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Nadakkavil Hospital
Insurance Department
The insurance help desk of Nadakkavil Hospital is always available to assist you. he department can be contacted at +91 8156 803 123
KASP - KARUNYA AROGYA SURAKSHA PADHATHI
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“KARUNYA AROGYA SURAKSHA PADHATHI (KASP) is the health care scheme which aims at providing a health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to over 42 Lakhs poor and vulnerable families (approximately 64 lakhs beneficiaries) that form the bottom 40% of the Kerala population”. State of Kerala decided to converge all the Government sponsored health care schemes namely RSBY (Central and State Government combined scheme, where the premium is shared in the ratio 60:40), Comprehensive Health Insurance Scheme-CHIS (Kerala government fully sponsored scheme i.e. full premium paid by the State), Senior Citizen Health Insurance Scheme-SCHIS (all the senior beneficiaries aged 60 years and above in the RSBY/CHIS families were provided additional coverage of Rs 30,000 per beneficiary) and Karunya Benevolent Fund-KBF (Trust model implemented through Lottery department) along with Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY) and formulated Karunya Arogya Suraksha Padhathi (KASP).
Ayushman Bharat PM-JAY is the largest health care scheme in the world which aims at providing a health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to over 10.74 crores poor and vulnerable families (approximately 50 crore beneficiaries) that form the bottom 40% of the Indian population. The households included are based on the deprivation and occupational criteria of Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas respectively. PM-JAY was earlier known as the National Health Protection Scheme (NHPS) before being rechristened. It subsumed the then existing Rashtriya Swasthya Bima Yojana (RSBY) which had been launched in 2008. The coverage mentioned under PM-JAY, therefore, also includes families that were covered in RSBY but are not present in the SECC 2011 database. PM-JAY is fully funded by the Government and cost of implementation is shared between the Central and State Governments. State of Kerala signed an agreement with NHA on 31st October 2018 and constituted State Health Agency (SHA) for implementing the scheme in the State as Karunya Arogya Suraksha Padhathi (KASP).
From 1st July 2020, the scheme will be implemented directly by Government of Kerala under trust mode (through the newly constituted State Health Agency (SHA)). The claims of Private Empanelled Health care Providers will be serviced by a TPA/ISA. The TPA selected through tender process is Vidal Health TPA Services Pvt. Ltd.
Key Features of KASP – PMJAY
- Health care scheme fully financed by the government.
• It provides a cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization across public and private empaneled hospitals.
• KASP – PMJAY provides cashless access to health care services for the beneficiary at the point of service, that is, the hospital.
• KASP – PMJAY envisions to help mitigate catastrophic expenditure on medical treatment.
• It covers up to 3 days of pre-hospitalization and 15 days post-hospitalization expenses such as diagnostics and medicines.
• There is no restriction on the family size, age or gender.
• All pre-existing conditions are covered from day one.
• Benefits of the scheme are portable across the country i.e. a beneficiary can visit any empanelled public or private hospital in India to avail cashless treatment.
• Services include approximately 1,573 procedures covering all the costs related to treatment, including but not limited to drugs, supplies, diagnostic services, physician’s fees, room charges, surgeon charges, OT and ICU charges etc.
• Public hospitals are reimbursed for the healthcare services at par with the private hospitals.
Benefit Cover under KASP – PMJAY
Benefit cover under various Government-funded health insurance schemes in India have always been structured on an upper ceiling limit ranging from an annual cover of INR30,000 to INR3,00,000 per family across various States which created a fragmented system. KASP – PMJAY provides cashless cover of up to INR5,00,000 to each eligible family per annul for listed secondary and tertiary care conditions. The cover under the scheme includes all expenses incurred on the following components of the treatment.
- Medical examination, treatment and consultation
• Pre-hospitalization
• Medicine and medical consumables
• Non-intensive and intensive care services
• Diagnostic and laboratory investigations
• Medical implantation services (where necessary)
• Accommodation benefits
• Complications arising during treatment
• Post-hospitalization follow-up care up to 15 days
The benefits of INR 5,00,000 are on a family floater basis which means that it can be used by one or all members of the family. The RSBY had a family cap of five members. However, based on learning’s from those schemes, KASP – PMJAY has been designed in such a way that there is no cap on family size or age of members. In addition, pre-existing diseases are covered from the very first day. This means that any eligible person suffering from any medical condition before being covered by KASP – PMJAY will now be able to get treatment for all those medical conditions as well under this scheme right from the day they are enrolled.
STAR HEALTH ALLIED INSURANCE
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Star Health and Allied Insurance Co Ltd is an Indian multinational health insurance company headquartered in Tamil Nadu, Chennai. The company provides services in health, personal accident and overseas travel insurance, directly as well as through various channels like agents, brokers and online.
List of information and advantages being with Star Health
- Protection for – Individual / Families on Floater Basis
- Sum Insured (INR) – up to 2 crores
- Innovative Products – Customer-Centric Policies
- Hassle-Free Claims – 90% in less than 2 hours
- Cashless Facility – 12000+ Network Hospitals
- In-house Claim Settlement – On all 365 days by Qualified Doctors
- Digital Platform – Highly sophisticated website
- Pre-insurance Medical Screening – Not Mandatory in most of our Policies
SAFE WAY INSURANCE Pvt.Ltd
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We have been licensed by I.R.D.A. As TPA in July 2005, and have setup our head office in New Delhi.
We are fully equipped with I.T infrastructure like Server, Computers, Printers and a State of the Art Software. We have a fully qualified and professional team of ex-Insurance industry professional and Doctors for running our Operations. We are equipped with latest IT infrastructure to meet out all requirements. Our website (www.safewaymediclaim.com) is well designed to provide comprehensive information to the Insured and the Insurer. We have tie up with more than 5,500 hospitals over the length and breadth of the country for giving cashless services to policyholders. Our Software is fully capable of handling claims and has ability to generate tailor made MIS reports/statistics as required by Insurance Companies/Organizations and other governing bodies like IIB, TAC & IRDA etc.
Reliance General Insurance
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Reliance General Insurance Company Limited is a vital part of our healthcare services here at Nadakkavil Hospital. As a trusted member of the Reliance Anil Dhirubhai Ambani Group, the company’s commitment to excellence is evident. With its inception in 2000, Reliance General Insurance Company Limited has become a cornerstone in India’s healthcare sector, offering a comprehensive range of insurance products.
With a dedicated team of over 3800 employees, Reliance General Insurance Company Limited has earned the trust of over 300 Crore customers. Their portfolio includes more than 100 insurance products, covering various aspects such as motor, health, home, travel, and marine insurance, among others.
In collaboration with Nadakkavil Hospital, Reliance General Insurance Company Limited provides a wide array of health insurance plans to cater to the diverse needs of our clients. These plans include group mediclaim health insurance policies, critical illness coverage, individual plans,
HDFC ERGO™ Insurance
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Established in 2002, HDFC ERGO General Insurance Company Limited extends a comprehensive array of insurance services at our esteemed Nadakkavil Hospital. Offering a diverse range of general insurance products, including health, travel, automobile, and personal accident coverage in the retail sector, as well as tailored solutions such as property, liability, and marine insurance for corporate needs, HDFC ERGO stands as a reliable ally in safeguarding your well-being.
With a vast clientele exceeding 1.5 crore individuals, this esteemed institution is a collaborative effort between HDFC and ERGO International AG, headquartered in Mumbai, Maharashtra. Staffed by a dedicated team of over 9700 professionals spread across the nation, HDFC ERGO General Insurance remains committed to serving its patrons with integrity and efficiency.
Boasting an extensive network of over 200 branches spanning across 170 Indian cities, HDFC ERGO General Insurance prides itself on its swift claims settlement process, resolving an average of one claim per minute. Impressively maintaining a commendable claim settlement ratio of 95% throughout 2023, the company ensures prompt assistance during times of need.
At Nadakkavil Hospital, we are pleased to offer HDFC ERGO’s comprehensive health insurance plans, tailored to cater to diverse needs, from basic coverage to critical illness and specialized cancer care. With exclusive plans designed for women, families, and senior citizens, HDFC ERGO prioritizes inclusivity and accessibility in its offerings.
ICICI Lombard Insurance
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At our Nadakkavil Hospital, we’re proud to partner with ICICI Lombard General Insurance Company, a trusted name in the insurance industry since 2001. Founded through a joint venture between Fairfax Financial Holdings Limited and ICICI Bank, this esteemed insurer offers a comprehensive array of services, spanning liability, engineering, health, auto, crop, fire, personal injury, and marine insurance. With a rich history spanning over two decades, ICICI Lombard embodies a commitment to customer-centric values, epitomized by their brand philosophy, “Nibhaaye Vaade.” Over the years, they have settled more than 3.6 million claims, showcasing their reliability and integrity.
In the realm of healthcare, ICICI Lombard Health Insurance stands out for its exemplary offerings. Catering to diverse needs, their policies such as Health Booster and Health AdvantEdge provide comprehensive coverage for individuals and families alike. What sets ICICI Lombard apart is their streamlined application process, where no medical checkup is required, ensuring accessibility and convenience for all. With a strong emphasis on quality healthcare solutions, ICICI Lombard is a trusted partner in safeguarding the health and well-being of our patients.
SBI General Insurance
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At Nadakkavil Hospital, we are proud to partner with SBI General Insurance to offer a range of insurance services that prioritize trust and security for our patients. SBI General Insurance has been a leader in the insurance industry since its establishment in 2009, expanding its presence to over 141 branches across India. With a strong commitment to customer service, SBI General Insurance has served over 55.55 crore customers, earning prestigious awards such as the ‘Insurer of the Year’ at the FICCI Insurance Industry Awards.
Our partnership with SBI General Insurance allows us to offer a diverse range of insurance products tailored to meet the needs of our patients. Through our robust multi-distribution model, including Bancassurance, Agency, Broking, Retail Direct Channels, and Digital tie-ups, we ensure that insurance services are accessible to all. With a wide network of distributors, including 23,000 plus SBI branches, agents, and digital partners, we can reach even the most remote areas of India.
Whether you are an individual looking for personal insurance or a business seeking corporate solutions, our partnership with SBI General Insurance ensures that you have access to the best insurance products and services.
CHOLA MS Insurance
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Nadakkavil Hospital is proud to partner with Cholamandalam MS General Insurance Company Limited, a trusted name in the insurance industry. This joint venture between the Murugappa Group, India, and Mitsui Sumitomo Insurance Company Limited, Japan, offers a wide array of insurance products tailored to meet the diverse needs of our patients and their families.
With a focus on providing exceptional service and support, Chola Health Insurance Company, a part of Cholamandalam MS, simplifies processes and ensures a seamless customer experience. Their comprehensive health insurance plans cover hospitalization, critical illnesses, super top-ups, and daily benefits, providing our patients with peace of mind during challenging times.
Cholamandalam MS Health Insurance Company’s commitment to excellence has earned them recognition and awards, including the Best CSR Practice Award, Golden Peacock Award for Risk Management in 2017, and being named one of the Dream Companies to Work for in the Private Insurance Sector. With 87 branches and over 34,000 agents nationwide, they are dedicated to serving our community with integrity and compassion