Objective
The various offerings for the Physical welfare or well being of the employees if provided in this section.
I. Mediclaim Policy
This policy aims at providing medical hospitalisation facility through mediclaim insurance coverage, applicable to employees along with their immediate family.
Salient Features
- The policy coverage starts from the date of joining of the employee.
- Immediate Family consists of employee, spouse and two dependent children. Children of employee shall be covered from birth up to the age of 21 years or in case of girl child in the event of marriage whichever is earlier.
- Network hospitals are those hospitals in India that have tie-up with the insurance company for providing round the clock medical assistance like cashless facility to all employees covered in mediclaim.
- Insurance Company: VNR Seeds has entered into an agreement with Reliance General Insurance Company (RGI) for providing mediclaim benefits to all employees.
Mediclaim Insurance Cover
Table 1. Insurance Slabs
| Grade | Insurance Limits |
| L4- MG | 5 Lakhs |
| L1-L3 | 3 Lakhs |
| S1- M5 | 2 Lakhs |
- The sum insured can be utilized by any one or all of the Insured persons in the family cumulatively.
- The policy offers coverage of Maternity benefits.
- Limits of maternity claim is Rs.25,000/- for normal delivery, Rs.45,000/- for delivery through cesarean procedure.
Salient Features
| Cover Name | Conditions & limitations |
| Hospitalization | Min 24 Hours hospitalization required |
| Pre Hospitalization | 30 Days prior to the date of Hospitalization |
| Post Hospitalization | 60 Days from the date of discharge from hospital |
| Room Capping | 2 % of Sum assured per day & 3% of Sum Assured for ICU per day |
| Ambulance Charges (In case of emergency ) | Rs. 2000/- |
| Baby cover from Day 1 | Day one Baby cover within family floater sum assured |
| Pre Existing illness cover | Covered in the policy |
| Member addition & Deletions | No mid-term addition is allowed except New joiners, spouse by marriage and child by birth within 30 days of the event |
Expenses under the following heads shall be covered under claims
- Room, Boarding Expenses as provided by the hospital / nursing home
- Nursing Expenses
- Surgeon, Anaesthetists, Medical Practitioner, Consultants, Specialists Fees
- Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines and Drugs, Diagnostic materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of pacemaker, Artificial Limbs and Cost of Organs and similar expenses.
Claim process for network hospital
- The mediclaim policyholder visits any of the network hospital listed in the guidebook and establishes his/her identity to the hospital by producing the card/e-card uploaded in ESS.
- The Network Hospital sends request to RGI/ HR for authorization.
- RGI cardholder commences his/her treatment after getting authorization from RGI, in case of planned hospitalization.
- The employee has to provide the Reference No. given by the hospital for further correspondence of the claim related matters with RGI.
- Authorization should be obtained prior to hospitalization, but in case of emergency, authorization can be obtained after hospitalization, within 24hrs of admission.
- Hospital will not charge the employee for any expenses except the deductibles like extra bed, phone charges etc.
- No original documents should be collected from the hospital by the employee to facilitate direct payment to hospital.
- The validity period of authorization is 3 days from the date of issue or date of hospitalization, whichever is later.
- For the expenses pertaining to Pre- and post hospitalization. The employee will have to submit the original documents containing prescriptions, cash memos, investigation report, etc. to HR directly and shall be reimbursed directly.
Claims for the Non-Network Hospital
- The employee will have to intimate to RGI/HR within 24 hrs. of hospitalization, through customer care number.
- The employee will have to pay the total expenses directly to the hospital.
- The employee will have to claim for the reimbursement from RGI after discharge from hospital on submission of original documents within 10 days of discharge.
- Any delay in submission of documents ( beyond 10 days) or incomplete medical documents submitted may lead to denial of claim reimbursement by the mediclaim company.
Claim Process
After getting the intimation letter, RGI will send claim form, which the employee will have to fill up properly. Documents to be enclosed with the claim form are:-
- Photocopy of registration certificate of hospital. If unregistered, a certificate from the hospital, about the facilities like No. of beds , Availability of In-house Operation Theatre , 24 hours doctor on duty etc.
- Pre-hospitalization documents: Prescription, Chemist Bills and Investigation reports.
- Hospitalization documents: Discharge Summary, Investigation reports, Hospital Bill, Receipts of payment, break-up of each heads of hospital bill separately, prescriptions and cash memo, incurred during hospitalization period, both supplied by the hospital and purchased from outside hospital.
- Post hospitalization Documents: Prescriptions, Chemist Bills and Investigation reports.
- The employee will have to deposit the above documents at HR within 10 days of hospital discharge.
- Any delay in submission of documents ( beyond 10 days) or incomplete medical documents submitted may lead to denial of claim reimbursement by the mediclaim company.
Information needed for hospitalisation
- Policy Number
- Insured/Claimant contact details (phone no. , email id, address, landmark etc.)
- Name of Insured/ claimant person, who is hospitalised
- Relationship of insured with the person who is hospitalised.
- Name of the hospital
- Nature of ailment-(For health claims)
- Nature of accident- (For accident cases)
- Date & time of accident (For accident cases)
- Location of accident (For accident cases)
- Commencement date of the symptom of ailment
II . Group Term Life Insurance Policy (GTLI)
Objective
This policy shall provide financial assistance to the family of the deceased team member in case of death due to health issues, accident or any natural causes.
Scope
The insurance policy compensates with the financial assistance to the family member of the deceased.
Sum Assured Slabs:
The Grade-wise Insurance coverage is provided as per the given Sum Insurance slab-
| Grades | Sum Assured |
| L1-L5 | 50 Lakhs |
| M1-M5 | 25 Lakhs |
| J1-J4 | 10 Lakhs |
| S1-S2 | 05 Lakhs |
Salient Features:
- No Medical Check-up required for coverage of team member.
- Coverage extended to even those with pre-existing diseases.
- Sum assured received at time of death shall be tax free (Section 10(10D) of Income Tax Act,1961; subject to change from time to time).
Coverage:
As per the chart given above
Procedure of claim:
- Intimation of the incidence/ accident to be provided to HR .
- In case of Natural Death: Copy of Death Certificate, Nominee and Insured KYC details, Nominee Bank details, etc.
- In case of Accidental Death : Copy of Death certificate, Copy of Police FIR, Nominee and Insured KYC details, Copy of Post Mortem Report, Copy of newspaper article, nominee bank details, etc.
- If the cause of death is Covid, then medical reports would be needed along with other documents.
III. Executive Health Check-Up Benefit
Executive Health Checkup is a welfare measure towards wellness of team member’s health.
- It is provided to all employees who have completed 40yrs. Applicable for VSPL employees.
- This benefit can be availed once in two years.
- The grade wise entitlement is as given;
Table 2: Health check-up benefit eligibility
| Grade | Amount (Rs.) |
| S1-M5 | 3000 |
| L1-MG | 4500 |
- The team members can choose hospitals/ Diagnostic centers of personal choice for undergoing complete health check-up plan for self.
- The reimbursement towards the approved amount shall be provided on submission of Medical Report Copy, Invoice and Payment Receipt to accounts.
- Any excess billed amount shall be borne by the team member.