Franciscan Ventures collaborates with NTT DATA to provide cost effective solutions to all the Religious organizations, Archdioceses, Dioceses, Provincialate, Hospitals, Schools along with other Organizations in all the 195 Countries in the World.

Group Medical Insurance - Introduction:

Group medical insurance policy is one of the key Religious People/Teachers/Employee benefits Arch/Dioceses/Provincialate/Hospitals/Schools /Other Organizations providing to their members. Members, Family Members including parents can be covered as per the policy of the organization. Besides standard group medical insurance plans, it can be customized by opting of add-on covers with the policy

Franciscan Ventures Pvt. Ltd. in collaboraon NTT DATA can offer unmatched rebates in premiums for:
Individuals, Groups, Assets, etc

Key benefits of the group medical insurance are as listed below:

  • Sum insured can be flat for all the covered members or graded sum insured for opted.
  • Coverage of pre-existing disease from day 01 i.e. 2 and 4 years of exclusion for the coverage of specific diseases are waived.
  • Waiver of 30 days waiting period i.e. covered member can take benefit of medical insurance from the date of issuance of the policy or from the date of renewal of the policy.
  • New born baby can be covered from the day one within family sum insured

  • Day care surgeries/procedures are covered

Other additional benefits can be opted as per specific requirements, including following :

  • Corporate Buffer – Provision of corporate buffer (the provision can be used on the discretion of the management) in case of exhaustion of sum insured for treatment especially in case of critical illness.
  • Copay – The option can opted as per suitability – Zero Co-Pay or 5/10 Co-Pay
  • R & C Charges – Waiver of Reasonable and Customary charges can be opted
  • Domiciliary Hospitalization – Extension of domiciliary hospitalization (It refers to a situation where the insured is considered to be hospitalized, even when he/she is still at home - The treatment was for an illness, injury or disease for which hospitalization would be required in normal circumstances) can be opted if required
  • Congenital Disease – a medical condition that is present at or before birth, coverage can be opted under the group health insurance plan
  • OPD – OPD cover including dental treatment
  • Special Conditions – Besides mentioned coverage other conditions such as automatic enhancement of Sum Insured in case of critical illness, no capping on disease wise sub-limits, room rent etc. can be opted
  • Maternity – Cover can be opted for providing maternity benefit within specified sub-limit.
  • Parents - Parents of our Religious can also be benefited.
  • Member Addition/removal - Members can be added/removed during the insurance people.
  • Seminarians/Religious - Seminarians/Religious Candidates/Students can also be benefited and can be added/removed if they join or leave the organisation.
  • Age Group - Member can be added of any age.

General Question & Answers

Q. What is covered under the policy?

Principally the policy covers all hospitalization expenses following a disease or an accident. The policy extends the following benefits;

Q. Pre-existing Diseases Covered From Day 1

Employee medi-claim insurance covers pre-existing diseases at the commencement of the policy period

No medical check-ups are required to determine an individual's coverage eligibility

Cover available even to members with chronic ailments such as diabetes or hypertension

Q. High Maternity Benefits for Normal and C-Sec

Maternity benefits are particularly valued by young employees. To attract talent, firms in service sectors such as IT, E-Commerce or outsourcing offer high cover for pregnancy and delivery related expenses

Separate limits can be set for normal, caesarean sections or ectopic pregnancies

New born babies can be covered immediately at the time of birth

Q. Wider Coverage with No Disease Limits

The standard waing period of 1 to 4 years for diseases such as cataract, hernia, piles, joint replacements, and cyst removals can be removed. All surgeries can be covered immediately aer the premium is paid

Standard medical exclusions such as for internal congenital diseases can be removed

Sub-limits and co-pay on specific diseases can be removed to allow full indemnity

Q. Cashless settlement of hospital bills

Cashless claims service is available at all network hospitals of the insurer across India. One just needs to produce a card issued to him/her at the TPA helpdesk to avail the cashless facility

About 7,500 hospitals are available on the network across India.

Q. Claim reimbursement facility

In case a member takes treatment at a non-network hospital, the insurance company reimburses expenses incurred on the treatment. To get the reimbursement, one needs to submit the medical bills along with other documents as specified by the insurance company. After submission of all the documents, insurance company typically takes 30 days to review the documents and transfer the claim amount the premium is paid

Q. Coverage for Pre and post hospitalization expenditure

The policy also covers expenses incurred within 30 days before the hospitalization and upto 60 days after the discharge from the hospital as a part of the claim. Pre and post hospitalization expenses are paid as reimbursement claims

Q. What is not covered under the group medical policy?

The claim amount is limited to the amount of sum insured under the policy. Any expenditure beyond the sum insured is to be borne by the member

The diseases existing at the time of birth (Congenital diseases) are not covered under the policy. However, the same can be covered by paying extra premium

How to get the Proposal?

To get the best proposal please share the following details of the Members to be insured. Details will be confidential.

Name of the Organization: Diocese, Provincial, School, Hospital Name)

Name of the Members (It’s optional to get the proposal. Dummy names can be used. It to be provided after finalizing the proposal)

Date of Birth || Profession

Commercial Proposal will be provided within 3 working days after providing the above mentioned details. *Below is the tentative Quote for an idea for the insurance sum of Rs. 3,00,000/- (Rs. Three Lac only) and Rs. 5,00,000/- (Rs. Five Lac only). Insurance sum can be as per organization requirement.
Quote is subject to change with change in information .

Policy Details | Group Mediclaim (Floater)
Member Details
Relation Coverage Count Age Restrictions
Employees YES 177 Upto 100 years
Spouse No 0 Upto 100 years
Dependent Children No 0 Upto 25 years
Parents No 0 Upto 100 years
Demography If Sum Insured Rs. 3,00,000/- (Rs. Three Lac only) per person
SI/Age 0-25 26-35 36-45 46-55 56-65 66-70 71-75 76-80 Above 80
300000 47 66 29 16 10 5 2 1 1
. Net Premium: Rs. 4,55,548/- (Rs. Four Lakh Fiy Five Thousand Five Hundred Forty Eight only)
. Add: 18% GST: Rs. 81,998/- (Rs. Eighty One Thousand Nine Hundred Ninety Eight only)
. Gross Premium: Rs. 5,37,546/- (Rs. Five Lakh Thirty Seven Thousand Five Hundred Forty Six only)
. Total Benefit: Rs. 5,31,00,000/- (Rs. Five Crore Thirty One Lakh only)
Demography If Sum Insured Rs. 5,00,000/- (Rs. Five Lac only) per person
SI/Age 0-25 26-35 36-45 46-55 56-65 66-70 71-75 76-80 Above 80
500000 47 66 29 16 10 5 2 1 1
. Net Premium: Rs. 6,43,065/- (Rs. Six Lakh Forty Three Thousand Sixty Five only)
. Add: 18% GST: Rs, 1,15,751/- (Rs. One Lakh Fifteen Thousand Seven Hundred Fifty One only)
. Gross Premium: Rs. 7,58,816/- (Rs. Seven Lakh Fifty Eight Thousand Eight Hundred Sixteen only)
. Total sum insured: Rs. 8,85,00,000/- (Rs. Eight Crore Eighty Five Lakh only)