Mediclaim Policy means coverage of employess on health or medical ground upto a certain limit in a year..
Actually it facilitates employees with free medical check ups and other medical emergency completely free upto a certain limit..
So many Insurance companies are providing the same.. those covered under this policy or scheme get an Health Card and list of network Hospitals where hospitalisation is completely free upto the limit given.. even one may get hospitalised in non-network hospital.. and can reimburse the same in actual on producing the receipt of the expenses occurred..
Mostly those employees, who are not covered with ESI gets facilitated with this scheme..
Mediclaim Policy is an Insurance coverage wherein any of your Health realted hospitalisation bills can be claimed from the insurance company. There are two different ways to get your bills claimed either by cashless facility i.e your bills are directly paid to the hospital or you can pay your bills in the hospital and get an reimbursement after submission of the same to the insurance company.
Major exclusions of the policy are : Pre existing diseases will not be covered
There are a couple of diseases which will not be covered on the 1/2 year depending on the company.
24 hrs hospitalisation or more is compulsory for a claim to be settled.
This is just a jist of mediclaim insurance. I am an insurance consultant located in chennai and doing both life and general insurance. For any clarification u can either post a topic or mail me on firstname.lastname@example.org
Its true that It is applicable for those who are not covered under ESI Act.
But is not sure that all those whose gross salary is above Rs.10000 will be eligible for this.
There will be a certain period of time after which all these will apply.
In my case even those my salary is above Rs.10000, i am eligible for this after one year only( depends on the company)
dear samanaveenkumar in reading please express your opinion on above said things. Am i right?
I have one query related to mediclaim policy -
1) What are the sickness benefit we can take in this?
2) Can we go for the skin surgery under mediclaim?
3) Can we get the free treatment for the eye related diseases such as taking out the eye number, glasses etc?
I know this answer can be given by insurance company specifically but if some one knows this pl. let me know. I will be greatful to the members.
Because you know naaa.... Insurance Companies never tell truth...........OR never gives the actual info..........
I have seen saman stating that mediclaim is for people who gets salary above 10000 and ESI for people below. i think it needs to be checked because in our company everyone is holding mediclaim with no discrimination with regard to salary. I am not sure of the rules of mediclaim. if such rules are there pls let me know so that my employees do not have a setback.
I dont think there is any cap on the salary for an employee to take an Mediclaim Insurance. If differs from comp to comp. A mediclaim insurance can be taken if the comp does'nt have ESI. Which is a better option.
To Mr. Amit's Query.
1) Any illness disease or sickness can be covered after 1 month of policy issuance date. This can also be waived off if the company pays an extra amount.(It differs from comp to comp)
2) If it not a cosmetic surgery and was caused due to any accident then it is permissible. Pre-existing diseases are not covered i.e for ex. if mr. x met with an accident before the commencement of policy and is doing grating or skin surgery etc... after the commencement of the policy then it is not allowed.
3) You will not be paid ofr Glasses, contact lenses, etc..
I dont know what you mean by "TAKING OUT THE EYE NUMBER" PLS SPECIFY...
To Mr. Dilip's Query.
I am working in manufacturing company where we have mediclaim policy i want to know what is procedure for that and who com under it?
Thanks & Regards
If your company has taken a group mediclaim policy then all employees are covered in it... I hope they would have given you the procedures because it differes from comp to comp... and the insurance coverage taken by your employer.
For any queries you can post your msg or mail me at
I was not aware of it .
In our company we do not have such tariffs or statements made .....
Its equal to all .....
but, I also agree that it may differ from company to company !!!!