Insurance FAQs 2023-24

1. What is the coverage period? Policy coverage period is from 9th November 2023 to
8th November 2024.

2. Who is our current TPA (Third party administrator) and Insurance company?
For the current policy (9th November 2023 to 8th November 2024) our TPA is Vidal Health
Insurance TPA Pvt Ltd and Insurer is Niva Bupa Insurance company.

3. What do I do if unable to login into Enrolment portal? Please take a screen shot of
the error and send it to ericsson.portal@vidalhealth.com.

4. Is claim intimation mandatory for a reimbursement claim?

Yes, Claim intimation is mandatory for all the hospitalization reimbursement claims. You need
to intimate claim by writing on ericsson.claims@vidalhealth.com including below mentioned
details.

1. Emp Code , Name, Signum ID

2. Patient Name

3. Hospitalization details i.e (Hospital Name, Date of admission, Estimated

expenditure & ailment.

4. Mediclaim Ecard copy,

5. Contact Number

5. In the absence of e-cards, can I still avail the benefits?

In the event employee does not have the e-card(s), please reach out to location SPOC. They
would provide the required assistance. Else, drop in a mail to
ericsson.claims@vidalhealth.com

6. What is the criteria on which the premium amount will be deducted?

The GTL top up premium will be deducted in 2 equal installments in Dec ’2023 and Jan 2024
payroll while GMC ESC Top up, GMC Parental Top-up, Parent-in-law Base & Top-up
premium will be charged in 4 equal instalments from your payroll, 25% each in Dec 2023,
Jan 2024, Feb 2024 & March 2024. This is applicable for existing employees only. For new
joiners deduction will be done on pro rata basis from the date of joining till 08 Nov 2024 as a
one time deduction in subsequent month.

7. What is the top up limit for sum insured under Mediclaim Employee policy? The
minimum option available is INR 1 Lac and maximum available is INR 10 Lacs.
8. Can an employee get his guardians enrolled under the parents policy? This policy
is strictly meant for benefits for employee’s parents (father and mother) and parents-in-
law (father-in-law and mother-in-law) only

9. What are the new changes introduced for parents and parents in law?
INR 3 Lacs family floater Sum Insured for Parents (Father & Mother), fully
funded by Ericsson. Employees can avail a top-up from INR 1 Lac to 5 Lacs (over and above
3 Lacs, already included) by paying extra premium. Parents in-law coverage will be remains
voluntary as is and premium for voluntary inclusion of Parents-in-Law (Base + Top-Up) will
be borne by employee. Therefore, employees can avail a Top up from 1 Lac to 5 Lacs.
Employees opting top up for parents / in- law need to select the same Top-Up Sum Insured
(SI) for both parents and in-laws.

10. Would employee be eligible for tax exemption for both, parents as well as parents
in-law if all of them are enrolled?
No, as per the income tax guidelines, one can get tax exemption, only for parents and not for
parents-in-law.

11. What is the maximum limit of tax exemption employee can avail under this policy?
Under Section 80D, employee will get tax benefit for the premium paid towards the
parent policy up to a limit of INR 25,000. There is of INR 50000 in case of parent(s)
being senior citizens. Senior Citizen – Parents who are 60+ as on 09th Nov 2023.

12. What is the waiting time to claim insurance for new Joiners?
The policy covers employee from date of joining hence, there is no waiting period applicable.

13. What are the deductions on the claims?

The deduction includes 10% copayment and NME (Non Medical Expenses) which has to be
paid by the insured.

14. I had covered my father last in the 2022-23 policy and had not taken the claim this
year. What will be the co-pay if I cover him for the 2023-24 policy?
The co-pay will be 10%. The co-pay of 5% is only applicable for the first claim registered in
2023-24 for employees who had covered parents in 2021-22 and 2022-23 policy and have
not claimed for these 2 years.

15. Is Dental Treatment covered?

Dental coverage (treatment) arising due to any illness / Injuries subject to medical indication
except cosmetic treatment (hospitalization claims only, Dental OPD is not covered) up to INR
1 Lac per annum within family floater sum insured.

16. Can you explain what is covered in Infertility?

Infertility / IVF treatment coverage over & above maternity limit on OPD/IPD basis up to INR
1.5 lacs.
17. What kinds of costs are borne by the company in case of surrogacy?
Surrogate mother to be covered for delivery expenses only subject to overall maternity limit
including pre or post hospitalization expenses if any. Coverage only if baby is for insured
member.

18. Will transportation cost be paid for sending sample overseas for breast cancer
treatment? Only sample testing cost will be paid. No transportation cost will be
considered.

19. I had removed my parents last year voluntarily. If I cover them this year will there
be a waiting period?
Yes, 60 days waiting period will apply if you cover them this year.

20. I need policy copy for GTL and personal accident.

Please visit the Local Instruction Page for details. As this is a corporate policy and cannot be
given to individuals.

23.How can I claim for the Ayush Treatment?

Ayush Coverage up to family floater S.I on both IPD/OPD basis currently for employee
policy.
Ayurvedic / homeopathic / naturopathy treatment - restricted to 30% of base S.I covered on
IPD basis in registered govt. hospitals only "The Insurance company shall pay to the medical
expenses or reimburse the insured in respect of the medical expenses pre and post
hospitalization expenses, incurred for Ayurveda and Homeopathy treatment up to the limit as
mentioned in the Table of Benefits provided treatment is taken in a government hospital or in
an institute recognized by the government and/or accredited by Quality Council of India/
National Accreditation Board for Health". This benefit is for parents and parents in law policy.

23.I have missed adding the parents during the enrollment window, can I add anytime
during the year?
Enrollment is a one-time activity; midterm addition is not allowed. You will get the option to
add the parents again in the next year cycle.

24. Can an employee take the top-up policy for parents and parents in law? Yes,
Top-up is allowed for parents and parents in law from 1 lakh to 5 lakh sum insured.

25. My date of discharge is after 8th November 2023, which policy will the claim fall
under?
Date of discharge is not of concern for claims processing, claims are processed as per your
date of admission.

26. I do not have the E-card for the current policy 2023-24, how can I avail of
cashless hospitalization?
You can connect with the location SPOC and he will assist you further for the cashless
process.