WBSAMB / CEO / 9 / R2 / 2025 - 26

Providing Family floater medical group health insurance for 35 Nos of employees and 80 nos Dependent (Spouse+ Parents+Children (maximum Two nos)) are to be covered policy with cashless facility covering .Rs. 7,50,000.00 / per family including critical illnesses, pre-existing conditions, etc and also provide the Premium of the Policy for one insured family in Rupees ......

1- Family Floater:- Self+ Spouse+ Parents+ Dependent Children up to age of 30 years (Dependent children (maximum Two nos) with any kind of disability should be covered on providing the supporting document for the same) 2- Pre-existing diseases to be covered from day one 3- 30 days waiting period to be waived-off. 4- Any other benefit available may be mentioned. 5- Room rent ceiling will be 1% of the sum Insured & for ICU 2% of the sum Insured. 6- Psychiatric treatment to be covered. 7- Treatment done through any advance technology e.g. Robotic Surgery/Gamma Ray Surgery, Cyber knife surgery to be covered without any capping if required based on age and health condition of the patient. 8- Pre and post hospitalization cover 9. The employees are located at different locations in India; there shoud not be any deduction on the approval claim amount due to geographical limits. 10- Congenital internal diseases to be covered, external to be covered only if for non-cosmetic reasons. 11- Donor expenses to be covered within over all SI limit only. 12- Homeopathic/Ayurvedic to be covered only if treatment is done in government hospitals/NABH/QCI accredited hospitals. 13- Reasonable clause waiver can be considered considering the condition of the patient.

14- Ambulance charges- To be covered, in case emergency up to Rs. 1000/-(Will be paid from Hospital to Home also depending on condition of the patient) 15- No deduction in case of employee death during hospitalization. Claim to be approved up to available sum insured. 16- In case of employee death, coverage for family members to continue till policy expiry. 17.Claim settlement ratio minimum 97% 18- Teleconsultation- Unlimited teleconsultations for employee and family members (complimentary). Option to opt for home sample collection and medicine delivery (employee paid on discounted basis 19. Day Care treatment to covered upto limit of sum insured like Cancer/Heart Ailment/Kidney etc. as per standard list available Day Care treatment.

The regular employees of West Bengal State Agricultural Marketing Board and their dependent family mmembers

Age limit (0 year to 17 year)

Age limit (18 year to 35 year)

Age limit (36 year to 45 year)

Age limit (46 year to 50 year)

Age limit (51 year to 55 year)

Age limit (56 year to 60 year)

Age limit (61 year to 65 year)

Age limit (66 year to 70 year)

Age limit (71 year to 75 year)

Age limit (76 year to 80 year)