O.-Siliguri, Dist.- Darjeeling Pin- 734 005,West Bengal. 0353 - 2500112 734005 Siliguri
56673 Charnock Hospital Pvt LtdTegharia, Rajarhat Po, 24 Parganas (N) -District, Kolkata - 700059
033 - 25735707 / 25735708 /55295710 700059 Kolkata
57482 Amri HospitalsP4 & 5 C.I.T Scheme - Lxxi, Block - A,Gariahat Road, Kolkata - 700029 33-66260000 700029 Kolkata
59514 Park Medicare Centre Pvt Ltd30a/148 Dr.P .T Laha Street. BangurPark, Rishra. Hoogly .[W.B] 033 - 26723471 / 3977 712248 Rishra
60690 Durgapur City Hospital And Clinic Pvt LtdN-5, 4th, 75th Street, Doctors Colony,City Centre 0343 - 2545262 / 2546600 713216 Durgapur
60752 Arogya Niketan Pvt Ltd # 105, R S Verma Road, Uttarpara 033 - 26644795 712258 Hoogly
61080Nightingale Diagnostic And MedicareCentre # 11, Shakespeare Sarain 033 - 22827255 700071 Kolkata
61520 Tulip Nursing Home Pvt Ltd 96 Rishi Bankim Ch.Rd.Kolkata 700028 033 - 25299045 700028 Kolkata61521 Care And Cure Hospital S N Road, Nabaplly, Barasat 033 - 25422899 700126 Barasat
61522 Vivekananda NetralayaRabindra Bithi, Bypass Road, Bolpore,Birbhum 0 731204 BOLPORE
61523 Green View Clinic 231/1 Rbc Rd.Po.Naihati, 24 Pgs (N) 033 - 25812429 / 2344 700029 NAIHATI61524 Midland Nursing Home Pvt Ltd 33 Anupama Road, Kolkata 033 - 2583-5766 / 9130 700056 Kolkata
61525 Vip Apex Medical Centre Pvt LtdH-1-16 Sachindra Lal Sarani, Vip Road,Kolkata 033 - 2570-2257 / 2392 700059 Kolkata
61528 Sunrise Nursing Home Pvt Ltd Udham Sing Sarani, Sevok Road, Siliguri 0353 - 2643-692 / 2531369 734001 Siliguri61528 Sunrise Nursing Home Pvt Ltd Udham Sing Sarani, Sevok Road, Siliguri 0353 - 2643-692 / 2531369 734001 Siliguri
61792 Mega City N H12 Jessore Road, Chanpadali, Barasat,24pgs(N) 033 - 25526319 700124 Barasat
61793 Sterling Hospital55/1 Bhupen Bose Avenue, ShyamBazar, Kolkata-700004 033 - 25301314 700004 Kolkata
61891 Medline Nursing Home
48/30 Purnachandra Mitra Lane,Tollygaunge, Kolkata, 48/30Purnachandra Mitra Lane, Tollygaunge,Kolkata 033 - 24240248 700033 Kolkata
61892 Panacea Nursing Home32(8)Barasat Road, (15 No.Rly.Gate),P.O-Nonachandan Pukur, Barrackpore 033 - 25928794 700122 BARRACKPORE
61964 South Suburban Clinic Pvt Ltd 67, Diamond Harbour Road, Kolkata 033 - 23967333 / 23980275 700038 Kolkata63945 Rotary Narayana Nethralaya Cn-5, Sector -V Saltlake 033 - 23673312 700091 Kolkata64156 Binayak Multispeciality Hospital 59 Kali Charan Ghosh Road, Kolkata 033 - 25329950 / 51 700050 Kolkata
64787 Sahid Khudiram Bose Hospital12 B T Road, Belghoria, 12 B T Road,Belghoria 033 - 25443250 700056 Kolkata
64788 Life Line Nursing Home 4-A Wood Street033 - 22801344 / 5086 /22878083 700016 Kolkata
65104 M B Nursing Home Pvt Ltd558/1, Dilkhusa Street, Near Park Circus4 No. Bridge
033 - 22873663 / 30901222 /30905278 700017 Kolkata
65198 Marina Medical Centre Pvt Ltd Babupara, Near Kotwali P S 03561 - 229604 / 231080 735101 Jalpaiguri65202 Labbaik Medical Centre # 40 Kavi, Md Iqbal Road 033 - 24491966 / 24480645 700023 Kolkata
65369 D M Hospitals Pvt Ltd113, James Long Sarani ,P.O.Thakurpukur 033 - 24536221 / 22 700063 Kolkata
65388 Chakraborty Nursing Home15, Aurrora Gate, Gate Bazar,Khargapur Midnapur (W) 03222 - 256770 721301 Kharagpur
65862 New Saraju Nursing Home 46/1g, B T Road, South Sinthee, Kolkata 033 - 2556-5100 / 6505 700002 Kolkata
66858 Eco HospitalIii/1, Jessor Roadbarasat, Po-Barasat,Dist-24 Pgs (N)Kolkata
033 - 25626/854 / 2548-0111/ 2548-0452 700124 Kolkata
66859 Dr Nihar Munsi Eye Foundation1/3dover Place Kolkata, 1/3dover PlaceKolkata
033 - 2461-9844 / 8733 /9769 700019 Kolkata
66860 Apex Inst Of Medical Sciences12/9, Survey Park, Near Big Bazar,Hiland Park 033 - 2416-4555 700075 Kolkata66860 Apex Inst Of Medical Sciences12/9, Survey Park, Near Big Bazar,Hiland Park 033 - 2416-4555 700075 Kolkata
66861 Salua Nursing HomeNo Shooting Area, Salua, Kharagpur, NoShooting Area, Salua, Kharagpur 03222 - 296444 700056 Kharagpur
66863 Shusrusha Nursing Home Pvt Ltd
P-290, Cit Scheme - Vi M, U.C. BanerjeeRoad, P-290, Cit Scheme - Vi M, U.C.Banerjee Road
033 - 2362-8863 / 8430 /23648910 / 32901609 700059 Kolkata
66864Satyarani Memorial Nursing Home AndDiagnostic Centre
Ghasiara More, Sonarpur , GhasiaraMore, Sonarpur 033 - 24347360 700150 Kolkata
67158 Priyamvada Birla Aravind Eye Hospital 10-Loudon St. 033 - 22894343-6 700017 Kolkata
67159 Kpc Medical College And Hospital1f, Raja S.C.Mallick Rd., 1f, RajaS.C.Mallick Rd 033 - 30016100 / 156 700032 Kolkata
67332 Netrajyoti Eye Care Centre116/1 G T Road, Puspa Appartment, 1stFloor, Bally, Howrah 033 - 26544154 / 64506641 711201 Howrah
67333 Rsv Hospital Private Limited 40 Deshpran Sasmal Road, Kolkata033 - 9903999659 /9903999660 700033 Kolkata
67534 Health Point 21 P Pandit Street 033 - 30585842 / 30585843 700025 Kolkata
69049 Spectra Eye Foundation108/1, Jessor Road, Madhyamgram,Chowmatha 033 - 25384949 700129 Kolkata
69050 Swastik Seva Sadan 16c, Tiljala Road., Tiljala 033 - 23430099 700046 Kolkata
69051 Shreema NhVill-Debra, Po-Debra Bazar, Dist-Paschim Medinipore, W.B, Debra 03222 - 243226 721126 Kharagpur
69463 Sunflower Nursinghome1/1a Monomohan Pandey Road,(Goabagan St), Goabagan, Hedua Park 033 - 25558200 700006 Kolkata
69716 Cure Centre N H 377/3 Prince A.Shah Rd., P.A.S. Road 033 - 24725962 700068 Kolkata69717 Tra General Hospital 7-Dr.Biresh Guha Road, Parkcircus 033 - 22895346 / 22894692 700017 Kolkata
70232 Bidhan Niramoy B-120, Aldrin Path, Sec-2b.Bidhannagar 0343 - 2537083 713212 Durgapur
70234H L G Memorial Charitable Hosp And ResInst
Housing More Sen Raleigh Road ,Asansol, Asansol
0341 - 2251510 / 2256611 /8348689036 713304 Asansol
70235 Bindu Basini Nursing Home76, Madhusudan Banerjee Rd.Birati.,Birati 033 - 25393892 700051 Kolkata
70234H L G Memorial Charitable Hosp And ResInst
Housing More Sen Raleigh Road ,Asansol, Asansol
0341 - 2251510 / 2256611 /8348689036 713304 Asansol
70235 Bindu Basini Nursing Home76, Madhusudan Banerjee Rd.Birati.,Birati 033 - 25393892 700051 Kolkata
70236 Phoenix Hospital And Diagnostic Centre2, Motilal Colony, Nirmal SenguptaSarani, (Near 2 No. Airport Gate) 033 - 25128114 / 7825 700081 Kolkata
70405 Dum Dum Eye Micro Surjery Centre 5/1/1c, Kalicharan Seth Lane., Kolkata 033 - 25573022 700030 Kolkata
70407 Paramount Health Care148&151, Gt Road, Maniktala,Serampore, Serampore 033 - 26525306 712201 Serampore
71997 Shakuntala Nursing Home 633-Biren Roy Rd.(W), Behala 033 - 24521252 700061 Kolkata71998 Green View Nursing Home Bt Rd.Dhankal Busstop, Panihati 033 - 30626386 700114 Kolkata
71999 Five Point Micro Surgery Centre Pvt Ltd227-Apc Rd. Kolkata 700004,Shyambazar 033 - 25302293 700004 Kolkata
72001 Apollo Gleneagles Heart Centre 48/1f, Leela Roy Sarani, Kolkata 033 - 24618079 700019 Kolkata72002 Health Care Centre 88 Jessore Rd.Nagerbazaar, Kolkata 033 - 25518282 700074 Kolkata
72003 Kanak Nursing HomeNo-1, Netaji Park, Gt.Rd., Bandel,Hoogly 033 - 26310821 712123 Bandel
72004 Mamata Nursing Home Dharpur, Po&Ps Tamluk, Tamluk 03228 - 266329 721636 TAMLUK
72005 Mediland Nursing HomeHpl Linc Rd.Po. Basudevpur, Haldia ,Paschim Medinipur, Do 03224 - 275200 721602 Haldia
72007 Sebayan Nursing Home Services Pvt LtdGarmirjapur(Andul Rd.), Post:Mashila,Ps:Sankrail, Dist:Howrah, Do 033 - 26416231 711302 Howrah
72008 Henry Grey Nursing Home And Poly ClinicSankhachil, 1no, Rly Gate, Jirat Rd.P.O-Habra, 24pgs (N). 03216 - 321569 743263 HABRA
72009 M/S Indus Nursing Home Pvt LtdAndul Rd.Podrah, Howrah, Howrah,Andul Rd 033 - 26445323 711109 Howrah
72964 Sankara Nethralaya#147, Mukundapur, E.M. Bypass , NearPurba Jadavpur Police Station 033 - 30416015 / 30416000 700099 Kolkata
73088 Salt Lake Eye Foundation Ia-173, Saltlake, Kolkata, Kolkata 033 - 23352681 700097 Kolkata
73089Samrat Nursing Home And DiagnosticCentre
Arobindanagar, Kulpi Rd.Baruipur,Baruipur 700144 Kolkata
73091Chittaranjan Advanced Med And RelatedInstitue Bamchandipur.G.T Rd.Burdwan 0342 - 2541182 713101 Burdwan
73092 Eye Microsurgery And Laser CenterNear Old Launch Ghat, Barabazar,Po.Chinchura, Hoogly, Chinchura 033 - 26805025 712101 Chinsurah73092 Eye Microsurgery And Laser CenterNear Old Launch Ghat, Barabazar,Po.Chinchura, Hoogly, Chinchura 033 - 26805025 712101 Chinsurah
73093 Nirama Nursing Home101/5, Jessore Rd.(No.1 Rail Gate),Habra, Habra 03216 - 238255 743263 HABRA
73094 Angelmaternity Nursing Home 3, Komedan Bagan Lane, Kolkata 033 - 22493361 700016 Kolkata
73095 Health Cure Nursing Home Block-A, P677, Lake Town, Lake Town 033 - 25345181 / 25212782 700089 Kolkata73096 Islamia Medical Institute 94, New Park Street, Do 033 - 22806487 700017 Kolkata73240 Singh Medicare Pvt Ltd 263/3 G. T. Road(South) 033 - 26782283 711102 Howrah
73255 Shree Jain Hosp And Research Centre493b/12, G.T Road(S), Shibpur,Howrah., Shibpur
033 - 26415831 / 32 /30917200 / 01 / 02 / 03 711102 Howrah
74018 Central Nursing Home85/1rabindra Sarani, Ranaghat,Ranaghat 03473 - 215249 700026 Ranaghat
74019Majumder Millennium Nursing HomeAnd Reliable Diagnostic Centre Pvt Ltd A-9x-3(Ca)Kalyani 033 - 25820685 741235 Kalyani
74020 Dr Bc Roy Hospital Banbishnupur, Balughata, Haldia 03224 - 269053 / 269048 721657 Haldia
74021 James Long Clinic Pvt Ltd 33james Long Sarani, Kolkata, Kolkata 033 - 24453778 700034 Kolkata74022 Arham Clinic 70, Chittaranjan Avenue, Kolkata 033 - 22217317 700012 Kolkata
74045 Medica North Bengal ClinicMeghnath Saha Sarani, Pradhan Nagar,Siliguri, Siliguri 0353 - 2510441 734003 Siliguri
74510 BMRC Hospitals Limited. 6/6-B.T. Road, Talpukur 033 - 25014947 / 4027 700123 BARRACKPORE74512 Kamala Ray Hospital Private Limited 20 Kgt Road, Hindmotor, Hooghly 033 - 26942721 712233 Hooghly74620 New Life Nursing Home Saha Bagan, Rajarhat Rd, Rajarhat 033 - 25708090 / 6565 700059 Kolkata
75215 Disha Eye Hospital And Res Centre Pvt Ltd 88, (63a) Ghosh Para Rd.Barrackpore 033 - 25947809 / 10 700120 Kolkata
75216 Disha Eye Hospital14, G.T. Rd.Seoraphully, Hoogly,Sheoraphully 033 - 26329944 712223 Hoogly
75726 The Mission Hospital219(P) Immon Kalyan Sarani, Sector-2c,Bidhan Nagar, Durgapur., Durgapur 0343 - 2535555 / 44 713212 Durgapur
76484 Narayana Multispecialty Hospital Andul Rd.Podrah, Howrah, Do 033 - 26448888 / 89 711109 Howrah78643 Columbia Asia Hospital Ib 193, Sector 3, Saltlake City 033 - 39898969 700091 Kolkata
79119 Green View Clinic Pvt LtdNh-6, Po-New Kolorah, Ps-Sankrail,Howrah, Alampur 033 - 26698988 711302 Howrah79119 Green View Clinic Pvt LtdNh-6, Po-New Kolorah, Ps-Sankrail,Howrah, Alampur 033 - 26698988 711302 Howrah
80228 Desun Hospital And Heart InstituteKasba , Golpark, E.M.Bypass, Kolkata,Kasba, Bypass 033 - 24434567 700107 Kolkata
80229 Zenith Superspecialist Hospital9/3, Feeder Road(Rathtala) Belghoria,Kolkata, Belghoria 033 - 25444390 / 91 700056 Kolkata
80272 Amala Nursing HomeKarbala More, ChinsurahvivekanandaRoad, Po+Dist -Hoogly, Hooghly 033 - 26802873 712103 Hoogly
82912 Bmri Hospital Pvt Ltd8a-Diamondhurber Rd. Thakurpukur,Thakurpukur 033 - 24534078 / 79 700063 Kolkata
85261 Renaissance Hospital Private LimitedNazruz Islam Avenue, Vip Road,Tegharia, Po- Hatiara 3340144016 700059 Kolkata
85262North City Hospital And Neuro InstitutePvt Ltd #73, Bagmari Road 033 - 23211101 / 02 / 04443 700054 Kolkata
85263 Saviour Clinic Pvt Ltd2dr. Suresh Sarkar Road, Kolkata, P.O.Entally 033 - 22657130 / 2868 700014 Kolkata
85265 Multicare Hospital A-9/14(S), Kalyani, Dist, Nadia 033 - 25828855 741235 Kolkata
85266 Gd Hospital And Diabetes Institute 139a, Lenin Sarani 033 - 22255030 / 31 / 32 / 33 700013 Kolkata
89653 Srijoni Healing Home56, Hemachandra Naskar RoadBeliaghata 033 - 23720038 700010 Kolkata
90524Anandaloke Hospital And NeurosciencesCentre
2nd Mile Sevoke Road, (Near PayelCinema Hall), P.O. Sevoke Road, Dist.Jalpaiguri, P.S. Bhatinagar, Siliguri 0353 - 2540980 / 2544352 734001 Siliguri
90527 Sri Aurobindo Seva Kendra 1h, Gariahat Road (South), Jodhpur Park 033 - 24143881 700068 Kolkata91188 Fortis Hospitals Ltd # 111-A, Rashbehari Avenue 033 - 24633316-20 700029 Kolkata
92146 Belle Vue Clinic #9, Dr. Un Brahmachari Street, Kolkata 033 - 23316925 / 7473 700017 Kolkata
94983 Anandalok Hospital Dk- 7/3 Salt Lake Near Karunamoyee 033 - 23592931 / 34 700091 Kolkata94984 Medica Superspecialty Hospital 127 Mukundapur E M Bypass 033 - 66520000 700099 Kolkata
95233 Hardik Medical Diagnostics Centre#442/3, Rabindra Sarani, Near SadarPolice Station 03242 - 250830 / 258281 722101 Bankura95233 Hardik Medical Diagnostics Centre#442/3, Rabindra Sarani, Near SadarPolice Station 03242 - 250830 / 258281 722101 Bankura
95714 Nabajiban Hospital 5, Shibdas Bhaduri 33-25551544/2613 700004 Kolkata95756 Institute Of Neurosciences 185/1 Ajc Bose Road. 033 - 22867094 / 95 / 96 700017 Kolkata
96894 Vivekananda Hospital Pvt LtdDr. Zakir Hussain Avenue, Bidhannagar,Durgapur
9647501479/8145660980/9564630766 713206 Durgapur
97048 Fortis Hospital Limited 730 Anandpur Em Bypass Road 033 - 66284444 700107 Kolkata
100643 Rotary Narayana Multi Speciality Hospital Cn, Sector V, Saltlake City 33-30115000 700091 Kolkata101798 Sana Nursing Home 5/1a, Nurulla Doctor Lane 33-30024786 / 6782 700017 Kolkata
102876 Sharanya HospitalNh-2, Bamchandaipur, Joteram, PoBurdwan, Ps Burdwan Sadar 0342 - 9475641904 713101 Burdwan
104045 Tata Medical Center#14, Major Arterial Road, New Town,Rajarhat, Jyoti Basu Nagar 033 - 66057000 / 7222 700156 Kolkata
106451 All Asia Medical Institute 8b Garcha 1st Lane 33-40012200 700019 Kolkata106474 Shree Netra Eye Foundation 73, Chakraberia Road (N) 33-24866487 700020 Kolkata106475 Amulya Jyoti Eye Foundation 105, Manoharpukur Road 33-24668529 700029 Kolkata
106652 Nayonika Eye CareJ N Roy Road, Shyamsayer East,Burdwan 33-2566661/2662011 713101 Burdwan
106728 Revive Nursing Home Baguiati, Baguipara 33-25704880 700059 Kolkata
106729 Dewan Medicare 48, Ambagan Road, Sukchar, B.T. Road 33-25235464/65 700115 Kolkata106730 Vivekananda Eye Care Centre 51/C2g Chaulpatty Road, Beleghata 33-23720271 700010 Kolkata
106731 Sunetra Family Eye Care CentreUnnayan Commercial Centre (2ndFloor) 1050/1 Survey Park 33-24188223/24/25/26 700075 Kolkata
106739 Rameswara Nursing Home P-155 Cit Scheme Vii M 33-23552923/2160/1140 700054 Kolkata106864 Vasan Eye Care Hospital Dd-30, Sec-1 Salt Lake 33-39890000 700064 Kolkata107154 Implants Better Sight Centre Pvt Ltd 13a Colonel Biswas Road 33-22800516 700019 Kolkata
107441 Vasan Eye Care HospitalAmbika Point, 27, Moulana, Abul KalamAsad Road, Howrah 033 - 39890500 711101 Howrah
107442 Vasan Eye Care HospitalNo, 177f, Bt Road, Panhati SodepurKolkata 33-39890600 700114 Kolkata
107618 Aurobindo Netralaya 4a, Rajendra Deb Road 33-22412269 700007 Kolkata108947 Svs Marwari Hospital 118 Raja Ram Moham Roy Sarani 33-30612200 700009 Kolkata
109406Saroj Gupta Cancer Centre And ResearchInstitute M.G. Road, Thakurpukur 33-24532781/82/83 700063 Kolkata109406Saroj Gupta Cancer Centre And ResearchInstitute M.G. Road, Thakurpukur 33-24532781/82/83 700063 Kolkata
109632 We Care Nursing Home 101/1/A/A/M R S Verma Road
33-26636141/26640444/26643456 712258 Hooghly
110577 Fortis Medical Centre2/7 Sarat Bose Road, BasundharaBuilding 33-24754320/4096 700020 Kolkata
111166 Revival Nursing Home 183/3 B.B Chatterjee Road, Kasba 33-24412121 700042 Kolkata111168 Eye Care Clinic And Nursing Home A/13 Amarabati, Sodepur 33-25651057 700110 Kolkata111890 Silverline Eye Hospital 396, Prince Anwar Shah Road 33-24720836/24736940 700045 Kolkata112428 Mother Nursing Home 52, Sukantnagar, 3rd Sarani 033 - 25676628 700133 Kolkata
112429 Dum Dum Municipal Specialised Hospital 4, Harimohan Dutta Road 33-25471319 700028 Kolkata112785 Sanjiban Hospital P.O Sijberia, P.S Uluberia Howrah 33-33543644 711316 Howrah
112786Disha Eye Hospitals And Research CentrePvt Ltd Rd-100, Palasdiha 0343 - 2549344 713208 Durgapur
113105Rg Stone Urology And LaproscopyHospital 33, Gariahat Road (South) 33-40271000 700031 Kolkata
113384 Probal Eye Institute34, Satish Mukherjee Road KalighatTram Depot 33-24641210/24642782 700026 Kolkata
114093Glocal Healthcare Systems Pvt Ltd. Ghspl.Bolpur Sean, Layak Bazar, Nanoor Road 18001234425 731204 BOLPORE
115182 Shradha Health Care Pvt Ltd#15/1 (246a), S.N. Roy Road P.O,Sahapur 33-65295993 / 24003522 700038 Kolkata
115436 Vasan Eye Care HospitalReni Towers 1842, Rajdanga Main Road,Near Geethanjali Stadium 33-39890700 700107 Kolkata
118341 Siliguri Greater Lions Eye Hospital2nd Mile Sevoke Road, Behind VishalCinema 0353-2543457/2643301 734002 Siliguri
118342 Neotia Getwel Healthcare Centre Uttarayan, Matigara 3053000 734010 Siliguri
118345 Vasan Eye Care Hospital76/3, Pidhansarani Formerly Rupbani,Hathibagan 033 - 30934600 700006 Kolkata
118422 Swastik Clinic And Seva Sadan Puratan Line, Dangalpara 3462-259550 731101 Birbhum
118803 Ils Hospitals 1 No. Khudiram Bose Sarani, Mall Road 40315000 700080 Kolkata
119112 Drishti Eye Hospital68, S.B. Gorai Road New-St. VincentSchool Asansol 341-2281233 713301 Asansol119112 Drishti Eye Hospital68, S.B. Gorai Road New-St. VincentSchool Asansol 341-2281233 713301 Asansol
119113 Midnapore Poly Clinic And Nursing HomeAligunj (Near Nimtovarchavak) Po-Pashchim Midnapore Ps-Kotwali 3222-263208 721101
PaschimMedinipur
120157 Vasan Eye Care HospitalCommercial Complex, Kamarpara,Merchant Road, Jalpaiguri 03561 - 222799 735101 Jalpaiguri
120589 Iris Hospital 82/1, Raja Sc Mullick Road 33-66096000 700047 Kolkata
122082 Vasan Eye Care Hospital30/1, Jessore Road, Near Dak BungalowMore 33-30940200 700124 Barasat
122498 R Flemming Hospital 11a/1h, Topsia Road (East) 33-40686160 700046 Kolkata
124764 Iq City Narayana Hrudalaya Hospitals Sovapur, Bijra Road, Jaymua, Burdwan 2608000 713206 Durgapur125008 Upkar Nursing Home 30d, College Street 33-22570165 700073 Kolkata
125803Kejriwals Stone Clinic And Kidney CareCentre
Pranami Mandir Road, Opp PayalCinema Hall 9197201180/9749094419 734001 Siliguri
126440 Nayan Eye HospitalG.T Road, City Tower, Kumarpur(Near-Manoj Talkies) Asansol 341-2253395 713304 Asansol
126570 Apex Clinic Pvt Ltd 844a Raja Ram Mohan Roy Road 33-24068071 700008 Kolkata128121 Anandalok Hospital N.S.B. Road Searsole Rajbari 341-2449930 713358 Raniganj
128729Gouri Devi Hospital And ResearchInstitute
National High Way-2 Beside IocTerminal Rajbandh 343-2520036 713212 Durgapur
129240 Spandan Advance Medical Pvt Ltd At Rabindra Nazar 3222-267212 721101 Medinipur129448 Park Clinic 4, Gorky Terrace 22801986/1987 700017 Kolkata
129968 Amri Medical Centre97a, Southern Avenue (Opp LakeStadium) 24654594/95/66228000 700029 Kolkata
130005 Amri Hospitals Ltd230, Barakhola Lane, Jadavpurba,Mukundapur 66060606/1000 700099 Kolkata
130108 Vasan Eye Care Hospital No. 25, G.T. Road, Usha Gram, Asansol 0341 - 3989000 713303 Asansol130234 Netaji Subhash Nursing Home 19a Ekbalpore Lane Khiddirpore 24490218 700023 Kolkata130569 Dreamland Nursing Home 2, Nayratna Lane 25553216/17/3245 700004 Kolkata
133527 Narayana Multispecialty Hospital 78, Jessore Road (South), 24 Parganas 33-40363636 700127 Kolkata135449 Citizens Eye And Health Care No.153/1, N.S Avenue, Serampore 033-26520070 712201 Hooghly135641 North Bengal Neuro Centre Pvt Ltd Meghnath Saha Sarani 0353-2511122 734003 Siliguri135449 Citizens Eye And Health Care No.153/1, N.S Avenue, Serampore 033-26520070 712201 Hooghly135641 North Bengal Neuro Centre Pvt Ltd Meghnath Saha Sarani 0353-2511122 734003 Siliguri135677 Medica Cancer Hospital Vill Post, Rangapani 353-2004080/9933312626 734434 Siliguri136089 North Bengal Eye Centre Pvt Ltd Udham Singh Sarani 353-3989000 734001 Siliguri
137873 Disha Eye Hospitals Private Limited620 Dh Road, Behala Comm EstateComplex Ii 24472442 700034 Kolkata
141695 Disha Eye Hospital Vill & P.O Duilla, Mourigram 26440046 711302 Howrah141786 Lotus Hospital Kanjialpara, Indiranagar 25731021/1022 700135 Kolkata
141817 New Panacea HospitalDebpukur, Barasat Road, P.O. Sewli,Telinipara, Titagarh (24 Parganas N) 26354043 700121 Kolkata
141843 Rabindranath Tagore Surgical CentreD-52, Sammilani Park, Near Big Bazar,Hiland Park 30913000/3001/3019 700075 Kolkata
141853 Re-Life 252/5 K.G.T Road Kotrung 26946225/6356 712233 Hooghly
142045Glocal Healthcare Systems Pvt Ltd. GhsplBankura Sonamukhi
Gangadinanga, Bankura to BurdwanRoad, 18001234425 722207 Bankura
142047Glocal Healthcare Systems Pvt Ltd. Ghspl.Dubrajpur
Nabadiganta Market Complex More,Power House 18001234425 731123 Birbhum
142059
Kamadakinkor Memorial Isap Hospital(Glocal Healthcare Systems Pvt Ltd.Ghspl.) Nagar,Murshidabad 18001234425 742159 Murshidabad
143977 Westbank Health And Wellness Institute 120/1, Andul Road 71205050 711103 Howrah145437 Bankura Seva Niketan Patpur (Jail Road) 250123 722101 Bankura149501 Disha Eye Hospitals Private Limited 1090, Krishnanagar Nabapally 25240262 700126 Kolkata149502 Disha Eye Hospitals Private Limited Rgm-17/201 Raghunathpur (N) 25160095 700059 Kolkata149503 Disha Eye Hospitals Private Limited 277/4, Bt Road, Sinthi, Ghoshpara 25460261 700036 Kolkata
149504 Disha Eye Hospital4th Floor, Pam Plaza, 169 Ras BehariAvenue 24602820/21 700029 Kolkata
154618 Shankar Bhaban NetralayaHCL Road, Near Rupnarayanpur PoliceStation,Opp IDBI Bank 2530189 713386 Burdwan
164592 St Josephs HospitalVillage, Phulpahari, VidyasagarUniversity, Paschim Medinipur
269902/275946/8768829889/8900163511 721102
PaschimMedinipur
164790Life Line Medicare And OrthopaedicCentre
38, Mother Teresa Road, LowerChelidanga 2282448 713304 Asansol
164592 St Josephs HospitalVillage, Phulpahari, VidyasagarUniversity, Paschim Medinipur
269902/275946/8768829889/8900163511 721102
PaschimMedinipur
164790Life Line Medicare And OrthopaedicCentre
38, Mother Teresa Road, LowerChelidanga 2282448 713304 Asansol
165849 Manorama Hospitex Block II 172, Berhampur Road, NH-34 210031 741201 Ranaghat166618 Alolika Nursing Home Lokepur, Kenduadihi 7797776555 722102 Bankura
169700Currae Eye Care Hospital - A PatniEnterprise 106, Jessore Road, Madhyamgram 66776677 700129 Kolkata
170962 Nehru Mrmorial Techno Global Hospital
6 Barsat Road, Near Lalkuthi More,Barrakpore, 24 Pgs(N), Wb, IndiaKolkata 66303030 700120 BARRACKPORE
175566 Ohio Cardiology Associates India Pvt LtdPLOT DG -6 NEW TOWN RAJARHATKOLKATA 66026602 700056 Kolkata
178820Currae Eye Care Hospital (PatniHealthcare Ltd) 1A AJC Bose Road 66306630 700020 Kolkata
183138 Barrackpore City Hospital Pvt Ltd 161 (86) East Ghoshpara Road 25453536/8336968711 700120 BARRACKPORE
192203
Glocal Healthcare Systems Pvt Ltd. Ghspl.Krishnanagar, Sambhav Knj HealthcareLlp NH-34 Opp Hotel Haveli 18001234425 741101 Krishnanagar
193273 Asg Hospital Pvt LtdAlcove Gloria, 403/1 DakshindariRoad,VIP Road 25212211 700048 Kolkata
195544 Ambika Eye Care27, Maulana Abul Kalam Azad Road,Ambika Point 26667258/59/9831089999 711101 Howrah
SBI GROUP HEALTH INSURANCE POLICY(For Employees of WBMSCL)
1
INTRODUCTION
• Health indemnity policy
• Designed for the employees of WBMSCL-Tailor made
• Master policy in the name of of WBMSCL with inception 1/1/2017 andexpiry 31/12/2017
• Individual health cards to the insured
• Floater family sum insured of Rs.5 lacs
• Health indemnity policy
• Designed for the employees of WBMSCL-Tailor made
• Master policy in the name of of WBMSCL with inception 1/1/2017 andexpiry 31/12/2017
• Individual health cards to the insured
• Floater family sum insured of Rs.5 lacs
2
SCOPE OF COVER
• Cover Extended to employees of WBMSCL and their family(self+spouse+2 dependent children+2 dependant parents) .
• Floater Sum Insured where anyone from the entire family can avail of theSum Insured upto Rs.5 lacs
• Cover Extended to employees of WBMSCL and their family(self+spouse+2 dependent children+2 dependant parents) .
• Floater Sum Insured where anyone from the entire family can avail of theSum Insured upto Rs.5 lacs
3
• Room & Boarding and nursing charges• ICU charges• Surgeon, Anesthetist, Consultants, Specialists Fees• Anesthesia, Blood, Oxygen, OT, Surgical Appliances charges• Pre-hospitalization and post hospitalization expenses• Cashless facility• Day Care Surgeries(listed 142)• Ambulance Charges• Non-Network hospitalization Co-Pay
COVERAGE
4
• Room & Boarding and nursing charges• ICU charges• Surgeon, Anesthetist, Consultants, Specialists Fees• Anesthesia, Blood, Oxygen, OT, Surgical Appliances charges• Pre-hospitalization and post hospitalization expenses• Cashless facility• Day Care Surgeries(listed 142)• Ambulance Charges• Non-Network hospitalization Co-Pay
BENEFIT SYNOPSISCoverages Remark Limits
Domiciliary Hospitalization No Not covered
Pre & Post Hospitalisation Yes Pre/Post Hospitalization of 30/60days respectively
Family defination Floater option Employee+Spouse+2dependant children+ 2 parents
Dependant children covered upto 23years of age(unmarried and
financially dependant only)for allemployees.Dependant parents
covered upto 80 years of age for allemployees
5
Pre existing waiver Yes Waived fo All
30 days exclusion waiver Yes Waived fo All
1 st year exclusion waiver Yes Waived fo All
Maternity Benefit Yes
Cover for employee & spouseonly.Upto 2 living births only.Normal
delivery limit:Rs.35000/- andCaesarean section limit : Rs.50000/-
9 months exclusion waiver Yes Waived fo All
Baby cover from day 1 Yes within family floater Sum insured
BENEFIT SYNOPSIS contdCongenital internal disease cover No Not covered
Ambulance charges YesAmbulance cover per family limit
restricted upto 1% of SI or Rs.1500/-per family whichever is lower
Co payment No No co payment on treatment
Corporate buffer Yes
Annual limit:Rs10 lacs subject torestriction of max per family limit: asper floater SI.Corporate buffer cannot
be utilised for maternity claims andnon allopathic treatment.
Additional limit for Critical illness No No additional limit for Critical illnessAdditional limit for Critical illness No No additional limit for Critical illness
Ayurvedic & Unani treatment cover No Not covered
Homepathic Medicine cover No Not covered
Dental expenses cover No Not covered
Room rent capping Yes
Maximum upto Rs.6500/- per day forNON ICU and Maximum uptoRs.10000/-per day for ICU.All
incremental expenses pertaining toroom rent,medical
practitioners/specialist fees andother incidental expenses to be
bourne by insured.
6
MAJOR EXCLUSIONS• Treatment outside India
• Cosmetic or aesthetic treatments of any description, any form of plasticsurgery (unless necessary for the treatment of Illness or accidental BodilyInjury)
• Complications or ailments requiring treatment due to use or abuse of anysubstance, drug or alcohol and treatment for de-addiction
• Participation in an actual or attempted felony, riot, crime, civil commotion
• Congenital Internal and /or external illness/disease/defect
• Treatment outside India
• Cosmetic or aesthetic treatments of any description, any form of plasticsurgery (unless necessary for the treatment of Illness or accidental BodilyInjury)
• Complications or ailments requiring treatment due to use or abuse of anysubstance, drug or alcohol and treatment for de-addiction
• Participation in an actual or attempted felony, riot, crime, civil commotion
• Congenital Internal and /or external illness/disease/defect
7
MAJOR EXCLUSIONS contd…..
• Intentional self-injury and any violation of law or participation in anevent/activity that is against law with a criminal intent
• Any loss arising out of War, civil war, invasion, insurrection, revolution, act offoreign enemy etc
• Nuclear Risks
• Mental illness or psychiatric or psychological ailment / condition
• Alternative medicines
• Intentional self-injury and any violation of law or participation in anevent/activity that is against law with a criminal intent
• Any loss arising out of War, civil war, invasion, insurrection, revolution, act offoreign enemy etc
• Nuclear Risks
• Mental illness or psychiatric or psychological ailment / condition
• Alternative medicines
8
• Cataract surgery is capped maximum upto Rs.50000/- per eye
• Addition/deletion shall be done on pro rata basis once in a month subjectto data being provided to us by 15th of succeeding month.
• Mid term inclusion of spouce & children shall only be allowed only in caseof marriage,child birth and legal adoption.The same is to be intimated tous within 30 days fromt he date of marriage/child birth/adoption
• Mid term inclusion of parents allowed only for new joinee employees
• Administration/Registration/Service Charges & Misc charges are notpayable
• For all admissible claims where treatment is taken at hospital/nursinghome which are not in he list of network hospitals empanelled by thecompany/administrator,insured person shall bear 10% of the eligibleadmissible claim.
Other Terms & Conditions• Cataract surgery is capped maximum upto Rs.50000/- per eye
• Addition/deletion shall be done on pro rata basis once in a month subjectto data being provided to us by 15th of succeeding month.
• Mid term inclusion of spouce & children shall only be allowed only in caseof marriage,child birth and legal adoption.The same is to be intimated tous within 30 days fromt he date of marriage/child birth/adoption
• Mid term inclusion of parents allowed only for new joinee employees
• Administration/Registration/Service Charges & Misc charges are notpayable
• For all admissible claims where treatment is taken at hospital/nursinghome which are not in he list of network hospitals empanelled by thecompany/administrator,insured person shall bear 10% of the eligibleadmissible claim.
9
Claims
• For intimating a claim with us please contact us with thefollowing channels:Phone: 1800-102-1111/1800-22-1111(Toll free from 8 am to8 pm on all business daysE mail: [email protected]
You may also contact SBIG Kolkata Officials:Somnath Banerjee -9073397637E mail : somnath [email protected] Roy – 8336087284E mail : [email protected]
• For intimating a claim with us please contact us with thefollowing channels:Phone: 1800-102-1111/1800-22-1111(Toll free from 8 am to8 pm on all business daysE mail: [email protected]
You may also contact SBIG Kolkata Officials:Somnath Banerjee -9073397637E mail : somnath [email protected] Roy – 8336087284E mail : [email protected]
10
11
Simplifying Healthcare
Multiplying Prosperity
ABOUT MEDI ASSIST
About us:
Third Party Administrator (TPA) of health insurance benefits Established in 2002 and 3rd TPA to be licensed in India by IRDA ISO 9001: 2008 certified
Size:
Premiums under management (PUM) of ~Rs 3500+ crores under current run-rate India’s largest TPA with over 15 years of experience, operating from 26 location PAN INDIA Lives serviced:
Core TPA lives – 14+million(Corporate + Retail) and 9+ lakh claims Government lives – 100+ million (Central / State Government)
Coverage
Large Pan-India hospital network of 5700+ Hospitals with 5000+ diagnostic centers areempanelled
Empanelled with all major insurers in India
Medical professionals of 500+ Claim Processors 600+ Account Management Team 750+ All Others(Ops/ Admin)
Decentralized Claims Operations; local setups facilitate faster turnaround
About us:
Third Party Administrator (TPA) of health insurance benefits Established in 2002 and 3rd TPA to be licensed in India by IRDA ISO 9001: 2008 certified
Size:
Premiums under management (PUM) of ~Rs 3500+ crores under current run-rate India’s largest TPA with over 15 years of experience, operating from 26 location PAN INDIA Lives serviced:
Core TPA lives – 14+million(Corporate + Retail) and 9+ lakh claims Government lives – 100+ million (Central / State Government)
Coverage
Large Pan-India hospital network of 5700+ Hospitals with 5000+ diagnostic centers areempanelled
Empanelled with all major insurers in India
Medical professionals of 500+ Claim Processors 600+ Account Management Team 750+ All Others(Ops/ Admin)
Decentralized Claims Operations; local setups facilitate faster turnaround
TPA SERVICES
ENROLMENT
On receipt of Insured Details ID card is issued
CLAIMS ADMINISTRATION
CASHLESS HOSPITALISATION (THROUGH NETWORK
HOSPITAL)
REIMBURSEMENT CLAIMSOn receipt of proper documents
ENROLMENT
On receipt of Insured Details ID card is issued
CLAIMS ADMINISTRATION
CASHLESS HOSPITALISATION (THROUGH NETWORK
HOSPITAL)
REIMBURSEMENT CLAIMSOn receipt of proper documents
Procedure for Cashless Hospitalization
Patient need to submit the following documents to the insurance desk at theNetwork hospital
Copy of MAID Card
Valid ID Proof
Doctor advice/ Prescription & investigation report
Patient need to submit the following documents to the insurance desk at theNetwork hospital
Copy of MAID Card
Valid ID Proof
Doctor advice/ Prescription & investigation report
Procedure for Cashless Hospitalization
Admission PA request Info Approval
Pre-auth requestis submitted toMedi Assist by
the hospital andis processed at
Medi Assist
Approval or denialis issued as perthe terms and
conditions of yourinsurance policy
You areadvised
admissionby yourdoctor
In case anyfurther info isrequired, the
hospital is askedto submit the infoand processing
happens
Procedure For Reimbursement ofClaims
• Please submit the following documents in original:
Advice For Admission/Emergency Note
Discharge Summary (Original )
Final Hospital Bill (with detailed break-up) &Cash paid Receipts(Original)
Medicine Bills along with Doctor Prescriptions
Investigations & Test Reports (Original)
Duly Filled Claim Form with Signature Copy of MAID card along with valid Photo ID proof
• Please submit the following documents in original:
Advice For Admission/Emergency Note
Discharge Summary (Original )
Final Hospital Bill (with detailed break-up) &Cash paid Receipts(Original)
Medicine Bills along with Doctor Prescriptions
Investigations & Test Reports (Original)
Duly Filled Claim Form with Signature Copy of MAID card along with valid Photo ID proof
Help LineName Mail Id Mobile No
SPOCChandranathBiswas
[email protected] 8584033171
1st Escallation Sanjiv [email protected] 8584888246
2nd EscallationMihir RanjanParida
[email protected] 8584067553
Kolkata Toll-Free No.
1800-419-1153(Mon-Sat 10Am-6Pm)
Kolkata Toll-Free No.
1800-419-1153(Mon-Sat 10Am-6Pm)
Wish you a healthy andhappy future !
Thank You