Hello,

Welcome to Saamarthya Family!

A monthly insurance premium deduction is made to the payroll of every Saamarthya employee. The
following insurance benefits are available against the insurance premium paid.

Group Personal Accident Insurance

The personal accident insurance provides cover in the event of disability or death resulting from an
accident.
Coverage:
# Rs. 5,00,000 per employee, provided by ICICI Lombard.
Benefits:
# Coverage for Accidental Death - Rs. 5,00,000.
# Coverage for Permanent Total/partial Disablement, Temporary Total Disablement - Rs.
5,000 per week .
# Children education welfare fund for dependent children in case of death of employee up to
Rs. 10,000 per child (Restricted to 2 children)
# Carriage of Dead Body 2% of SI subject to max to Rs 2500/# Terrorism is covered, however, terrorism activity arising out of Nuclear, Biological and/or
# Exclusions
Suicide, attempt to Suicide or intentionally self- inflicted injury, sexually transmitted
conditions, mental disorder, anxiety, stress or depression. Being under influence of drugs,
alcohol, or other intoxication or hallucinogens Participation in actual or attempted felony,
riot, civil commotion, crime misdemeanour Committing any breach of law of land with
criminal intent. Death or disablement resulting from Pregnancy or childbirth

How to avail:
Please inform your family of the available benefit. You or your family should get in touch with
Sammarthya s HR Helpdesk will provide support on the claims process.

Group Health Insurance

The Group Health Insurance covers the hospital admission, doctor's fees, and other medical
Expenses in case of the employee suffering from an ailment that result into a hospital admission of
more than 24 hours except some treatment covered day care procedure.

Coverage:
# Rs. 2, 00,000 from ICICI Lombard (Policy covers Pre Exiting Disease from Day One)

Benefits:
# Room rent of Rs. 2,000 for normal admissions and Rs.4, 000 for ICU is
covered
# Following Indoor-patient treatment are covered up to Sum Insured of 2 Lacs
(If insured is admitted in a higher category, then insured will bear difference of all
medical
expenses as in final hospital bill in same proportion.)
o Surgical operations, including pre and post-operative care
o Nursing care, drugs and surgical dressings
o Doctors' fee
o Operation Theatre charges and intensive care
o Pathology, X-rays, diagnostic tests and therapies
o Prosthetic implants
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Pre hospitalization 30 days and post hospitalization 60 days expenses including doctor's
Consultation, diagnostic tests, medicines, drugs etc. are covered up to sum insured of 2 Lacs
Emergency ambulance for Rs 1000 per hospitalization is covered
Maternity is not covered under this policy
24 hours hospitalization (In-patient treatment) is mandatory to claim the medical benefit
Any Dental expenses not covered in policy

TPA: ICICI Lombard Healthcare

Health Cards: Physical Health Card to be issued

How to avail:
The Health Insurance Card from ICICI Lombard will be provided to employees within 45 days of
joining subject to the necessary documents uploaded by them within a week of joining. Please
present the card at your hospital at the time of admission and the hospital will provide cashless
coverage if the hospital is part of the ICICI Lombard panel (you can search hospital list as per

below link)
https://www.icicilombard.com/Content/ilom-en/Hospital_list/search.asp .
If the hospital is not part of the panel, you will have to pay the expenses and raise a claim on the
insurance company for reimbursement.
In case of any difficulty, please contact the HR helpdesk

Disclaimer:
Please note that Saamarthya only assists in employees getting access to the above insurance plans,
and all insurance coverage is a contract between the employee and the insurer. Saamarthya is
working as facilitator but not responsible or liable for any claims if the insurer is not able to, or
declines to, provide coverage for any claim that might or might not be valid or eligible under the
insurance schemes.