Manipal Cigna

CORONAVIRUS (COVID-19)

BACKGROUND

What is coronavirus?

    Coronaviruses are a large family of viruses found in humans and animals. Some can infect humans and are known to cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS)

How is the coronavirus transmitted?

    Most often, spread from person-to-person happens mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza spreads. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled in to the lungs.

What are the symptoms of coronavirus?

    Symptoms can include fever, cough and shortness of breath. The Center for Disease Control and Prevention (CDC) believes that symptoms of COVID-19, may appear in as few as 2 days or as long as 14 after exposure at this time.

MANIPALCIGNA COVERAGE & INFORMATION

Do ManipalCigna Health Insurance policies cover medical expenses related to coronavirus?

    Yes, ManipalCigna’s comprehensive health insurance policies cover hospitalisation expenses arising out of coronavirus. Please refer to the terms and conditions for details of the coverage you are entitled to in your plan.

These days viral infections are very common, do ManipalCigna plans help financially in treating such ailments

    Yes. Buying a health insurance plan not just for yourself but for your entire family is important to make sure your hospital admission and treatment expenses are covered seamlessly.

Are there any waiting period applicable for viral infections like Ebola, H1N and now coronavirus?

    Our indemnity plans covers outpatient treatments (OPD) without any waiting period. A claim for diagnosis and treatment on OPD basis can be made in accordance with the claims procedure mentioned in the policy wordings. In case of hospitalization on account of COVID-19, the hospitalization expenses incurred will be covered provided the illness is contracted after completion of 30 days in case of a fresh policy. In case of a policy that has been renewed continuously without a break 30 days of waiting period will not be applicable.

RELAXATION OF MANDATORY CO-PAY FOR CLAIMS RELATED TO COVID-19 TREATMENT

What is Mandatory Co-pay?

    Mandatory co-pay is a compulsory Co-payment of 20% applicable on all claims for Insured Persons aged 65 years and above irrespective of age of entry in to the Policy. For persons who have opted for a Waiver of Mandatory Co-pay the same will not apply.

What is Mandatory co-pay waiver for COVID-19?

    In a first-of-its-kind initiative, ManipalCigna Health Insurance has waived mandatory co-payment to provide Senior Citizens aged 65 years and above, a cushion against COVID-19 treatment.

    ManipalCigna will waive the mandatory co-payment clause for senior citizens aged 65 years and above covered under ManipalCigna ProHealth Insurance policy, on all treatments arising due to Coronavirus (COVID-19). This is to safeguard the most vulnerable population of our society and ensure that the cost is not a barrier for them in getting the care they need related to COVID-19 treatment.

Who is eligible for this Mandatory co-pay waiver for COVID-19?

    1. This relaxation will apply to all ProHealth Insurance policies covering insured aged 65 years and above, enforced on or before 30th April 2020.
    2. Waiver will apply only to claims including pre and post hospitalization expenses related to Coronavirus (COVID-19) treatment.
    3. Date of hospitalization shall be between the period of 30th April 2020 to 31st August 2020.

I have ProHealth Plus Plan, my age is 35 years and I have selected Voluntary co-pay option. Am I eligible for Mandatory co-pay waiver for COVID-19?

    No, this relaxation will apply only to:

    1. All ProHealth Insurance policies where the insured is aged 65 years and above.
    2. Policy is enforced on or before 30th April 2020.
    3. ‘Waiver of Mandatory Co-pay’ is not opted.
    This Mandatory co-pay waiver is applicable to all ProHealth plans namely – Protect, Plus, Preferred, Premier and Accumulate plan. The waiver of mandatory co-pay is applicable even if voluntary co-pay is opted, provided above conditions are met. But please note, this relaxation is only on mandatory copay and not on voluntary copay.

I have ProHealth Preferred Plan, my age is 66 years, I have selected Waiver of Mandatory co-pay with my policy. Am I eligible for co-pay waiver for COVID-19?

    Since, you had selected waiver of Copay, hence no such mandatory copay is applicable on any claim including the ones related to VOCID 19, you may file with ManipalCigna. However, this relaxation is only for those customers who have mandatory copay applicable in their policies and the relaxation is provided only for a limited period and for COVID 19 related claims only under ProHealth policy(ies) enforced on or before 30th April 2020 with insured aged 65 years and above.

I am 65 years of age; I want to purchase ProHealth Protect Plan now. Am I eligible for co-pay waiver for COVID-19?

    No, this relaxation will apply only to existing ProHealth Insurance policies enforced on or before 30th April 2020 with insured aged 65 years and above

What are the types of claims that are admissible under Mandatory co-pay waiver?

    This relaxation will only apply to claims related to Coronavirus (COVID-19) treatment. ​
    All other claims arising due to illness, injury, disease not related to COVID 19 will be treated as a standard hospitalization claim under ProHealth Insurance policy following all terms and conditions as applicable and will not fall under the purview of this relaxation.

If readmission or prolonged hospitalization happens due to complications of COVID 19, will that be eligible for co-pay waiver for COVID-19?

    Yes, if there is any complication arising due to COVID-19, all such claims will be eligible for this relaxation.

If hospitalization for COVID-19 is before 31st August 2020 but claim is intimated after 31st August 2020, whether it will be eligible for Mandatory co-pay waiver for COVID-19?

    Yes, to qualify for the Mandatory co-pay waiver, date of admission for hospitalization for Covid-19 treatment need to be between the period of 30th April 2020 to 31st August 2020 with both dates inclusive.

If hospitalization for COVID-19 was before 30th April 2020 but claim was made between 30th April 2020 to 31st August 2020, whether it will be eligible for Mandatory co-pay waiver for COVID-19?

    No. In order to qualify for the Mandatory co-pay waiver, date of admission for hospitalization for Covid-19 treatment shall be between the period of 30th April 2020 to 31st August 2020.

    The claim will be treated as a standard hospitalization claim under ProHealth Insurance policy following all terms and conditions as applicable.

If hospitalization for COVID-19 was before 30th April 2020 and claim was also made before 30th April 2020, whether it will be eligible for co-pay waiver for COVID-19?

    No. In order to qualify for the Mandatory co-pay waiver, date of admission for hospitalization for Covid-19 treatment need to be between the period of 30th April 2020 to 31st August 2020.

    The claim will be treated as a standard hospitalization claim under ProHealth Insurance policy following all terms and conditions as applicable.

CLAIM PAYOUT TO CUSTOMER’S BASIS ELECTRONIC SUBMISSION OF DOCUMENTS

I got admitted for some ailment on 28th March 2020, but by then lockdown was imposed in whole country due to COVID-19, due to which I am unable to submit my documents to insurance company. How can I apply for reimbursement of my expenses in this situation?

    To ease the problems faced by customers due to COVID-19 and lockdown, ManipalCigna is providing an option to get your claim processed based on scanned documents. At the moment you are not required to submit original documents to insurance company but rather you can provide us with scanned copies of all your documents with a declaration and get your claim processed.

What all I have to do to get my claim processed on scan documents?

    You are needed to submit scanned and self-attested copies of all your documents along with a declaration form to us to get your claim processed.

Who is eligible for proposed process of claim processing on scan documents?

    . All fresh claims for hospitalization incurred in between 15th March 2020 to 30th September 2020.
    . Claims which are already lodged or old claim which are outstanding due to query raised and customer not able to submit the query responses due to lockdown.

If my hospitalization happened before 15th March but till date I am not able to submit the claim document, can I be eligible for this benefit?

    No, only hospitalization that happened between 15th March to 30th Sept 2020 is eligible.

What if I got admitted before 15th March and that claim was approved by ManipalCigna in cashless but now I want to apply for post hospitalization expenses incurred after 15th March but within my policy limit for length of post hospitalization?

    All post hospitalization bills dated post 15th March 2020 can be claimed basis scanned documents.

I had already submitted my scanned claim documents 1 month back and received message that my claim has been approved but payment is pending for original documents. What can I do as courier services have not yet resumed in my area?

    You have to share your signed declaration form of “submission of original documents post lockdown” with us by either getting it uploaded on medi buddy or through your registered mail Id.

Can I also apply for HMB bills incurred after 15th March 2020 on scanned documents?

    Yes, you can apply in the same way as for Reimbursement claim.

Where does insured need to submit the claims?

    . Direct Upload on Medibuddy portal / Website https://me.medibuddy.in/ OR Download the App Medibuddy from Play store . In case you are not able to access this portal then please reach out to ManipalCigna customer care over call. ​

    . Share scans of claims to your sales agents / ManipalCigna relationship manager over an email through your registered email Id with ManiplaCigna Health Insurance, which will be further taken up for processing.

    . In case the couriers are operational, kindly courier your claims documents to nearest ManipalCigna Branch

How can I log into medibuddy?

    Step 1. Open the web browser and type www.me.medibuddy.in then press enter.
    Step 2. If you are a new user then click on “activate here” tab on right lower side of screen.
    Step 3. Sign up/ activate your medibuddy portal- enter policy holder/ employee name as mentioned in policy copy, date of birth in DD/MM/YYYY format, chose any one option out of three ( emp code, MAID/ Policy no.), enter CAPTCHA code and click on identify and enter the OTP sent on your registered mobile number.

How can I submit my claim in Medibuddy portal?

    Step 1. Once you login to portal, click on submit reimbursement
    Step 2. Enter hospitalization details and click on submit
    Step 3.- click a picture of your document or take scanned image through printer and upload them in medibuddy in their respective headers
    Step 4.- once the scans are uploaded, an intimation/reference number would be generated which will help you to track status of your claim.

What if the mail Id through which I am sending my document is not registered with ManipalCigna Health Insurance?

    In that case, you can reach out to ManipalCigna Health Insurance customer care over call and get your mail Id endorsed with us. You can also get your claim registered through your policy agent.

What is the advantage of uploading documents on medibuddy portal in comparison to sharing over mail?

    . Easy to track as you have your intimation number with you.
    . No need of endorsing mail Id with insurer.
    . Faster processing

What if original claim documents are already submitted in the ManipalCigna branches but still pending at ManipalCigna branch due to lock down?

    ManipalCigna Health Insurance branches are equipped with tool / email through which they can get these documents processed. Please reach out to your agent / customer care

Is there any list of mandatory documents to avail this facility?

    . Consent /declaration of the insured.
    . Claim form ( can be downloaded from our website)
    . Discharge summary
    . Final bill with breakups and receipts,
    . Medicine bills and prescriptions,
    . Investigation reports
    . KYC documents if claim amount more than 1 lac.
    . Cancel cheque

    Each and every page of original documents has to be signed by proposer/ patient before sharing scans for processing.

    Documents should be submitted only through your registered email id registered with us, otherwise your claim won’t be registered.

What is this consent or declaration form and from where can I get it?

    It is Self-declaration by insured that he retains all the original documents and on demand by the Insurer or the TPA he/she shall provide the original documents after the lockdown gets over or the situation gets normalized. Insured is solely liable for the genuineness of the claims submitted online to Insurer/TPA. That the claim has not been made elsewhere to any other insurance company.
    You can get this declaration form from ManipalCigna Health Insurance website

What if I can’t get a print out of this declaration? ​

    A hand written declaration would also suffice

Who need to sign this declaration and original claim documents before scanning them?

    Proposer or patient can sign these documents. ​

How to submit query reply?

    The process for submission of documents of query reply will remain same as above for fresh claims.

ASSISTANCE IN TIME OF COVID-19 PANDEMIC

Claims:

    Cashless Claim:Our cashless claim services continue to be hassle-free experience during hospitalizations. For all emergency hospitalizations, get in touch with your Hospital TPA desk to initiate the cashless process. Please visit the link https://www.manipalcigna.com/claims-process to get detailed information

    Planned Hospitalization: You may raise a cashless request for planned hospitalization using our E- Cashless facility. Give a missed call at 1800-572-9792, we'll SMS the download link to your smartphone. Login to app and click on e- cashless facility

    Reimbursement claim: Customers can now upload scanned claim documents using Medibuddy app or by logging onto https://me.medibuddy.in/We shall keep your claims processed and disburse payment once we receive the hard copies. To locate our branch, visit https://www.manipalcigna.com/branch-locator

    GIC proposed charges for COVID Cases : https://bit.ly/36TA9UA

ASSISTANCE IN TIME OF COVID-19 PANDEMIC

Where can I get answers to Coronavirus Claims related queries?

Will Quarantine charges incurred during hospitalization be covered in the policy?

    Yes, quarantine related charges along with the other hospitalization charges incurred for management of COVID 19 shall be covered in our indemnity policies as per policy terms.

Are the consultations with a medical practitioner and diagnostic tests in relation to COVID-19 covered under my Health Insurance policy?

    Yes, expenses as a result of medical consultation and diagnostic tests, shall be covered under in our indemnity policies as per policy terms.

Will the policy cover hospitalization in a country other than India?

    Our worldwide emergency benefit ensures that Covid-19 hospitalizations are covered internationally

Is Domiciliary treatment covered?

    Yes, the same is covered as per the policy terms and conditions

POLICY RENEWAL AND SERVICING

Where can I pay the renewal premium / purchase a new policy?

    If you are making an online payment then you can visit www.manipalcigna.com to make the renewal payment

    We have tied up with ICICI bank where you can visit any of the 1350 locations for New business premium / renewal premium to be paid through cheque or cash. The premium payment must be done over the counter & the cheque should not be dropped in any drop box. ​

Where should I give servicing request for my policy?

    You can contact your agent/advisor/sales manager who will accept documents for servicing of your policy & will in turn coordinate with ManipalCigna Health Insurance branch for processing.

    Customers can call our toll free no 1800-102-4462. Retail customers can write to us at customercare@manipalcigna.com & Group customers can write to us at servicesupport@manipalcigna.com

    Union Bank of India, Andhra Bank, Corporation Bank customers can call toll free no 1800-123-263-472 or write to service.unionbankofindia@manipalcigna.com.

    Bank of Maharashtra customers can call toll free no. 1800-108-6242 or write to support.bom@manipalcigna.com Our distribution partners can call us on our toll free no. 1800-102-4462 and press option 5

If not satisfied, how can I raise a complaint?

    We are always here to help you. The above touchpoints should be able to manage all your queries; however, if the resolution provided does not meet your expectations, you can write to our Grievance Redressal Officer, Ms. Shruti Vyas, Assistant Vice President - Grievance Cell at complaints@manipalcigna.com or call at 022-48832666

Worried about insuring yourself and your family with adequate health cover OR renewing your existing ManipalCigna Health Insurance policy?

    Don’t stress, as a health insurance partner, our top priority is to protect the health and well-being of those we serve.

    Our ManipalCigna ProHealth Insurance Plan covers hospitalisation expenses, immediate OPD expenses, ambulance cover arising out of COVID-19. Click https://buyonline.manipalcigna.com/buy-health-insurance/renew
    OR https://buyonline.manipalcigna.com/buy-health-insurance/makepayment to renew your policy and ensure a seamless cover for you and your family.

    Please note, we have also extended the Grace period for all policies due onwards 01/02/2020 to 60 days from the original 30 days in case you are unable to pay your premium on time, in view of the disruptions caused by the Coronavirus outbreak.

    We urge you to stay alert, stay home and exercise personal hygiene. In case you have any queries or need any assistance while renewing your policy, Please feel free to call us on our toll free 1800-102-4462