IFFCO Tokio Group Medishield Insurance Policy
IFFCO Tokio Group Medishield insurance is a type of medical insurance that covers your employees as well as their families against unforeseen healthcare expenses. These plans, also known as employee health insurance or corporate health insurance, defend your staff and their dependents from diseases, accidents, and other similar medical conditions.
The group Medisheild plan from IFFCO Tokio policy has much more affordable premiums when compared to individual health insurance plans. Additionally, a group health insurance plan grants the employer significant tax advantages. As a result, both employers and employees greatly value these plans. The best part of these plans is that they assist you in finding and keeping the best employees in the industry.
Read on to know more about the IFFCO Tokio Group Medishield Insurance policy in detail!
Key Features and Benefits
The following are the key features and benefits of the IFFCO Tokio Group Medishield Insurance Policy.
- Day Care Treatment
Even if the hospital stay is shorter than 24 (twenty-four) hours, daycare medical services will still be reimbursed.
- Tax benefits
Additionally, group health insurance offers you tax advantages! A group medical insurance policy’s premium is legally fully deductible from taxes. It falls under the category of business expenses and can aid in reducing your organization’s taxable income.
- Cover for family members
Group Medishield insurance plan from IFFCO Tokio generally includes coverage for the employees’ families as well, though this may vary from policy to policy. The dependents of the employees are safeguarded by these plans, which provide them with assistance when they need money.
- Renewal of Policy
Every year, the policy may be renewed by both parties with the renewal premium due to the company on or before the policy’s expiration date or the date of the subsequent renewal. The business is not required to notify customers that the renewal premium is due, though.
- Pre-Hospitalization & Post-Hospitalization
The policy also offers cover for pre-hospitalization and post-hospitalization costs. The maximum Limit for Pre-Hospitalisation Medical Benefits is 30 days, while the maximum Limit for Post Hospitalisation Medical Benefits is 60 days.
- Grace Period
The grace period, which is a set amount of time immediately after the premium payment deadline, during which a payment can be made to renew or keep the policy in effect without losing continuity benefits like waiting periods and coverage for pre-existing conditions, is included with the policy.
- Cashless Facility
Another significant aspect of the IFFCO Tokio Group Medisheild insurance plan is that, to the extent pre-authorization has been granted, the company will make payments directly to the network provider for any treatments received by the insured person(s) by the terms and conditions of the policy.
- AYUSH Treatment
The Ayush Treatment, or hospitalisation treatments provided under “Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy systems,” is also covered by the policy.
- Domiciliary Hospitalization
The above-mentioned pertinent expenses for in-home hospitalization will also be covered by the plan at reasonable and customary level fees.
Exclusions Under the IFFCO Tokio Group Medishield Plan
- Treatment costs for pre-existing conditions (PED) and their direct complications are excluded from coverage until 48 months have passed since the start of the first policy with the company.
- If the amount insured is increased, the exclusion will once again apply to the new amount insured.
- The waiting period for the same would be shortened to the extent of prior coverage if the insured person maintains continuous coverage, as defined by the portability norms of the current IRDAI (Health Insurance) Regulations, without a break.
- Any pre-existing conditions must be disclosed at the time of application and approved by the insurer for them to be covered under the policy after the first 48 months have passed.
Specific Waiting Period:
- Following the date of the first policy’s issuance with the company, any costs associated with the treatment of the conditions listed below, including surgeries and treatments, shall be excluded until the conclusion of 12 consecutive months of continuous coverage. Claims resulting from accidents are not subject to this exclusion.
- If the amount insured is increased, the exclusion will once again apply to the new amount insured.
- The longer of the two waiting periods will be applied if any of the specified diseases or procedures fall under the pre-existing disease waiting period.
- Even if contracted after the policy’s effective date or declared and accepted without a specific exclusion, the waiting period for the conditions listed shall apply.
- The waiting period for the same would be shortened to the extent of prior coverage if the insured person maintains continuous coverage without a break as defined by the applicable portability norms set forth by IRDAI.
- War (whether declared or not), warlike occurrences, invasions, hostilities, acts of foreign enemies, civil wars, uprisings, revolutions, insurrections, mutinies, military or usurped power, as well as all types of appropriation, capture, arrest, restraint, and detention.
- Circumcision, excluding diseases not specifically excluded, injuries, immunizations, or changes in life
- Costs associated with cosmetic or plastic surgery, as well as any other procedure intended to alter the appearance, unless necessary for reconstruction following an accident, burns, cancer, or as part of a medically necessary procedure to eliminate a direct or immediate threat to the insured’s health. This must be authorised as a medical necessity by the attending medical professional.
- The price of hearing aids, glasses, and contact lenses.
- Any type of surgery or dental work that doesn’t require hospitalization.
- Treatment for addiction-related conditions like alcoholism, drug abuse, and substance abuse, as well as their effects.
How To Buy IFFCO Tokio Group Medishield Insurance Plan?
It is no secret that buying the IFFCO Tokio Group Medishield insurance plan is a wise choice to protect more than 2 or more people at once. Since the plan is not available on the official website to buy, you can still make your purchase via Probus Insurance.
Probus Insurance Broker Private Limited is a well-known insurance broker with a focus on retail customers, a presence across all of India, and the best possible balance of life and non-life insurance business.
If you want to buy the IFFCO Tokio Group Medishield insurance plan, then Probus Insurance can help you out! Locate the “We Are Here” chatbot at the bottom right-hand side of this page. After that, you will need to enter your full name, email ID, and contact number, select your department, and then click on “Start Chat”. The moment you click on it, you can start chatting with any of the customer care representatives of the company. After that, tell your queries, and they will ultimately help you with the buying process.
Alternatively, you can also contact the customer care team of the company through any of the following means:
|Say “Hi” to 7304332968|
How To Make a Claim for IFFCO Tokio Group Medishield Insurance Policy?
If you want to reap the benefits listed in a health insurance policy, then you are required to file a claim for your IFFCO Tokio Group Medishield Insurance Policy. To lodge a health insurance claim, you need to provide your IFFCO Tokio with supporting documents like medical bills, reports, admission slips, and pharmacy bills, among others.
Listed below are the steps to claim your IFFCO Tokio Group Medishield Insurance Policy.
- As soon as possible, but no later than seven days after the date of hospitalization, the company must be notified of an event that could result in a claim under the policy.
- Except in extreme hardship, cases, where it is proven to the company’s satisfaction that due to the circumstances in which YOU, the person who was insured, or his/her representative were placed, none of YOU could give notice or file a claim within the stipulated time limit, a written statement of the claim will be required, and a claim form, will be provided.
- The insured person must provide all invoices, receipts, certificates, information, and other evidence requested by the company in the manner and format they may specify. If and when they deem it reasonable, the company’s representatives in such claims may conduct an examination and gather information regarding any alleged injury or illness that necessitates hospitalization.
Claim Settlement (provision for Penal Interest)
- Within 30 days of receiving the final required document, the company must resolve or deny a claim, as applicable.
- If a claim payment is delayed, the company is responsible for paying You (the policyholder) interest at a rate that is 2% higher than the bank rate from the date it receives the final required document until it pays the claim.
- However, if a claim’s circumstances call for an investigation, the company must start it as soon as possible and finish it no later than 30 days after receiving the last required document. In these situations, the company must resolve or reject the claim within 45 days of the date of receipt of the last required document.
- The Company shall be liable to pay interest to the policyholder at a rate of 2% above the bank rate from the date of receipt of the last required document to the date of payment of the claim if the delay exceeds the allowable 45-day period.
Frequently Asked Questions
If you cancel this policy with 15 days written notice, the company will refund your short-term rate premium for the remaining time left on the policy.
Yes, the policy covers nursing expenses and even provides coverage for the room, Boarding Expenses as provided by the Hospital/Nursing Home.
The following are the additional coverages offered by the IFFCO Tokio Group Medishield Insurance Policy.
- Expense on Anesthesia Blood, Oxygen, and Operation Theatre charges.
- Surgical Appliances
- Medicines and Drugs
- Diagnostic Material
- Diagnostic imaging modalities
- Cost of pacemaker
- Artificial Limbs
- Cost of organs and similar expenses