Group Medical Insurance Client ASHOKA TRUST FOR RESEARCH IN ECOLOGY AND THE ENVIRONMENT Contents Group Medical Insurance 1 1

Disclaimer: This benefit summary will serve as a guide to the benefits provided by ASHOKA TRUST FOR RESEARCH IN ECOLOGY AND THE ENVIRONMENT. The information contained here is only a summary of the policy documents which are kept by the company. If there is a conflict in interpretation, terms & conditions of the policy will prevail. Prepared by Emedlife Insurance Broking Services Ltd No. 862, 3rdFloor Prabhat Arcade, 80 Ft Road Koramangala 8th Block  Bangalore – 560 095 Tel: 080-4265000  Fax: 080-4265000 Copyright © 2012. All rights reserved. No part of this publication may be reproduced, stored in the retrieval system, or be transmitted in any form or by any means, electronic or mechanical, photocopying, recording or otherwise, without the prior written permission of the publishers. 2 2

Help Line Numbers For all queries and assistance, please contact Emedlife Insurance Praveen Raj S. (Sr. Executive - Client Services) – 90081 44417 (Email: praveenraj_s@emedlife.co.in) Arjun (Escalation 1) – 90081 44456 (Email: arjun_k@emedlife.co.in) Ramani (Escalation 2) - 99808 11326 (Email: ramani_hs@emedlife.co.in) The Insurance Third Party Administrator is Medi Assist India TPA and their contact details are: Tel: 080- 26584811 Fax: 1 800 425 9559 Toll free number: 1-800-425-9449 Email: info@mediassistindia.com Website: https://www.mediassistindia.com

Agenda Group Medical Insurance TPA Service Offerings Log in Procedure Process for Hospitalization Escalation Matrix 4

Group Medical Insurance Broker Emedlife Insurance Broking Services Limited Insurer National Insurance Company Ltd TPA Medi Assist India TPA Pvt Ltd 5

Group Health Plan Policy Holder ASHOKA TRUST FOR RESEARCH IN ECOLOGY AND THE ENVIRONMENT Period of the Cover 12 months Inception Date 21th May 2015 Expiry Date 20 th May 2016 Insurer National Insurance Company Ltd TPA Medi Assist India TPA Pvt Ltd. Sum Insured Limits INR 2 Lacs, 3 Lacs and 4 Lacs Sum Insured per Employee. Members Covered Self only Geographical Limits India (Covers treatment in India only) 6

Group Mediclaim Coverages Pre-existing Diseases covered Waiver of Time exclusion for diseases (30 days/1 Year/2 Years/4 Years ) Maternity Benefit of INR 25,000 for Normal and 35,000 for C-Section. Maternity benefit covered from day one. New Born baby cover. 30 and 60 days Pre & Post hospitalization covered. Ambulance Charges covered up to 1% of Sum Insured with maximum limit of INR 1,000/- per incidence . Room rent (Including Nursing charges) charges payable up to 1% of Sum Insured for normal and 2% of Sum Insured for ICU with max limit of INR 5,000 per day. 7

Scope of Insurance Cover Includes: Only “in-patient” hospitalization expenses. Active treatment with minimum 24 hours hospitalization. Pre-hospitalization expenses of 30 days before admission and post hospitalization expenses for 60 days after discharge for an eligible hospitalization Cashless facility against Pre-Authorisation at Network hospital only Excludes: Non - Medical Expenses - Registration/Admission fees, hospital surcharge, food bills for attendants, telephone charges, pharmacy charges for non-medical items etc. Other standard exclusions Stay in hospital without undertaking any treatment or where there is no active regular treatment 8

Standard exclusions to the Insurance Cover Injury or disease directly or indirectly caused by or arising from or attributable to war or war like situations and by nuclear weapons. Circumcision unless necessary for treatment of diseases Congenital ailments or defects/anomalies Hospitalization for convalescence, general debility, intentional self-injury, use of intoxicating drugs/ alcohol. Venereal diseases, HIV and AIDS, Infertility treatment and Naturopathy  Cost of spectacles, contact lenses, hearing aids Any cosmetic or plastic surgery except for correction of injury Hospitalization for diagnostic tests only even if prescribed by a medical practitioner 9

Voluntary termination of pregnancy during first 12 weeks (MTP) Pre and Post Natal expenses are not covered unless admitted in Hospital/Nursing Home for active line of treatment Unproven or experimental treatment not approved by Indian Medical Council Any Dental treatment or surgery except arising out of an accident, which requires Hospitalization for treatment

Enrollment in the program Existing employees are covered under the policy from 21th May 2015. All New joiners must enroll themselves within 20 days of joining the company. Provide required details of yourself to the HR HR sends the data to the EMEDLIFE to upload their system EMEDLIFE will upload this data and inform ATREE on the activation of all facility for employees TPA will upload E cards on their Website for all employees Employee verifies details of the E card on TPA website Error in data on E card Send mail to EMEDLIFE / HR with ID Card Nos. Use E card/Physical card for cashless hospitalization authorization E Card Ok 11 11

Medi Assist India TPA Pvt Ltd – Service Offerings Online access to view self details, claim status and e card download Cashless Hospitalization SMS facilities for Pre-authorizations. 24 hour telephonic Nurse line. Claims Administration. 12

Procedure for Online Access Procedure for Online access Please follow the below steps to Login Log on to https//:www.mediassistindia.com . Select “Login” option present on the top Right of the screen Select “Corporate Employee”. User ID: Password:

How does the plan work ? Hospitalization event can be: Planned or Emergency In a Network hospital or Out of Network Hospitals have details of TPAs - please check with hospital helpdesk if they accept Medi Assist Insurance card to avail cashless hospitalization For updated list of Network hospitals, see http://www.mediassistindia.com 14

Network Hospitalization (Planned) Fill up the Pre-Authorisation form with the help of the treating Doctor and fax it to the Medi Assist Nurse line with the assistance of the hospital staff 48 hours prior to Admission Medical Management Team assesses the Pre- authorisation request and after it is approved, Medi Assist Nurse line sends Credit letter to Network Hospital All Medical Expenses including Room Rent would be covered under Cashless 15

Call up Medi Assist Nurse line if possible Network Hospitalization (Emergency) Call up Medi Assist Nurse line if possible Or else, get hospitalized into the nearest Network Hospital with the medical E- card/Physical card Get the Patient treated and after the patient has stabilized, complete the Pre-authorisation process You can also identify yourself as a member of TPA so that they can assist you with the Pre-authorisation formality. 16

Possibility of Denial of Cashless - examples Admission for investigations/ observation / evaluation only . Admission beyond a certain number of days apart from the normal package stay. Treatment not matching with disease mentioned on pre-authorisation form. Any treatment which otherwise could have been taken on OPD basis. Any congenital external disease. Hospital not sending proper query reply raised by TPA on time. Active line of treatment not mentioned in the pre-authorisation form 17

Non-Network Hospitalization (Planned & Emergency) Claim Intimation has to be provided to Emedlife/Medi Assist Kindly make the arrangements for the admission and pay all expenses at the hospital Collect all original documents from the Hospital including the Hosp. & Doctor Reg- istration No. Claim needs to be sent to Emedlife within 20 days from the Date of Discharge Pre & Post Hospitalization Bills Pre Bills: 30 days prior to Date of Admission Post Bills: 60 days after Date of Discharge 18

Procedure of Discharge & Claim without Cashless facility The employee should arrange for the admission and all other payments required by the hospital. Collect and submit to Emedlife the following documents (in original) after discharge Discharge Card/Summary Main pre-numbered Hospital Bill Signed Claim Form Pre-numbered payment Receipt Prescriptions, reports and bills for all investigations done. Prescriptions and bills for medicines consumed during hospitalization. Break-up of the medicines bills amount of Rs. 200/- or more. Sticker of lens in the case of cataract cases GPLA certificate in maternity cases Medico-legal certificate and FIR in accident cases Hospital’s registration number is required and Mandatory Claims will not be assessed if all the documents mentioned are not submitted. Claim Submission Timeline - All claims to be submitted to Emedlife within 20 days from date of discharge. NOTE : Any delayed submission beyond the timeline mentioned above will not be processed. In such cases, letter from the employee would be required with a valid reason for delay in submission. It is at the discretion of the Insurer to provide the approval for such cases. 19

Claims Administration Process Claims Administration Team Document handling Registration of claim with insurer Liaison with insurer for payment Explanation of paid amounts and rejection Document Recovery Team (DR Team) Sends reminders for the missing/required document(s). In case of non-receipt of the same, may send the entire claim back to the employee or deduct the appropriate amount and send the balance claim for QC Quality Check Team (QC Team) Re-assesses the claim to ensure that the claim is complete in all respect before sending it for payment to the insurance company. Claim settlement Approximate time to settle claim is 10 - 15 working days after receipt by TPA of complete documentation 20

Some Important Do’s & Don'ts Submit the Reimbursement claim documents to Emedlife Helpdesk within 20 days from date of Discharge Always carry photo ID proof along with your medical card. Photo ID proof can be: Driving license / PAN Card / Passport / Voter ID. For Planned hospitalization: take approval before getting admitted in hospital For Reimbursement cases, always collect all originals from Hospital including final bill with break up and payment receipt. Any issues in getting cashless approval, please contact the Account Manager (Emedlife). On leaving ATREE, the Insurance card is to be returned to HR Deptt. 21

For any kind of clarification, please contact: Emedlife Medi Assist Account Manager Praveen Raj S. Gajendra Phone no 90081 44417 93425 33651 Mail ID praveenraj_s@emedlife.co.in gajendra.jothimala@mediassistindia.com 1st Escalation Arjun K Venkatakrishnan 90081 44456 96861 95495 arjun_k@emedlife.co.in venkatakrishnans@mediassistindia.com 2nd Escalation Ramani 99808 11326 ramani_hs@emedlife.co.in 22

THANK YOU 23