1.) Insurance Plan Details

Group Mediclaim Insurance Plan

SME Chamber of India would like to present a comprehensive Group Mediclaim Insurance policy for the benefit of Employees & Family of Member SMEs Companies.

The exclusively developed Group Mediclaim policy includes Parental Coverage, Pre-existing diseases coverage, Maternity coverage, Health checkup & other benefits for members at extremely competitive premium is now available from the following the leading, professional & reliable partners from the Insurance Industry.

Insurance Partners:
  • Insurer: The New India Assurance Co. Ltd.
  • Broker: Edelweiss Insurance Brokers Ltd.
  • TPA: Paramount Health Services
Policy Features in Brief

Family Policy

Family Floater with following family plans:

  • Self only
  • Self + Spouse + 2 children
  • Self + Spouse + 2 children + 2 parents/in-laws
Employee entry age upto 70 years and Children upto 21 years
(Note: Any option selected above would be applicable for all employees)

Sum Insured Options

Sum Insured options of Rs. 2 lakh / Rs. 3 lakh / Rs. 5 lakh
(Note: SME Members can offer sum insured to employees as per their internal designations)

Pre-existing Diseases Coverage from Day 1

All pre-existing diseases are covered from Day 1 without any waiting period

Maternity Coverage

Maternity expenses covered upto Rs.25,000/- for Normal & Rs.35000/- for C-section for Self or Spouse. No waiting period applicable

No Health Checkup

Health checkup requirement is waived

Cashless & Reimbursement Facility

Cashless available at Paramount TPA’s Network Hospitals. Reimbursement is available at all hospitals in India

Pre-hospitalization Expenses

Upto 30 days from the date of admission

Post-hospitalization Expenses

Upto 60 days from the date of discharge

Day Care Procedure

Listed & Selected Day Care Procedure Covered

Internal Congenital Disease or defects

Covered

Terrorism

Covered

Ambulance Charges

Upto Rs. 2,000/- per year

 
Other standard features of Mediclaim policy applicable

Conditions and Exclusions:

  1. Standard Conditions & Exclusions of Policy wordings of New India Assurance Co. Ltd. would be applicable
  2. Co-payment of 10% for Self and 20% for Parents Claims
  3. Ailment capping as follows:
    • TKR capped to Rs.125,000/- for unilateral surgery including cost of stent.
    • Cataract Restricted for Rs.24, 000/- per eye.
    • Hernia, Fistula, Hysterectomy and Piles capped for Rs.60,000/-- ( Hernia to be read as Hernia Unilateral)
    • Chemo & Radio therapy limited to Rs.1 lakh per patient per year during policy period.
    • CABG restricted for Rs.2 Lakh.

Annual Premium (in Rs.):

  • Premium to be paid by Corporate Member for all their employees.
Annual Premium Per Family (excluding 18% GST)
Family Size/Sum Insured

Rs. 2 lakh
(Family Floater Sum Insured of each Employee)

Rs. 3 lakh
(Family Floater Sum Insured of each Employee)

Rs. 5 lakh
(Family Floater Sum Insured of each Employee)

Self

Rs. 2,695/-

Rs. 3,789/-

Rs. 5,221/-

Self + Spouse + 2 Children

Rs. 5,053/-

Rs. 6,000/-

Rs. 8,947/-

Self + Spouse + 2 Children + 2 Parents/ in-laws

Rs. 10,737/-

Rs. 13,198/-

Rs. 18,902/-

 

2) Process of availing Insurance Policy:

Members from JIO and SME Chamber of India are invited to complete the following process:
  • Step 1

    Register details about your company.

  • Step 2

    Representatives from Edelweiss Insurance Brokers Limited will get in touch with you to explain the plan details and advantages.

  • Step 3

    3 Step of payment:

    1. SME Membership fees (if not existing member)
    2. Jain International Organisation (JIO) Sadbhavna card for wellness benefits fees
    3. Insurance Premium Payment
  • Membership fees of SME Chamber of India is Rs. 590/- inclusive GST for Corporates upto 50 employees and Rs. 1,180/- inclusive GST for Corporates above 50 employees
  • Sadbhavna Card Membership fees are Rs. 250/- per employee

FAQs

There are 3 parts of payment-
  1. Membership fee in favour of SME Chamber of India
  2. Sadbhavna Card (JIO Wellness) Card fees in favour of Jain International Organisation
  3. Insurance in favour of The New India Assurance Co. Ltd.

Our team will guide you with the process

Any permanent employee in your organisation can be covered. Employee’s entry age is restricted to 70 years. Once enrolled the policy continuity would be for lifetime. Legal Dependents of Employees can be covered.

We would introduce online option soon. However, for time being the process would be offline. Once you show interest and agree to be contacted, Edelweiss Insurance Brokers Limited team members would call you within 24 working hours and explain the plan details and process.

Policy would be issued in the name of Corporate with Employees as beneficiaries. Premium would be collected in bulk from corporate for all employees. Claims however would be settled in name of Employees.

You would need to insure all employees in your corporate without any selection.

No. SME Membership and Sadbhavna membership is pre-requisite for Insurance.

With the blessings of Gurudev Shri Naypadmasagarji Maharajsahebji, Jain International Organisation (JIO) has introduced a noble benefit plan which offers benefits beyond insurance offering Corporate Wellness Programme. This includes discount on various services like:

  • Diagnostic and Lab : 30 % to 50% discount
  • Hospital OPD : 25% discount
  • Gym and Spa : 40% discount
  • Dental care : 25% discount
  • Eye care : 25% discount

Under the Sadbhavna Wellness Programme initiative, this year every insured member can earn financial benefit- irrespective of whether you have claimed or not claimed.

Additionally, through partners, JIO will keep workshop for all card users on:

  • Alcohol rehabilitation programme
  • Parenting session
  • Living stress free life,
  • Yoga Sessions
  • Session on Work Life Balance

And many more activities at your work site.

No. Religion is no bar for this scheme. Financial security through Mediclaim is required by all individuals irrespective of caste, creed or religion. JIO wishes to serve humanity through this programme. The only requisite is membership of SME Chamber of India

Buy Insurance

I hereby authorize Edelweiss Insurance Brokers Limited and SME Chamber of India to communicate with me on the given number. I am aware that this authorization will override my registry under NDNC.