Infosys Health

Insurance Plan

FY 2024-25
HEALTH INSURANCE POLICY – 2024-25

Contents

Health Insurance plan objective & scope ................................................................................4

Wellness cover ..........................................................................................................................4
General Insurance .....................................................................................................................4
Health Insurance 24-25 .............................................................................................................5
Eligibility: ...............................................................................................................................5
Insurer & Policy tenure: ........................................................................................................5
Health Insurance Plan Coverage: .........................................................................................5
Summary of the Health Insurance Plan (HIP) for Policy Period 2024-25 ...........................5
Plan Benefits..........................................................................................................................6
Nomination & Enrolment for 2024-25 ...................................................................................7
Nomination & upgrade/Downgrade ......................................................................................7
Existing Employees: .............................................................................................................7
New Joinees: .........................................................................................................................7
Base transfer: ........................................................................................................................7
Employees on Overseas Deputation and family coverage: ................................................8
Life Changing Events: ...........................................................................................................8
Post Separation from Infosys, Status of Coverage: ............................................................8
Demise of Employee: ............................................................................................................8
Tax Exemptions on premium payment for Gold, Platinum, Titanium and Titanium+
plans:......................................................................................................................................8
Spouse Working in Infosys – Coverage:..............................................................................8
Plan Coverage Definition ......................................................................................................8
Scope of the Cover – General terms and conditions: ....................................................... 10
Room Eligibility and Co Payment Table for all plans: ....................................................... 11
Third Party Administrator (TPA): ........................................................................................ 11
Scope of Services of TPA (Medi Assist) ............................................................................. 11
Definition of Network Provider: .......................................................................................... 11
Explore your health benefits on the move: (Single Sign on): ........................................... 11
Wellness service provider (MediBuddy): ........................................................................... 11
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HEALTH INSURANCE POLICY – 2024-25

Exclusions under HIP plan.................................................................................................. 12

Contact Details of Medi Assist (DC contact details refer table here below): ................... 12
Escalation Matrix: Hospitalisation/cashless/reimbursement (Mediassist) ............................... 13
Escalation Matrix: Wellness (Medibuddy) .............................................................................. 13
Escalation Matrix: National Insurance Company.................................................................... 13
Escalation Matrix: Infosys ...................................................................................................... 13
Mediassist DC Contact ........................................................................................................ 14
FAQ (Frequently Asked Questions) .................................................................................... 15
Illustration on proportionate restriction as per room eligibility (EXAMPLE ONLY) ........ 19
Cyber Insurance cover ........................................................................................................... 21
Eligibility & Coverage .......................................................................................................... 21
General Terms ..................................................................................................................... 21
Sum Assured for each plan ................................................................................................ 21
Claim Conditions ................................................................................................................. 22
Exclusions ........................................................................................................................... 22
Duties of Insured ................................................................................................................. 22
Documents to be submitted for claims processing. ......................................................... 23
Contact details..................................................................................................................... 23
Household Content Policy...................................................................................................... 24
Eligibility & Coverage .......................................................................................................... 24
General Terms ..................................................................................................................... 24
Sum Assured for each plan ................................................................................................ 24
Exclusions ........................................................................................................................... 25
Duties of Insured ................................................................................................................. 25
Documents to be submitted for claims processing .......................................................... 26
Contact details..................................................................................................................... 26
Group Personal Accident Death cover .................................................................................. 27
Eligibility and Coverage ...................................................................................................... 27
General Terms ..................................................................................................................... 27
Sum Assured for each plan ................................................................................................ 27
Scenarios ............................................................................................................................. 27
Documents to be submitted for claims processing .......................................................... 27
Contact details..................................................................................................................... 28

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HEALTH INSURANCE POLICY – 2024-25

Wallet Usage............................................................................................................................ 29
Escalation Matrix: Wellness (Medibuddy).......................................................................... 32
FAQ- Health Check up ......................................................................................................... 33
FAQ - Pharmacy ................................................................................................................... 34
FAQ Online doctor Consultation ........................................................................................ 35
FAQ- Vision .......................................................................................................................... 36
FAQ - Dental ......................................................................................................................... 36
FAQ - Offline Consult .......................................................................................................... 36
FAQ- Vaccination ................................................................................................................. 37

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HEALTH INSURANCE POLICY – 2024-25

Health Insurance plan objective & scope

The Health Insurance Plan (HIP) at Infosys aims to minimize the financial risk arising out of
sickness or injuries for employees & their immediate dependents. HIP aims to provide reasonable
insurance protection which covers necessary hospitalization expenses for the treatment of illness
& injuries requiring in-patient Hospitalizations in Healthcare facilities such as Hospitals/Nursing
Homes in India. Thus, securing good health and well-being.

Year on Year our Health Insurance Plan benefits are reviewed/revisited taking your needs into
consideration and this year Infoscions are being offered comprehensive and robust health
insurance plans which could be tailored to your needs!

We encourage you to take advantage of this valuable program and explore the plan options
available before choosing the right plan for you and your loved ones.

Wellness cover

At Infosys, your well-being is our priority. That's why we offer comprehensive wellness
program, including doctor consultation, prescribed pharmacy, dental, vision, lab tests,
vaccination etc.

The program includes health checkups designed to identify any early signs of problems. This
allows you to catch things early, when they're easier to treat, and avoid the need for more
extensive treatment or hospitalization down the road. We're committed to fostering a work
environment that supports your overall health and happiness.

For detailed information please click here

General Insurance

From insurance viewpoint, "risk" is another word for "peril" and refers to things that can go wrong.

Risk management involves taking steps to minimize the likelihood of things going wrong, a
concept known as loss control. It also involves the purchasing of insurance to reduce the financial
impact of adverse events, despite best efforts, things do happen which are beyond our control.
This is a step to cover a small portion of the financial loss only which might occur under:

• Cyber Insurance cover: Any financial loss due to online fraud like an event of hacking of
bank account, credit card, e-wallet, etc. in India.
• Household Content policy: Any loss of belongings i.e. furniture, fixtures, etc. due to fire
or natural disasters
• Group Personal Accident Death cover: Death due to accident of dependents declared
/ updated as per HIP portal (spouse and children only).

For detailed information please click here: Cyber | Household content | Accident Death cover

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HEALTH INSURANCE POLICY – 2024-25

Health Insurance 24-25

Eligibility:
This policy is applicable to all India base employees and deputees (including their immediate
family members).
Insurer & Policy tenure:
The Health Insurance Policy has been renewed with National Insurance Company Ltd for the
period July 01, 2024, to June 30, 2025.
Health Insurance Plan Coverage:
• Employee
• Spouse /Partner
• Up to 2 Dependent Children
• Dependent children up to 25 years, who are bona-fide students, not gainfully employed /
married.
• Legally adopted children can be enrolled within the scope of the policy subject to the
submission of relevant documents / proofs for validating the same.
Summary of the Health Insurance Plan (HIP) for Policy Period 2024-25
The HIP at Infosys has flexible plans to suit different groups of employees as detailed below.
Standard &
Particulars Gold Platinum Titanium Titanium+
Standard +
Sum insured (Family Floater) ₹ 5,00,000 ₹ 10,00,000 ₹ 16,00,000 ₹ 26,00,000 ₹ 30,00,000
Maximum No. Of Members 4 4 4 4 4
Eligible Members
Yes Yes Yes Yes Yes
Employee Spouse/Partner / Children
Premium for Enhanced plan (Per Standard: NIL
₹ 7,600 ₹ 13,025 ₹ 20,650 ₹ 25,500
Annum) Standard+: ₹1000
Flex Wallet (Refer wallet usage
NIL ₹ 500 ₹ 1,500 ₹ 5,000 ₹10,000
document)
Maternity Table
Maternity – Basic Limit ₹ 50,000 ₹ 50,000 ₹ 50,000 ₹ 50,000 ₹ 50,000
Upgrade to ₹ 60,000 NA ₹ 4,000 ₹ 4,000 ₹ 4,000 ₹ 4,000
Upgrade to ₹ 70,000 NA NA ₹ 8,000 ₹ 8,000 ₹ 8,000
Upgrade to ₹ 80,000 NA NA NA ₹ 12,000 ₹ 12,000
No. of installments (Premium payment) NA 2 3 3 3
Infertility treatment (for
Employee/Spouse/Partner)
Yes Yes Yes Yes Yes
Restricted to base maternity limit
₹50,000
Legal Surrogacy (Max upto Rs 50,000) NA Yes Yes Yes Yes
Egg freezing or Oocyte
Cryopreservation is an Assisted
Reproductive Technology (ART) NA Yes Yes Yes Yes
Restricted to base maternity limit
₹50,000
• Premiums are annual rates and inclusive of taxes,
• These are the annual limits admissible during the entire policy.
• Pre and Post-natal expenses up to Rs 3500/- included within Maternity limit
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HEALTH INSURANCE POLICY – 2024-25

Plan Benefits
These are the annual limits admissible during the entire policy
Standard &
Particulars Gold Platinum Titanium Titanium+
Standard +
Critical Illness: One-time Premium Premium Premium Premium Premium
option to re- instate of sum applicable as applicable as applicable as applicable as applicable as
insured on 1st claim beyond per retail policy per retail policy per retail policy per retail policy per retail policy
₹2,00,000/- for the policy rack rates as rack rates as rack rates as rack rates as rack rates as
period charged by NIC charged by NIC charged by NIC charged by NIC charged by NIC
Ambulance (per insured
person, in a Policy year Upto Yes Yes Yes Yes Yes
₹ 2,500)
Air Ambulance charges Up to
Yes Yes Yes Yes Yes
5% of Sum Insured
Upto 50% of Upto 50% of Upto 50% of Upto 50% of
LGBTQIA: Hormonal, total expense total expense total expense total expense
Psychological and Gender incurred per incurred per incurred per incurred per
NA
Reassignment (Including claim subject to claim subject to claim subject to claim subject to
counselling & consultations) maximum maximum ₹ maximum ₹ maximum ₹
₹2,00,000 2,50,000 2,50,000 2,50,000
COVID Expenses on Home
₹ 35,000 ₹ 50,000 ₹ 75,000 ₹ 1,00,000 ₹ 1,00,000
Quarantine per Family
Mental Health - Psychiatric or
Upto ₹ 30,000 Upto ₹ 50,000 Up to ₹ 75,000 Upto ₹1,00,000 Upto ₹1,00,000
Psychosomatic / Autism per
including OPD including OPD Including OPD Including OPD Including OPD
family
Cataract/ Power correction of
eyesight (+/-4) above
₹ 35,000 ₹ 35,000 Actual Actual Actual
Administration of intra vitreal
injection
Ayurveda treatment as per Upto 25% Sum Upto 25% Sum Upto 50% Sum Upto 50% Sum Upto 50% Sum
Ayush Guidelines Insured Insured Insured Insured Insured
Organ Donor’s Medical
Expenses Upto ₹ Upto ₹ Upto ₹ Upto ₹ Upto ₹
(Including pre post 2,00,000 2,00,000 2,00,000 2,00,000 2,00,000
hospitalization)
Oral/ Injection and IV
Adjuvant / Target/ Immuno
/Hormone
Replacement/Maintenance /
Chemotherapy/Iodine
therapy for cancer, Multiple
Sclerosis 50% co-pay 25% co-pay No co-pay No co-pay No co-pay
Cyber Knife Surgery,
Cochlear Implant, Robotic
Surgery /any
New advanced line of
treatment/Any experimental
treatment
Automatic one time
Reinstatement of sum
insured
or ₹ 2,00,000 /- due to Yes Yes Yes Yes Yes
Accident injuries wherein the
single claim amount exceeds
₹ 4,00,000 /-
Blood transfusion (Medical
conditions like Anemia, ₹20,000 ₹30,000 ₹40,000 ₹50,000 ₹50,000
Cancer, Injury etc )

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HEALTH INSURANCE POLICY – 2024-25

Nomination & Enrolment for 2024-25

• Company provides Standard plan to all our employees without any cost. Upgrade of plans
is voluntary, with additional benefits/conditions.
• HIP Policy is applicable only with in India.
• Any upgrade to higher plans will have lock in for 3 years.
• No Lock in is applicable on enhanced maternity plans.
• Please refer FAQ for detailed explanation with example.

Nomination & upgrade/Downgrade

• The lock in period of 3 years starts from July 01, 2024.
• During lock in period, downgrade of the plan is not allowed. However, one step up
(upgrade) to the next level will be allowed at each renewal period.
• Any new additions/edits to dependent details needs to be updated in InfyMe on timely
basis. Please go to Infy me-personal data (+ add dependents) Link and then go to benefit
tab and visit HIP and select the new dependent for nomination & update/submit the plan
Link
• HIP policy cover for dependents will start only from the Date of nomination in HIP portal.

Existing Employees:
• The Nominations data for last policy period will be unfrozen for employees to revisit
nomination for upgrade of plans.
• It is recommended that employees review and reconfirm even if there are no changes to
the nominations.
• The previous year plan will be continued as-is, if not revisited and appropriate premium
will be deducted wherever applicable.
• Upgrade of plans is voluntary, with additional benefits/conditions.

New Joinees:
• The New Joinees are automatically covered from the date of joining under the standard
plan.
• Window period of 45 days is provided to add their immediate dependents and choose the
top up plans.
• Hospitalization claims of dependents are eligible to be claimed only if hospitalization is
post the date of nomination.
• Premium mentioned is yearly and the same will be deducted max of 3 monthly
installments.
• For all nominations post Dec 2024, 50% of the yearly premium will be charged and flex
wallet will not be applicable.

Base transfer:
Employees returning to India from overseas location (Base transfer) the enrolment procedure will
be as per new joinees. Employees getting transferred from India- HIP benefits including top up
benefits will cease to exist from the date of joining in new location.

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HEALTH INSURANCE POLICY – 2024-25

Employees on Overseas Deputation and family coverage:

In case of India base employees who are deputed to other countries, the plan chosen will continue
based on current year nomination and their dependents are covered under the plan.

Life Changing Events:

Newly married spouse and Newborn will be covered, from the date of nomination. They must be
enrolled within 30 days from the date of event.

Post Separation from Infosys, Status of Coverage:

The coverage will be discontinued from the date of employee’s separation from Infosys. If any
wallet balance available will be lapsed and there will not be any premium refund.

Demise of Employee:
HIP plan will continue to cover existing dependents under the standard plan for the policy period.

Tax Exemptions on premium payment for Gold, Platinum, Titanium and Titanium+
plans:
• The premium payment for health insurance top up plans qualifies for tax exemption. The
premium applicable for cyber, home and Personal accident insurance does not qualify for
tax exemptions.
• No requirement to submit proof for availing tax benefit.
• Applicable premium paid for health insurance plan will be reflected automatically in the
Form 16.
• Tax exemptions are not applicable to employees who have opted new tax regime.

Spouse Working in Infosys – Coverage:

If self and spouse working in Infosys, then the Insurance coverage will be limited to single plan
limits. (If different plans are opted, higher plan will be considered.)

Plan Coverage Definition

Maternity:

• Add on plan can be availed only for upgraded plans with additional premium.
• All pregnancy and related ailments/complications will fall under the overall Maternity limit.
• The company shall pay to the hospital or reimburse the insured medical expenses incurred
as an inpatient towards first 2 deliveries along with 2 terminations of pregnancy (lawful
medical termination of pregnancy during life of the insured or his spouse)
• Newborn baby expenses will be covered within the maternity limit only.
• Newborn having complication will be covered separately up to the plan limit.

Multiple Child Births:

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HEALTH INSURANCE POLICY – 2024-25

• In case of multiple childbirth (Twins/Triplets) on a single occasion, then all the children
would be covered under the Policy. Child to be enrolled within 30 days from the date of
birth subject to availability of vacant slot(s).
• Three or More children can be covered under top up plan by paying additional premium
of Rs 2,000 per child to insurance company. The total sum insured remains unchanged.

Egg Freezing & Terms:

• Egg freezing or Oocyte Cryopreservation is an Assisted Reproductive Technology (ART)

that allows the harvesting and preservation of eggs of women of child-bearing age in order
to be used at a later date.
• Cancer treatment (chemotherapy & radiation therapy) during the reproductive age that
might cause significant impact on ovaries.
• Women with ovarian disease or those undergoing treatment for the same.
• Women with a family history of early menopause.
• Maximum payable will be under basic maternity limit.

Legal Surrogacy:

• Surrogacy is an arrangement, supported by a legal agreement, whereby a woman (the

surrogate mother) agrees to bear a child for another person, who will become the child's
parent(s) after birth.
• Employees may seek a surrogacy arrangement when pregnancy by the employee/spouse
is medically impossible/when pregnancy risks are too dangerous for the intended mother
and is so advised by a qualified medical practitioner.
• IPD Delivery expenses of Surrogate Mother would be treated at-par with the delivery
expense cover eligibility of employee or spouse.
• It does not cover maternity related complications or any other pregnancy disorder
treatment costs of the surrogate mother.
• Employee has to produce certificate and other necessary documents as per the Surrogacy
(Protection) Act 2018.
• Only cost of first child delivery through Surrogate Mother would get covered up to the base
maternity limit

Mental Health - Psychiatric or Psychosomatic:

• This benefit is extended to Employees/ Spouse/Partner /Children.

• The Medical expenses for treatment of mental health such as depression, bipolar disorder,
schizophrenia, autism etc. under IPD/OPD as per limits specified in the policy schedule.
• The nature of mental health, Investigation Reports, treatments undergone, prescriptions,
etc, duly certified by treating doctor, registered counsellors should be provided for
admitting the claim.

LGBTQIA – Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual cover:

The term ‘family’ is inclusive of people from the lesbian, gay, bisexual, transgender, queer,
intersex, asexual (LGBTQIA) community.

• This includes same sex partners irrespective of their marital status.

• Hormonal, Psychological therapy and Surgical procedures for Sex / gender confirmation
are covered.

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HEALTH INSURANCE POLICY – 2024-25

Inclusion of Partners:

• 'Partner' means same-sex or opposite-sex partners, who are both of legal age, unmarried,
in a close personal and sexual relationship and are voluntarily cohabitating together.
• Please note that while claiming the benefits under this scheme, one may need to submit
documents as proof of relationship with the dependents, whom you have enrolled under
the Scheme.

Ayurveda Treatment:

Expenses incurred towards Ayurveda treatment are payable as per the below plan guidelines:
• Administered in Central or state Government hospitals.
• NABH accredited Ayurveda hospital.
• Teaching hospitals attached to Ayurveda colleges recognized by Central or state
Government/ Central Council of Indian Medicine.
• Ayurveda hospitals registered with a Government Authority in a State with adequate
number of qualified paramedical staff, dedicated Ayurveda therapy sections and daily
maintenance of medical records.
• Massage and other treatments such as Abhyangam, Khizhi, pizhichill , udwarthanam
Steam bath, sweda, kuti sweda, patra potala sweda, Shirodhara takradhara, katidhara ,
etc are payable if these in line with the diagnosis/treatment suggested.
• Claim will be payable as per Ayush guidelines and hospitalisation limit will be restricted as
per capped benefits however total expenditure will be capped as per maximum limit
mentioned in above table.

Scope of the Cover – General terms and conditions:

• Pre-existing diseases covered from day one.
• Benefits can be availed post nomination.
• Policy covers inpatient treatment having active line of treatment with hospitalization for
more than 24 hours.
• All hospital Bills for the reimbursement should be submitted within 30 days from the date
of discharge.
• Minimum Hospital Criteria of 15 beds must be met with an exception to day care
procedures.
• 140 Day care procedures do not require hospitalization (for details refer Day Care
procedures Annexure).
• 30 days Pre and Post hospitalization expenses are covered.
• The expenses should be related to the same ailment for which insured was hospitalized.
• Pre and post hospitalization expenses will be payable within their defined benefit limit.
• Hospitalization expenses relating to External Congenital anomaly/defect/disorder are
admissible provided the same is life threatening to the individual insured or substantially
affects the normal functioning of the body and not for Cosmetic purpose.
• Peritoneal Dialysis are covered.

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HEALTH INSURANCE POLICY – 2024-25

Room Eligibility and Co Payment Table for all plans:

Features Standard & Standard + Gold Platinum Titanium Titanium+
Room Charges Entry level Single
Entry level Single
(per day per Occupancy AC/Non Actual Actual Actual
Occupancy AC/Non AC
insured person) AC
10% of admissible
claim amount
10% of admissible
OR ₹ 3,500
Co-Pay on every claim amount OR ₹
whichever is higher NO NO NO
claim 3,500 whichever is
including pre and
higher
post hospitalization
claims
Standard/+ & Gold – If room rent opted is higher than the eligible room then the proportionate
deduction will be applicable. Illustration has been updated in FAQ.

Additional co-pay: 5% additional co-pay (irrespective of plan) is applicable on planned

hospitalization reimbursement claims registered under Network hospital.

Third Party Administrator (TPA):

TPA means a Third-Party Administrator who holds a valid License from Insurance Regulatory and
Development Authority. They are engaged by the insurers for providing health services. For
providing in-patient / hospitalization claims services Medi Assist is our TPA. You can log onto
https://infosys.mediassist.in for registering the claims.
Scope of Services of TPA (Medi Assist)
TPA administers the health insurance benefits for Infoscion and their family members who are
covered under the policy.
• Facilitate cashless hospitalization at the Medi Assist Network of Healthcare Providers (on
best effort basis)
• Has tie up with majority of hospitals across the country for special price for procedures
and room rent.
• Reimbursement process for Claims of Hospitalization expenses other than cashless
• 24X7 Dedicated toll-free numbers to support Infoscion (01206937306)
Definition of Network Provider:
Network Provider means the hospital/nursing home or health care providers enlisted by the
insurer or by a TPA to provide medical services to an insured by providing cashless facility for any
hospitalization expenses.

Explore your health benefits on the move: (Single Sign on):

Visit link to get updates on the network hospitals, for claims submissions, tracking and cards, etc.
Log in using your Infosys credentials.

Wellness service provider (MediBuddy):

All the wellness services offered under various plans (flex wallet offerings) can be availed through
our wellness service provider MediBuddy. Please note all wellness benefits are extended only

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HEALTH INSURANCE POLICY – 2024-25

through MediBuddy application. You may download the app from Playstore / iOS by searching
the key word “MediBuddy”.

Exclusions under HIP plan

Please note that this list is indicative only and not exhaustive.
• Hospitalizations less than 24 hrs. (other than 140 listed day care procedures)
• Hospitalizations for evaluation or diagnosis purposes
• No active line of treatment during the hospitalization
• Out-patient treatment means treatment in which the insured person visits a clinic / hospital
or associated facility like a consultation room for diagnosis and treatment based on the
advice of a medical practitioner.
• Contact lens, Spectacles, and Hearing aid.
• Dental treatment or surgery of any kind unless necessitated by accident and requiring
hospitalization.
• Voluntary Termination of Pregnancy
• Sterilization procedures /Family Planning
• Plastic and cosmetic surgery
• Any condition directly or indirectly caused to or associated with HIV, AIDS, complications
of AIDS and other sexually transmitted diseases (STD)Experimental and unproven
treatments.
• Treatment for obesity or a condition arising there from (including morbid obesity) and any
other weight control and management program/services/supplies or treatment.
• Naturopathy Treatment, acupressure, acupuncture, magnetic therapies, experimental and
unproven treatments/ therapies
• Treatment/Admission standalone for Massage and other treatments such as Abhyangam,
Khizhi, pizhichill , udwarthanam Steam bath, sweda, kuti sweda, patra potala sweda,
Shirodhara takradhara, katidhara , etc
• Any purchase of Machine cost like CIPAP, BIPAP, Oxygen Cylinder, Oxygen Concentrator
• Treatment arising out of disease/injury due to misuse or abuse of drugs/alcohol or use of
intoxicating substances.
• Stem cell Therapy/Bone Marrow transplant excluding life threatening (donor charges not
covered only screening charges will be covered)
• Botox injection not covered.
• OPD Ayurveda treatment is not covered under policy.
• Infertility treatment taken under OPD is not covered under policy.
*For complete details on policy conditions / coverages/ Inclusion and Exclusion please refer the
Group Mediclaim Insurance policy document

HIP Portal link: HIP (sharepoint.com)

Contact Details of Medi Assist (DC contact details refer table here below):
Email ID Toll Free Number(24X7)
Infosys@mediassist.in 0120-6937306
Claims Tracking Number 96631 49992
Downloading MediBuddy app - Missed call to 1800- 3010- 1696
Status online: https://infosys.mediassist.in

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HEALTH INSURANCE POLICY – 2024-25

Escalation Matrix: Hospitalisation/cashless/reimbursement (Mediassist)

Escalations Name Email Id Contact No
First Level Rani G/ rani.g@mediassist.in/ 7337873913/
Sujata Prem Shetty sujata.shetty@mediassist.in 8884662790

Second Level Jeyamurugan a.jeyamurugan@mediassist.in 7022877321

Third level Sushma Venkatesh sushma.venkatesh@mediassist.in/ 7338467570/

/Reema Ransaria reema.ranasaria@mediassist.in 7899391328

Escalation Matrix: Wellness (Medibuddy)

Escalations Name Email Id Contact No
First Level Helpline number (24*7) hello@medibuddy.in 999-999-1555
Whatsapp (7 am to 9 8884336668
pm)
Second Level Kailash Infosyssupport@medibuddy.in 8884336668

Third level Denish Singh denish.singh@medibuddy 6366569459

Escalation Matrix: National Insurance Company

Escalations Name Email ID Contact No
First Level G.Kavitha g.kavitha@nic.co.in 8939845829
Second Level
Soma Rani somarani.saha@nic.co.in 8884499406
Third level Vikrant J P JP.Vikrant@nic.co.in 7506345302

Escalation Matrix: Infosys

Escalations Name Email Id Contact No
First Level Aadithya Kamath / aadithya.2158322@infosys.com 8904287942
Ramesh Nayak Ramesh_Nayak@infosys.com 9731263006

Second Level Sriram H Sriram_H05@infosys.com 9791073071/

Priyadarshini Hegde priyadarrshini_h@infosys.com 6366930854

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HEALTH INSURANCE POLICY – 2024-25

Mediassist DC Contact
DC Location Contact Weekdays Timings
Tuesday &
Bangalore
Building#9,Near ICICI ATM Kalai Selvi 9035674473 Wednesday 10 AM to 4 PM
Phase -2, SDB-2, Ground Floor, A-
Pune Wing, Finance Section, Near FOREX Mr. Sunil/Ms Priyanka All working
Desk 7028971094 days 10 AM to 5 PM
All working
Building 7, near CAG Mr. Azam - 7671820008 days 10 AM to 5 PM
Hyderabad
Mr M Vijay Kumar All working
Pocharam SEZ, Bldg. No.2 8897378682 days 10AM to 5 PM
Mr. Santhosh - 2:30 PM to
Pacifica - Food Court 9003072218 Wednesday 4:30 PM
Mr. Santhosh - 10:30 AM to
Chennai
Shols- Building # 6 (Left wing) 9003072218 Wednesday 1:00 PM
Mr. Santhosh - 10:30 AM to
M City, Building-04 (Left Wing) 9003072218 Tuesday 4:00 PM
Ms Nisha Abdul Tuesday & 9.30 AM to
Trivandrum
SEZ Campus, SDB 2, A wing 9072593386 Thursdays 4.30 PM
Monday to
Chandigarh
SEZ Campus -SDB1 A ,wing Mr Ravinder 9915539154 Friday 10 AM to 5 PM
Mr .Jyoti Ranjan Wednesday 4.30 PM to 6
Bhubaneswar CCD Food Court 9438409998 and Friday PM
STPI Mr .Jyoti Ranjan Wednesday
CCC Building Finance Desk 9438409998 and Friday 6 PM to 7 PM
Bhubaneswar Mr .Jyoti Ranjan
SEZ SDB A- Finance Desk 9438409998 Wednesday 11 AM to 1 PM
Mr Syed Muddasir Tuesday &
Mysore
Sdb1 Groundfloor, 'B 'Wing, 6366935351 Thursdays 10 AM to 5 PM
11 AM to 3:30
Gurgaon
Uniworld Towers Rakesh Tiwari 9315412525 Friday PM
Mudipu, SEZ, SDB3, Ground Floor C Ms Sujata Shetty Monday to
Mangalore
wing 8884662790 Friday 11 AM to 5 PM

Jaipur Medical Room GF Corporate Bay Mr.Pankaj Tuesday 11AM to 2 PM

IBPO Building 9610098732/8448697087 Wednesday 7PM to 9 PM

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HEALTH INSURANCE POLICY – 2024-25

FAQ (Frequently Asked Questions)

1. Where/how can we download the e cards/health card?
Please login to MediBuddy portal or download MediBuddy mobile app from Playstore /App
store and access your data.
Logging in from Infosys Intranet
Please log in to the link infosys.mediassist.in using your Infosys login and password.

2. How to view list of network hospitals?

Please log in to the link infosys.mediassist.in using your Infosys login and password. In the portal
under the hospitalization tab list of network hospitals available

3. What are the documents required to be submitted at the hospital for cashless claims?
• Infosys ID card copy.
• Medi Assist card (Available online: https://infosys.mediassist.in/Indexinfy.aspx )
• Any government issued photo ID card of the person hospitalized.
• PAN card for claim above one lakh.

4. Circumstances under which a Request for Cashless Hospitalization can be denied?

• If the information contained in the request is insufficient for Medi Assist to arrive at a
decision
• The ailment for which hospitalization sought is not covered under the policy.
• The entire sum available for your family for the year has been exhausted during the year
• Age proof Photo ID not furnished
Note: The reasons stated above are only indicative and not exhaustive

5. How do I Log/Track my claim status in real-time?

• Log into https://infosys.mediassist.in and click the Claims tab and update to submit a
claims/track a claim.
• Claims can be submitted online using the link. Submission of claims needs to be done
within 30 days of hospitalization and also hard copy of the documents needs to be
submitted immediately.
• SMS “Claims (Claim Number)” to +91 96631 49992

6. Why are Original Documents required for claiming Reimbursement of Hospitalization

Expenses?
The documents have to be in Original since the Insurer who makes the payment require them
as per Standard Accounting norms and also to meet the requirements of the external Govt
Agencies like CAG, Income Tax, IRDA, etc.
It is suggested that the Insured should keep Photocopies of all documents for any future
reference.

7. What is Reimbursement of claims?

In case you choose to pay the hospital bills directly for any of the below reasons, you may
submit reimbursement claim using MediBuddy.
• Hospitalization at a non-network hospital.
• Post-hospitalization and pre-hospitalization expenses.
• Denial of preauthorization for cashless at a network hospital for lack of documents.

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HEALTH INSURANCE POLICY – 2024-25

8. What are the documents required to be submitted for reimbursement claims?

The following original documents are to be submitted for reimbursement of claims.
• Hospital final bill.
• Printed pre numbered Receipts for payments made to the hospital.
• Complete breakup of the hospital bill.
• Discharge summary.
• Investigation reports supported by note from attending surgeon.
• All Medicine bills with relevant prescriptions.
• Copy/Cancelled Cheque to validate the Bank Account number & IFSC Code.
• The above list is not the exhaustive list TPA may seek additional documents if required.
• Mandatory Document – Pan card, Aadhar Card, Infosys ID Card

9. How many days of pre and post hospitalization expenses can be claimed?
Policy allows Pre/Post-hospitalization expenses, for up to 30 days prior/post hospitalization.
The documents that you need to submit should be relevant to the treatment during
hospitalization and are as follows:
• Copy of the discharge summary of the corresponding hospitalization.
• Relevant doctors’ prescriptions for investigations and medication.
• Bills for investigations done with the respective reports.
• Bills for medicines supported by relevant prescriptions.

10. If I am advised to get admitted by the treating doctor, will the claim be payable?
The policy covers hospitalization expenses only if there is active line of treatment.
Hospitalization for investigation alone is not payable.

11. I have spent Rs 20,000 on hospitalization. Can I claim the full amount?
Claims are subject to Co-pay and other conditions. Co-pay means the portion of the claim
value that is borne by the employee. Employees / dependents claims will be subject to a co-
payment of 10% or Rs 3,500 of the payable amount per incident (whichever is higher) under
the standard and gold plan. There would be no co-payment for platinum, Titanium and
Titanium + plans.

12. What is the SLA (Service Level Agreement) for TPA for Pre-Authorisation
/Reimbursement claims?
Claims Pre-authorization SLA
Processing - approval/denial/ query Within 2 hours
Claims Reimbursement
Processing-approval/ Denial (approval +
10 working days*
payment settlement)
Processing and communication of
3 working days
additional information requirement
*this is subject to receiving all the documents/clarifications if any required from the insured

13. Online Reimbursement Claim Submission – Do’s & Don’ts

• Please retain a copy of all documents submitted to Medi Assist for further reference.
• Please retain POD copy of the courier for tracking your consignment in case of any delay
etc.
• Please note that online submission of claim documents to be registered in the system and
payment will be processed based on soft copies, however, as per the mandate from IRDA
and insurance company original documents/hard copies are required for audit purpose
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HEALTH INSURANCE POLICY – 2024-25

thus we would request you to submit the original documents within 3 working days for the
completion of claims process at the respective DC locations or courier documents to Medi
Assist
• Print out of the claim form has to be signed & submitted along with the documents
• All original documents like hospital main bill, main bill-break up, receipts/ advance paid
receipts and any other bills/reports are required in original hard copy to be submitted at
the nearest help desk or to be couriered to Nearest Medi Assist office within 3-4 working
days for the claim processing. Photocopy or duplicate copy of the financial documents will
not be considered for processing.
• Please submit the patient photo ID proof and Infosys ID during claim submission
• Insert page numbers on all the document and Update total number on the first sheet.
Documents should be numbered from last page to first page on top right hand side of
document.
• Don't raise the duplicate claims in the system for the same admission
• Pre and Post hospitalisation claims to be submitted separately
Once claims created cannot be cancelled/altered thus please review the claim form and
documents before submitting the claims

14. What is active line of Treatment?

Active Line of Treatment is a continuous medical treatment provided by a medical practitioner
to a patient suffering from a specific ailment / life threating situation.

15. Whether HIP policy document exhaustive?

Policy document provides only highlights and some of the features of the policy for easy
understanding. Under no circumstances will supersede the policy that is issued by Insurance
under IRDA guidelines.
One can access the Detailed HIP policy 2024-25 uploaded in the site which covers all the
terms and conditions.

16. How to nominate /add baby/dependent under HIP policy?

• InfyMe - Profile Icon - Show Full Profile – Personal – Add Dependents.
• If child name is not decided, please update child name as "Baby of Mother's name"
• Add the newly added dependent in the dependent section eg: Spouse, adopted kid.
• Then go to benefit tab and visit HIP and select the new dependent & update/submit the
plan Link

17. What is the procedure to correct name/DOB in between policy period?

• Please update the correct name/DOB by accessing INFYME
• InfyMe - Profile Icon - Show Full Profile – Personal – Add Dependents.
Once updated please raise an AHD with CAG Insurance to update on Mediassist portal
card.

18. What are the documents required for partial claim?

• Online Claim form duly filled and signed.
• Attested copy of the documents (inpatient bill, reports, summary, break up etc.,)
• Original hard copy of the receipt for the excess amount paid.
• Claim settlement letter from the other insurer.

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HEALTH INSURANCE POLICY – 2024-25

19. Is there an option to add more than 2 Kids under standard plan?
No. 2 kids or more can be covered under top up plan, please refer the illustration below.
Standard/+ Gold/Platinum/Titanium, Titanium+
No of Children Eligible 2 No Restriction
Premium per additional Kid NA 2000

20. Where can we send the claim documents, if we are not able to submit to the helpdesk
in the campus?
Documents can be sent to below mentioned address.
Medi Assist Insurance TPA Pvt. Ltd
58/1A, Singhasandra Village,
Hosur Main Road,
Begur Hobli,
Bangalore South Taluk
Bangalore -560068

21. Is there any time limit to submit the pre-authorization request in case of a planned
hospitalization?
In case of a planned hospitalization, it is prudent to send the preauthorization request to Medi
Assist at least 48 hours prior to the admission date. This will ensure:
• Easy admission
• Pre-approved cashless limits
• Ease of discharge
• Avoid additional co-payment.
• Pre-approved discounted rates with hospitals You can log in a request using MediBuddy
app

22. Who will send the pre-authorization to Medi Assist in case of emergency/unplanned
hospitalization?
In case of an emergency or unplanned admission, the hospital must send the pre-
authorization request to Medi Assist at the time of admission or on the day of discharge before
billing.

23. What if I am working from a remote location during the renewal cycle and I am unable
to access mails?
Family cover will be intact even if the employee is not able to get the mails/communication
w.r.t the same. If the employee is working on remote network/location the plan chosen in the
last renewal cycle will continue to be in force covering their dependents under the plan.

24. What if I opt for a gold/platinum/platinum+ plan this year and selected 60k/70k plan for
maternity, can I discontinue?
Yes, Maternity is only an add on cover and there is no restriction to subscribe to maternity
plan in subsequent renewals.

25. Can one change the plan post closure of enrolment period?
No. Plan once opted during enrolment period cannot be changed during the policy period (1st
Jul current to 30th Jun of next year). However subsequent years, employees will have an
option to upgrade the plans depending on renewal terms.

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HEALTH INSURANCE POLICY – 2024-25

26. How can I pay the premium in case of plan upgrade?

Following options are available for premium payment.
• Gold plan: Premium will be deducted from salary in two (2) interest free instalments.
• Platinum/Titanium/Titanium+ Plan: Employees will have an option to pay the
premium in three (03) interest free instalments.
• For Gold/Platinum/Titanium/Titanium+ plan can be paid through Debit card, Net
banking, Credit card

27. Is infertility treatment covered in policy and is there a cap on claims?

Yes, infertility treatment is covered, however both infertility and maternity treatment during
same policy period has a max cap of Rs. 50,000 (both incidents put together). Ex: Infertility
claim if Rs 25,000 and maternity claim of Rs 45,000 in the same policy period. Maximum
amount payable in this scenario will be Rs 50,000

Illustration on proportionate restriction as per room eligibility (EXAMPLE ONLY)

Scenario: Hospitalization is for 3 days and total bill amount is 25000 with following bill bifurcation
(patient is Eligible for room rent at Rs 3500. But, occupied / opted room rent at Rs 4900 per day )

Deduction
Charge Head Amount Deduction payable amount reason
room rent for 3 14700 4200 excess of eligible
days (4900*3) (4900-3500)*3 10500 room rent
proportionate
excess as per the
lab + professional eligible room rent
charges 8000 2285 5715
Total 22700 6485 16215

In this case, total variables (room, nursing, lab and professional) (14,700+8,000)
= Rs 22,700

Patient is eligible for single AC room with rent at Rs 3,500, but opted deluxe room at Rs 4,900
Hence, eligible variables after proportionate restriction = 22,700*3,500/4,900 = Rs16,215

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HEALTH INSURANCE POLICY – 2024-25

28. What is the definition of Hospital?

• Hospital is any institution established for in-patient care and day care treatment of illness
and/or injuries and which has been registered as a hospital with the local authorities under
the Clinical establishments (Registration and Regulation) Act, 2010 or under the
enactments specified under the Schedule of Section56(1) of the said Act OR complies
with all minimum criteria as under:
• Has qualified nursing staff under its employment round the clock.
• Has at least 15 inpatients beds
• Has qualified medical practitioner(s) in charge round the clock.
• Has a fully equipped Operation Theatre of its own where surgical procedures are carried
out.
• Maintains daily records of patients and makes these accessible to the insurance
companies.
• authorized personnel.

29. What is a Non-Network Hospital?

Non- network means any hospital, day care center or other providers who are not part of the
network hospitals of Mediassist.

30. Where can we get information regarding porting the policy and premium for market
policy?
• Retail policy details are available in National Insurance Company Limited (nic.co.in)
• For porting, please drop mail to arjun.chamala@nic.co.in / mob: 8884499388

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HEALTH INSURANCE POLICY – 2024-25

Cyber Insurance cover

against online fraud resulting in financial loss

Eligibility & Coverage

This policy is applicable only to Infosys employees who have opted for Platinum, Titanium,
Titanium + top up covers, holding bank accounts in India (including salary account), any
debit/credit card/e-wallet, issued by any bank, denominated in INR only and linked to employees
PAN number as a primary account holder.

Infosys employee being a joint account holder (not being primary holder) will not be covered under
this policy.

Coverage
This policy is issued by National Insurance Company and is valid from July 01, 2024, to Jun 30,
2025. Cyber policy cover starts from date of nomination in HIP portal.

Subject to the terms, conditions, and exclusions of this policy, the insurer shall indemnify the
insured (employees of Infosys) for direct financial losses, covered hereunder after application of
deductible and limit of liability. This applies to insured events discovered during the policy period
and reported to us during the policy period and up to 72 hours after the termination of the policy
period.
General Terms
Theft of Funds: Policy will indemnify you for any direct and pure financial loss incurred.
a) as a result of a theft of funds due to an unauthorized access to your bank account, credit
or debit card or mobile wallets by a third party, and
b) as a consequence of you being a victim of phishing or email spoofing,
c) any legal costs incurred by you as set forth above.

Example:
a) Card-present fraud: Claims involving the cloning through skimming at ATMs or
establishments, and interception of new or replacement cards during postal delivery.
b) Card-not-present (CNP) fraud: Offline instances of CNP fraud include completing
payment forms with stolen details and submitting them via email or phone – incidents
leading to CNP credit card fraud range from theft in physical locations to phishing via email
or text and exploiting public Wi-Fi vulnerabilities.
Sum Assured for each plan

Plan Cyber cover limit Limit per incident

Platinum 75,000 37,500
Titanium 100,000 50,000
Titanium + 200,000 100,000

Deductible: Rs 2500 /- for each event.

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HEALTH INSURANCE POLICY – 2024-25

Insurance liability: Insurers will not be liable for the deductible applicable to each and every
insured event or third-party claim. Our liability will be in excess of any deductible and subject to
the limit of liability for each and every insured event or third-party claim as stated in the schedule

i.e Any claim less than Rs 2,500/- will not be eligible under this policy.

Claim Conditions

1. Onus to prove the theft lies on the insured i.e Infosys employee.
2. The insured must report the occurrence of any covered event within the policy period.
3. The insured must notify the issuing bank or mobile wallet company within 3 days upon
discovery of theft of funds.
4. An FIR must be filed with the authorities within 3 days of discovery of the incident.
5. Discovery of the incident must be reported to insurance company within 3 days from the date
of occurrence.
6. The insured must provide evidence demonstrating the refusal of reimbursement by the issuing
bank or mobile wallet company.
7. Legal Defense Costs to pursue legal action against third parties.

Exclusions
We will not cover any claim under this policy arising directly or indirectly from the following:

1. Insured events or circumstances that could reasonably lead to an insured event which are
known by insured prior to the inception of this policy.
Eg: Incident which has occurred prior to policy inception OR pre-existing.
2. Any action or omission or misbehavior of the insured, which is intentional, malicious,
dishonest, deliberate or reckless.
Eg: Sharing of user ID and password intentionally and then denying the fact of sharing willfully.
3. Account should not be a business account and should be used for personal purpose only.
Eg: This policy is issued only in personal capacity and policy will not extend in case of carrying
on any business / professional activity.
4. Any type of war (whether declared or not), use of force or hostile act.
5. Loss of or damage to tangible property and any consequential losses resulting therefrom,
including the loss of use of tangible property.
6. Investment or trading losses including without limitation any inability to sell, transfer or
otherwise dispose of securities.
7. Contractual liability
8. Any type of crypto currencies (e.g. Bitcoin, Ethereum, Ripple, IOTA).
9. Gambling and unexplained losses
10. Use of any restricted websites (Immoral/Obscene) and illegal activities.
11. Sharing user id, OTP, password
Duties of Insured
1. Make sure the personal devices or smart home devices are used and maintained as
recommended by the manufacturer or supplier, and
2. Prevent and mitigate loss or damages covered under this policy by:

a) Providing, maintaining and updating the operational system of your personal devices and
smart home devices within 14 days after a security patch was advised to be installed,
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HEALTH INSURANCE POLICY – 2024-25

b) Maintaining up-to-date patch-states of the OS, browser, E-Mail, other software programs.
c) Deployment of appropriate system, device and data security measures (e.g. antimalware
solutions),
d) Usage of appropriate passwords, and
e) Maintaining and updating at appropriate intervals backups of your data, at least every 14
days.

Other Insurance. If there is other insurance for the same insured event this policy will apply in
excess of this other policy and will not contribute with this other insurance

Subrogation. If any payment is made under this policy, we will be subrogated to the extent of
such payment up to all your rights of recovery from any third party. You must do all that is
necessary to secure and must not prejudice such rights. Any monies recovered will be applied
first to any costs and expenses made to obtain the recovery, second to any payments made by
us, and third to any other payments made by you.

Third party rights. No third party who is not a party to this policy shall have any right to enforce
any part of this policy.

Documents to be submitted for claims processing.

1. Fully completed and signed Claim form.
2. Copy of FIR lodged with Police Authorities / cyber cell.
3. Copies of correspondence with financial institutions regarding IT Theft Loss.
4. Proof to demonstrate the Loss incurred by the Insured.
5. Legal notice served on any Financial Institution and/or case filed against Financial Institution
for single loss exceeding Rs 20,000.
6. Any other documents required by the insurance Company.
Contact details

In case of any event, intimation needs to be sent to 608300@nic.co.in CC to

cag_insurance@infosys.com

Escalations Name Contact No Email Id

st
1 Level
National insurance 8095551800 608300@nic.co.in
2nd Level
K Ramesh 7799908342 ramesh.k@nic.co.in
3rd Level
Vikrant J P 7506345302 JP.Vikrant@nic.co.in

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HEALTH INSURANCE POLICY – 2024-25

Household Content Policy

against Fire and Natural disasters

Eligibility & Coverage

Policy is applicable to only India based employees who have opted for Platinum, Titanium,
Titanium + top up covers, and it covers household contents against the Standard Fire and Special
perils.

Coverage will be extended only to the present address as declared / updated in InfyMe.
General Terms
This policy is issued by National Insurance Company and is valid from July 01, 2024 to Jun 30,
2025 and renewed annually. Household content policy cover starts from date of nomination in HIP
portal.

In case Insured Person shall sustain any physical loss or damage, or destruction caused to
Household contents at current address (as per the records) by the following unforeseen events
occurring during the Policy Period.

In case of a rented premises, agreement should be in the name of the employee / employee to
be one of the party in the tenant list.
Sum Assured for each plan
Plan Home SI

Platinum 2,50,000

Titanium 5,00,000

Titanium + 10,00,000

Policy Deductible: Rs 10000 /- for each and every loss.

Insurer liability: Insurer will not be liable for the deductible applicable to each and every insured
event or third-party claim. Our liability will be in excess of any deductible and subject to the limit
of liability for each and every insured event or third-party claim as stated in the schedule.

Any loss below Rs 10,000 will not be eligible for the claim.

Insured Perils
1. Fire
2. Explosion or Implosion
3. Lightning
4. Earthquake, volcanic eruption, or other convulsions of nature
5. Storm, Cyclone, Typhoon, Tempest, Hurricane, Tornado, Tsunami, Flood and Inundation
6. Subsidence of the land on which Your Home Building stands, Landslide, Rockslide

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HEALTH INSURANCE POLICY – 2024-25

7. Bush fire, Forest fire, Jungle fire

8. Impact damage of any kind, i.e., damage caused by impact of, or collision caused by any
external physical object (e.g. vehicle, falling trees, aircraft, wall etc.)
9. Missile testing operations
10. Riot, Strikes, Malicious Damages
11. Bursting or overflowing of water tanks, apparatus and pipes.
12. Leakage from automatic sprinkler installations.
Exclusions
1. Your deliberate, willful or intentional act or omission, or of anyone on behalf, or with Your
connivance.
2. War, invasion, act of foreign enemy hostilities or war-like operations (whether war is
declared or not), civil war, mutiny, civil commotion amounting to a popular rising, military
rising, rebellion, revolution, insurrection or military or usurped power.
3. Ionising radiation or contamination by radioactivity from any nuclear fuel or from any
nuclear waste from combustion of nuclear fuel, or the radioactive, toxic, explosive or other
hazardous properties of any explosive nuclear assembly or nuclear component that is part
of it.
4. Pollution or contamination, unless
a) the pollution or contamination itself has resulted from an Insured Event, or
b) an Insured Event itself results from pollution or contamination.
5. Loss, damage or destruction to any electrical/electronic machine, apparatus, fixture, or
fitting by over-running, excessive pressure, short circuiting, arcing, self-heating or leakage
of electricity from whatever cause (lightning included). This exclusion applies only to the
particular machine so lost, damaged or destroyed. Eg: TV/LCD/Refrigerator burnt due to
arcing/short circuit not covered.
6. Loss or damage to bullion or unset precious stones, manuscripts, plans, drawings,
securities, obligations on documents of any kind, coins or paper money, cheques,
vehicles, apparels and explosive substances.
7. Loss of any Insured Property which is missing or has been mislaid, or its disappearance
cannot be linked to any single identifiable event.
8. Loss or damage to any Insured Property removed from Your Home to any other place
9. Loss of earnings, loss by delay, loss of market or other consequential or indirect loss or
damage of any kind or description whatsoever.
10. Any reduction in market value of any Insured Property after its repair or reinstatement.
11. Burglary including Theft
12. Building
13. Costs, fees or expenses for preparing any claim.
Duties of Insured
1. Take care to prevent theft, loss or damage to Your Home Contents.
2. Inform NICL of any change in circumstances such as change of address.
3. Give notice of loss to NICL, as required.
4. Inform the respective authorities, as required.
5. Make true and full disclosures in Your claim form.
6. Give all documents supporting the claim.
7. Give full cooperation for inspection and investigation of claim.

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HEALTH INSURANCE POLICY – 2024-25

Documents to be submitted for claims processing

1. Claim intimation: Within 3 days of the incident, need to reach out to National Insurance
team – contact details shared below.
2. Brief statement of the loss
3. Details of the Insured Event
4. Report to Police authority, fire authority in case of loss of life
5. submit photographs of loss or physical damage, wherever possible.
6. Any other reports as may be requested by insurance company.

In case of occurrence of any insured event, before starting any repair intimation needs to be done
to National Insurance co to enable them to appoint surveyor to assess the loss.

Other Insurance. If there is other insurance for the same insured event this policy will apply in excess
of this other policy and will not contribute with this other insurance

Contact details

In case of any event, intimation needs to be sent to ramesh.k@nic.co.in CC to

cag_insurance@infosys.com

Escalations Name Contact No Email Id

1st Level National insurance NA 608300@nic.co.in

2nd Level K Ramesh 7799908342 ramesh.k@nic.co.in

3rd Level Vikrant J P 7506345302 JP.Vikrant@nic.co.in

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HEALTH INSURANCE POLICY – 2024-25

Group Personal Accident Death cover

for dependents (spouse and kids)

Eligibility and Coverage

Policy is applicable to only India based employees who have opted for Gold, Platinum, Titanium,
Titanium + top up covers, and basic coverage is for Spouse and kids as per nomination in HIP
portal.

General Terms
This policy is issued by National insurance Company and is valid from July 01, 2024 to Jun 30,
2025 and renewed annually. GPA policy cover starts from date of nomination in HIP portal.
Incase Insured Person shall sustain any bodily injury resulting solely and directly from accident
caused by external, violent and visible means which has caused Death, the insurance company
shall pay to the employee or legal heir of the insured, as the case may be, the sum set forth as
follows.

Sum Assured for each plan

Capital Sum insured
Plan Spouse Per Kid
(spouse & 2 children)
Gold 100,000 100% 50%
Platinum 250,000 100% 50%
Titanium 500,000 100% 50%
Titanium + 1000,000 100% 50%
The above said limits are on family floater basis only. The total death compensation paid out at
any point of time during the policy period will not exceed the sum insured limit as defined above.

Incase if nomination is missing in HIP portal, cover will not be extended.

Scenarios
• In case of death of any one child, then the total payment will be restricted to 50% of sum
insured.
• In case of death of more than 1 child, then the total payment will be restricted to 100% of
sum insured.
• In case of death of spouse and one child, then the total payment will be restricted to 100%
of sum insured.
• In case of death of spouse only, then the total payment will be restricted to 100% of sum
insured.
• In case of death of entire family, then the total payment will be restricted to 100% of sum
insured to legal heir.

Documents to be submitted for claims processing

In case of any death, intimation needs to be done to insurance team/insurer within 30 days of the
event.
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HEALTH INSURANCE POLICY – 2024-25

Below are the documents to be submitted for claims processing.

1. Claim form with Attending Doctor’s report
2. Attested copy of Death Certificate
3. Attested copy of Post Mortem report
4. Attested copy of FIR /Panchanama
5. Attested copy of all medical records including admission / discharge / deaths summary &
investigation / Laboratory / radiological reports, etc.
6. Any other reports as may be requested by insurance company.

Contact details

In case of any event, intimation needs to be sent to 608300@nic.co.in CC to

cag_insurance@infosys.com

Escalations Name Contact No Email Id

1st Level
National insurance 8095551800 608300@nic.co.in
nd
2 Level
K Ramesh 7799908342 ramesh.k@nic.co.in
3rd Level
Vikrant J P 7506345302 JP.Vikrant@nic.co.in

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HEALTH INSURANCE POLICY – 2024-25

Wallet Usage

Overview of the benefits associated with plan selection

Standard Standard + Gold Platinum Titanium Titanium +
Sum Insured in Rs 5,00,000 5,00,000 10,00,000 16,00,000 26,00,000 30,00,000
(Family Floater)
Top up Premium (in Rs per annum) NIL 1,000 7,600 13,025 20,650 25,500
Flex Wallet* (in Rs) NIL NIL 500 1,500 5,000 10,000
*Utilization of wallet amount through cashless facility in network only through MediBuddy app.
Reimbursement of invoice is NOT applicable.
Flex Wallet - (no offline reimbursement) Standard Standard + Gold Platinum Titanium Titanium +
only through MediBuddy
Prescribed Pharmacy - Restricted to 50% of - - ✓ ✓ ✓ ✓
total wallet points
Health Check Packages - - - ✓ ✓ ✓
Dental (cosmetic excluded) - - - - ✓ ✓
Vision (Prescribed powered contact lens / - - - - - ✓
glass only)

Lab test, In person doctor consultation, Standard Standard + Gold Platinum Titanium Titanium +
vaccination, Diet & Nutrition)
Lab Test - - ✓ ✓ ✓ ✓
Doctor Consultation - In Person - - ✓ ✓ ✓ ✓
Vaccination - - ✓ ✓ ✓ ✓
Diet & Nutrition - - - - ✓ ✓

Doctor Consultation Benefits Standard Standard + Gold Platinum Titanium Titanium

+
Online Doctor Consultation (General *4 ✓ 24 ✓ Unlimited Unlimited Unlimited Unlimited
Practitioner) - App based ✓ ✓ ✓ ✓
Dental Consultation (Network only) - - Unlimited Unlimited Unlimited Unlimited
✓ ✓ ✓ ✓
Online Doctor Specialty Consultation - App - - - Unlimited Unlimited Unlimited
based ✓ ✓ ✓
Unlimited consultations are subject to fair usage policy

* This benefit will be extended only for employees who have completed the nomination in system
and selected standard plan during nomination window period. Employees who have not visited
the portal during the nomination window period will not be eligible for 4 free consultations.

As per the fair usage policy any Unlimited consultation will be limited to 8 monthly consultations.

This benefits / services to be availed only by Infosys employees who have subscribed to the
respective top up plans, which include their spouse and children only. Any misuse of service would
lead to disciplinary action including termination of employment.

General Exclusions:
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Any cosmetic procedures are not covered in wallet. (All cosmetic related consultations or
diagnostics, and medicines (unless called out in inclusion) are not covered. Cosmetic Surgery or
Treatment means surgery or medical treatment solely or primarily to improve or preserve physical
appearance, but not physical function or treatment of an underlying ailment/conditions (Example
- Chemical peel treatment, Laser hair removal and others. The exact nature of the procedure will
be determined by program administrators at the time of processing the claim.)

• All non-medical expense or standard deductions incurred during inpatient hospitalization

or daycare treatments will not be covered under wallet.
• IPD related expenses are not covered in wallet.
• IVF, Infertility related treatments are not covered.
• Treatment related to obesity are not covered.
• Naturopathy and related treatments/expenses are not covered.
• Physiotherapy expenses are not covered.
• Cosmetic, Hair fall, Skin related, Smoking Cessation/Alcohol/Drug related, Infertility,
Alternate medicine related tests will not be approved even with valid prescription.

All services covered can be availed through cashless mode only on MB platform
(Reimbursements not applicable)

Services as updated in wallet can be availed from first week of August 2024 till June 30, 2025.
All services should be scheduled and completed by June 30, 2025. Any unutilized wallet amount
will not be carried forward to the next policy period and would lapse.

In case of separation of employees from Infosys, wallet amount will lapse on the date of separation
and there is no provision to port the same to any other corporate / market policy.

Detailed mailer will be sent to employees post the window closure on the process to avail the
service

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Service Inclusion Exclusions

Prescribed Pharmacy - Medicine Prescribed with valid prescription are Non prescribed medicines, FMCG
Restricted to 50% of total covered (Coverage excludes the Medicines products, devices, Food supplements,
wallet amount which are on the Exclusion list) Dietary Pills, Cosmetics, Pimple & Acne,
Hair fall, Skin care, Weight loss, Ayurvedic
products, non-consumables (syringes,
needles, etc.), Hygiene products
(Pads/Menopause/Period related,
Toothpaste, mouthwash, masks,
sanitizers, etc.), Alcohol/drug abuse,
infertility related medicines will not be
approved even with valid prescription.
Doctor Consultation - In 1. All Specialty for Offline consult is covered AYUSH is not covered
Person 2. Slots and appointment confirmation is purely
on Doctor's availability
Lab Tests/Health Check 1. All Prescribed lab test are covered Cosmetic, Hair fall, Skin related, Smoking
(Coverage excludes the Lab test which are on Cessation/Alcohol/Drug related, Infertility,
the Exclusion list) Alternate medicine related tests will not be
2. Curated preventive health check packages approved even with valid prescription.
can be availed without prescription
3. Both Center visits and Home sample pick up
Health check and Labs are available on the
platform
MediBuddy Gold Coverage of family members will be enrolled Excludes Oncology, Cardiology,
dependents Neurology, Pulmonology, Nephrology,
Urology, Psychiatry, Psychology
Dental 1. Dental Consultation is covered Following procedures are not covered (Ex.
2.Only dental procedures that are booked with Surgery, Implant, Braces, and any
valid prescriptions from a registered medical Cosmetic procedures meant for
practitioner (Dentists) through online network beautifying purpose)
providers only
3. Coverage: X-ray, Filling, RCT, Extraction,
Scaling, Polishing and Crowning are covered.
Vision Prescribed Powered glasses and Powered Frames not covered, Procedures not
lenses are covered covered, Sunglasses are not covered

Flex Wallet - In network only (no Example / Explanation

reimbursement)
Prescribed Pharmacy - In case of fever, if doctor prescribes antibiotics, the said prescriptions to
Restricted to 50% of wallet be uploaded in the app for availing the medicine
MediBuddy has partnered with TATA 1Mg and Apollo
Health Check Packages Different packages are available on health check for employees to
choose from
Dental ( cosmetic excluded) Eg: Root canal treatment, extraction, etc. can be availed
Vision (Prescribed powered Prescribed powered contact lens / powered glass can be purchased
contact lens / glass only) using the wallet. MediBuddy partnered with Lenskart and Specsmaker
Lab Test Prescribed lab tests only
Doctor Consultation - In Person Eg: Apollo is a network provider, browsing the MediBuddy app can select
the desired specialist in your location and avail the service
Vaccination Prescribed children vaccination in network hospitals / clinics only
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Diet & Nutrition Online program conducted by MediBuddy through Nutritionists

Doctor Consultation Benefits – Unlimited*

Online Doctor Consultation Online doctor consultation through the app only.
(General Practitioner) - App
based
Dental Consultation (Network Free consultation only in network dental clinics
only)
Online Doctor Specialty Online Specialist doctor consultation through the app only.
Consultation - App based
*Unlimited is restricted as per fair usage policy i.e if the consults go beyond 15 numbers a month,
services will be stopped and reported to HR for action.

Escalation Matrix: Wellness (Medibuddy)

Escalations Name Email Id Contact No
First Level Helpline number (24*7) hello@medibuddy.in 999-999-1555
Whatsapp (7 am to 9 pm) 8884336668
Second Level Kailash Infosyssupport@medibuddy.in 8884336668

Third level Denish Singh denish.singh@medibuddy 6366569459

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FAQ- Health Check up

1. How should I book an appointment for a Health Checkup?

You can book an appointment via the following steps:
• Choose your city.
• Choose your package.
• Confirm tests in your package.
• Centre visit: Choose a date, time and location.
• Home sample collection: Enter your pin code and choose a date and time.
• Add additional tests if needed.
• Book tests for family members
• Confirm your contact information.
• Appointment confirmed.

2. Can you help me with my insurance claims?

For Claim related queries contact MediBuddy corporate customer care 08068239354

3. What are the lab centers that are tied up with MediBuddy?
MediBuddy has tied up with many labs’ centers Like Apollo, Suburban, Aarthi scan center, Fortis,
and Manipal.

4. When will I receive my Health Check-up reports? What is the TAT?

Your Health Check-up report shall be available for download within 24 to 48 Hours.

5. Where to I find the Reports on the app?

Steps to download the report on the application:

• Select the Profile icon on the top-right corner.

• Select Track orders.
• Select Download Report

6. After booking the lab test do I have an option to cancel/reschedule my appointment?

Yes, you can: we have the option to reschedule/cancel the appointment, you can reschedule
your appointment by clicking on the Reschedule TAB on the application
• Select the Profile icon on the top-right corner.
• Select Track orders.
• Select Re-schedule.

7. Do you guys have a cash on delivery (COD) option?

No, we don’t have COD Option, we are providing only prepaid service.

8. How many days in advance do I need to book an appointment?

This depends on the availability of the diagnostic centers. Usually, you can book your health check
one day prior for next day booking before 4:00PM

9. Can an appointment be canceled? And how do I cancel it?

YES, follow these steps for the same.
• Select the Profile icon on the top-right corner
• Select Track orders
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• Select Cancel

10. What should I do before a Health Check-up?

You must follow the mentioned practices before a Health Check-up:

• Unless otherwise specified, you must fast overnight for 12 hours before the appointment.
Only water can be consumed.
• Avoid smoking or consuming alcohol for a minimum of 24 hours before the Health
Check-up.
• Women should not undergo Health Check-ups at the time of menstruation.
• Pregnant women should not undertake X-Ray.
• You may carry urine & stool samples in a sterilized container obtainable from the nearest
pharmacy. (if applicable)
• Specific to Centre visit Health Check-up:
• Registration is mandatory at the medical center; this may take 15-20 minutes.
• Health Check-ups at your medical center may take 4-5 hours on weekdays and 5-6
hours on Saturdays. Kindly plan accordingly

11. Refund: In case of advance payment, will I be refunded for not making an appearance
on the appointment date?
YES, Sponsored Health Check-up Packages will be available for booking again instantly,
Payments made through a payment gateway, or a wallet will be refunded within 24 to 48 Hours.

FAQ - Pharmacy
1. Can we buy over the counter (OTC) products using the Wallet amount?
OTC products are not available and cannot be purchased using the MediBuddy wallet.

2. How can I reach out if I'm facing an issue?

You can connect with us via WhatsApp at 8884336668. Simply send us your query, and we will
provide an instant solution between 7 am to 9 pm.

3. Will I be able to place medicines order without a prescription?

No, you cannot get medicines without prescription.

4. Can I track my medicine order?

Yes, you can track your medicine order. To get an estimated time of arrival (ETA), please call our
customer service number.

5. Can I place an order for Ayurvedic medicine?

No, we do not provide Ayurvedic medicine.

6. Why is the TAT time 24-48 hours?

TAT is usually 24 to 48 Hours in Tier 1 and 2 Cities, However the delivery TAT might vary on Tier
3 and interior locations we might not be able to extend the service.

7. Can I pay cash on delivery?

No, you will only be able to pay through the link we share. We also offer multiple online payment
options.

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8. What is the eligibility of Medicine order?

a. Medicines may be purchased with Valid Prescriptions from a registered medical
practitioner only, only quantities mentioned in the prescription shall be availed. FMCG
products & Devices not covered.
b. Exclusions: Food supplements, Dietary Pills, Cosmetics, Pimple & Acne, Hair fall, Skin
care, Weightloss, Ayurvedic products, non consumables (syringes, needles, etc.),
Hygiene products (Pads/Menopause/Period related, Tooth paste, mouthwash, masks,
sanitizers, etc.), Alcohol/drug abuse, infertility related medicines will not be approved
even with valid prescription.

9. Is there any restrictions on usage of my flex wallet for pharmacy orders?

Yes, you can utilize upto 50% of the wallet amount for pharmacy orders according to the top
up plan you have opted for. Eg: If you have selected Titanium plan and 5000 being your wallet
point, you can use upto 2500 points only for pharmacy orders.

FAQ Online doctor Consultation

1. How does online doctor consultation work?
Online consultation is the easiest and the most convenient way to get access to Doctors at the
comfort of your home, you can take any medium of conversation chat, call and Video call to
interact with the Doctors anywhere at any place, In MediBuddy you get this feature of taking with
any of the MD level doctors on over 26 specialist department and diagnose your problems with
them at the comfort of your home, Doctor available for you 24*7.

2. How will the doctor connect to me?

MediBuddy has provided you with the facility that you need not have to call the doctor as soon as
you book an appointment on the application the doctor will be contacting you within 30 minutes
the medium of interaction between you and the doctor will be by chat call and Video call any of
your preference.

3. What is the qualification of your doctors?

MediBuddy doctors are mostly MBBS, MD and few DM level doctors with an experience of over
6+ years and are working in prestigious hospitals like Apollo, Fortis, Manipal ETC

4. Can I get Lab test done from MediBuddy post consultation? If yes, what is the TAT?
Yes, MediBuddy provide Lab facility as well that too with free home sample pick up, which means
the sample pick up will be done free of cost at the comfort of your home and once the sample has
been picked up you will get the report within 24 to 48 hours in your MediBuddy application and
on your registered email address.

5. How can my family members take consultation?

You just must add your family members name and your relation on the application, and they also
can take the consultation with all the 26 departments available with us.

6. In which departments will I get help?

MediBuddy has 26 departments available, starting from General Medicine, Orthopedics, Corona
Virus, Gynecologist, Psychiatry, Pediatrics, Dermatologist, ENT, Sexologist, Weight
management, Neurology, Oncology, Cardiologist, Ophthalmology, Nephrology, Diabetes consult,
Pulmonology

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FAQ- Vision

1. How should I book a Vision Order?

You can book your Vision order from the MediBuddy application, Once booked you can either
visit the store or opt in for Home delivery

2. Who all are your providers?

We have tie up with Lenskart and Speckmakers and service available in most part of India.

3. How is the booking procedure?

You can book your lenses from the application and select your provider once completed you will
receive a link to select your lenses from the provider website, also you will receive a coupon which
you will use at the provider website to place the order (The coupon will be equivalent to the amount
of your lenses which will be deducted from your corporate MediBuddy wallet)

4. What all I can order here?

a. Only powered lenses & powered contact lenses are covered (Frames are not covered)
Submission of Prescription is mandatory.
b. Procedures are not covered.

5. Is cataract / any other eye procedure covered under wallet?

No, any eye surgery / procedures cannot be covered under wallet.

FAQ - Dental
1. Is dental treatment covered under my insurance policy?
Yes, if your plan has dental benefits, covers dental treatment on a cashless basis, you can receive
treatment at a network hospital or clinic only.

2. What types of dental treatments are typically covered and what are the limits?
Only dental procedures that are booked online through network providers with valid prescriptions
from a registered medical practitioner (Dentists) will be accepted. Limits are linked to your wallet
balance.
Coverage: X-ray, Filling, RCT, Extraction, Scaling, Polishing and Crowning are covered.

3. What types of dental treatments are NOT covered?

Following procedures are not covered (Ex.Surgery, Implant, Braces, and any Cosmetic
procedures meant for beautifying purpose)

FAQ - Offline Consult

1. How it Works?
You can book your appointment with Doctors from Hospitals nearby to your location from the
MediBuddy application and visit the center at the appointment date and complete your
consultation.

2. Do I have to pay the consultation amount on the Hospital?

No, Your bookings and payments everything will be done on the MediBuddy Application (subject
to the availability of wallet balance, else differential amount might have to be paid), You just need

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to visit the center and complete your consultation and upload your prescription given to you by
the Doctor on the application

3. Can I choose my family Doctor for the offline consultation?

Yes, MediBuddy has onboarded Doctors from all over India, If your family Doctor is available on
MediBuddy app, you can book an appointment and avail the services.

4. Will I be getting the prescription on the application after the consultation?

You will receive the prescription at the time of the consultation with the doctor, however you would
need to upload the prescription on the MediBuddy application in order to complete the
consultation

5. Is treatment under AYUSH covered?

No, treatment under AYUSH not covered.

FAQ- Vaccination

1. How it Works?
Search for required Vaccine and select Hospital of your choice. Choose your preferred Date and
Time. Visit Hospital as per your booking.
Get the Vaccination!

2. What all vaccinations are covered?

Child & Adult vaccinations are covered as per WHO guidelines only.

3. Do I have to pay the Vaccination amount on the Lab?

All your bookings and confirmation will be done from the application, once you book the
vaccination price will be automatically deducted from your wallet

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