Medi + Claim

Pancard Clubs Ltd. besides offering Room Nights to its Applicants also offer Value Added Promotional benefits like Medi+Claim depending upon the Room nights Amount.

The Pancard Management Ties up with various leading Insurance Companies to offer the benefits to their Applicants.

The Mediclaim Policy is renewed yearly and after every 24th Dec Applicant is requested to contact Pancard Insurance Dept.

Terms and Conditions:

  1. The onus of sanctioning / rejecting the Mediclaims totally depends on the Insurance Company. The Pancard Clubs Ltd does not have any right to sanction / reject claims.
  2. Pancard Clubs Ltd offers the Mediclaim benefits to its applicants (Free of Cost) as a matter of promotional activities; the company does not charge any premium to its applicants till the room night period gets over.
  3. Mediclaim coverage will start after 30 days from the Mediclaim commencement date printed on Pancard Clubs Room Nights Entitlement Certificate.
  4. The applicant is requested to buy Annexure A Booklet priced at Rs 5/-. If applicant is admitted in the Hospital mentioned in Annexure A, the Mediclaim file will be rejected.
  5. As per the Terms & Conditions, the original Mediclaim file should be submitted to the nearest Pancard Branch within 15 days from the Date of Discharge of Hospital.
  6. The original Mediclaim file papers will not be returned back once the file gets sanctioned / rejected.
  7. Mediclaim Intimation Form should be faxed on the Number mentioned within 2 days or 48 hours from the Date of Hospital Admission after getting the Authorized Signature of the Hospital Doctor duly stamped under his / her seal.
  8. The applicant is required to study the Terms of the Mediclaim Policy viz (Fixed Amount sanctioned for certain operations, Diseases not covered for certain periods etc)
  9. The requirements asked by the Insurance Company should be furnished within 15 days to the nearest Branch failing which the Claims will be rejected on the grounds of Non-Submission of the requirement.
  10. Applicant in connivance submitting Fraud case intentionally is a Legal Offence under the Indian Penal Code.

Reason for Rejection of Medi+claim files by Insurance Company:

  1. Intimation to be faxed within 2 days from the Date of Admission to the Hospital is compulsory.
  2. Treatment taken in Black Listed Hospital (Ann A) will be rejected by the Insurance Company. To avoid this kindly purchase Black Listed Hospital Book at any Pancard Office. Kindly purchase Intimation Form.
  3. If concern Hospital/Nursing Home is not Authorized by Local Govt Body.
  4. Few Operations and Diseases are payable only after 2 and 4 years from the Date of membership. (Refer Medi+claim guidelines 2012)
  5. Claim Requirements submitted after 15 days will be rejected (Disease related Hospital papers required by Insurance Company)

Kindly note that following diseases will not be covered under the Medi+claim Policy by the Insurance Company hence files of such Disease will not be accepted at any Pancard office:

  1. Headache
  2. Loose Motion
  3. Vomiting
  4. Cold and Normal Fever
  5. Sprains in Leg or Hand
  6. No Medi+claim will be given for OPD Treatment
  7. Diseases caused due to excess usage of Alcohol, Tobacco, Smoking or any Other Intoxicants.
  8. Adventure Sports related injury (For ex Dahi handi, Motorcycle, Car race, Leaning on the doors of Local train, Mountaineering, Self inflicted Injury)

Please note that in following cases the Medi+claim file will not be accepted and accordingly Non acceptance letter will be issued by Pancard Company:

  1. Files submitted after 30 days from the date of discharge from the hospital.
  2. Few Operations and Diseases are payable only after 2 and 4 years from the Date of membership. (Refer Medi+claim guidelines 2012)
  3. Pre existing Disease Clause.
  4. Treatment taken in Black Listed Hospital.
  5. If OPD Treatment taken.
  6. In case of the diseases not covered in Medi+claim policy. (Diseases mentioned above)

Any rules changed by the Insurance company are fully binding upon the old and new applicants.

Kindly attach the following papers:

  1. The member is requested to write clearly on a fools cap paper the total expenses of the bill item wise so that these can be written clearly on the Mediclaim form.
  2. Copy of Pancard certificate (Compulsory)
  3. Annexure form
  4. Insurance claim form duly signed by the Applicant.
  5. Original discharge card.
  6. Original bill of the hospital mentioning the details of the treatment and medicines prescribed.
  7. Original hospital receipt.
  8. Original prescription written by the doctor.
  9. Advance payment receipt (if paid)
  10. Original bills received from the chemist.
  11. Original investigation reports: blood report, X=ray report, Ultra sound report, city scan report, MRA etc.
  12. Indoor case papers (true copy duly attested ): detail information taken at the time of admission.
  13. In case of accident FIR / MLC copy issued by the Police authorities.
  14. Please note that the members name on all the documents should be same as that on the Pancard certificate.