Gen provides 100% company-paid medical cover of ₹6,00,000 per family per year.
Eligibility
All permanent team members are eligible for cover under the medical policy. This cover is also extended to up to five dependants: your spouse, two dependent children up to age 25, and up to two dependent parents or parents-in-law.
Gen couples
If both you and your spouse are employed by Gen, you can avail double cover under medical insurance. This means you can cover your spouse as a dependant and vice versa. However, you cannot double cover your other dependants (parents and children).
The double cover benefit is not applicable for maternity benefits under the plan: if one spouse exhausts the maternity benefits, the other spouse cannot avail the benefit to cover any excess of expenses under their policy.
Same-sex partners
You can add your same-sex partner within 30 days from hire date or during the annual open enrolment window.
You can enrol a maximum of two dependent children. Children can be biological or adopted. Relevant documentation (e.g., birth or adoption certificate) must be provided to Marsh before enrolling the child.
For female team members who have a same-sex partner, the insurer provides infertility and maternity benefits only to the team member and not to their partner.
How to enrol
New joiners
You must enrol your eligible family members into the mediclaim policy within 30 days from your start date.
New hires will receive a notification in Workday to access the benefits platform where you can select your benefits and follow the instructions [PDF] to enrol your dependants. Be sure to add your depandants in the Dependents section before selecting your benefits.
Existing team members
You can enrol dependants during the enrolment window in April or October or when you have a life event such as marriage or the birth of a child. You must enrol new dependants within 30 days of a life event.
During an enrolment window, access Workday through MyApps, and follow the instructions [PDF] to enrol or delete dependants.
Outside of the enrolment windows, access Workday through MyApps, and update the Dependents section. Once added, raise a SupportNow ticket to request enrolment of your dependant to medical insurance. The benefits team will manually add this dependant to the plan and report to our insurance partners.
You must provide the birth certificate or adoption documents to Bajaj Allianz at medical.support@bajajallianz.co.in and copy Marsh at nortonlifelock@marsh.com before enrolling your child.
For a same-sex partner, fill the details in the same-sex partner member declaration template [xls] and send it to Marsh at nortonlifelock@marsh.com before enrolling your partner.
Mediclaim benefit
Gen has partnered with Bajaj Allianz General Insurance Company Limited as our insurance provider.
The medical sum insured cover is ₹6,00,000 for team member, spouse, and up to two children. The sum insured cover for parents is ₹5,00,000.
The mediclaim policy cover includes:
- Expenses on medical treatment, provided there is a minimum hospitalisation of 24 hours
- Preexisting disease
- Maternity expenses up to ₹75,000 for normal delivery and ₹1,00,000 for caesarean delivery
- Prenatal expenses up to ₹5,000 for the nine-month period before delivery
- Postnatal expenses up to ₹5,000, limited to six weeks after delivery
- Newborn baby cover from day one
- 30 days of prehospitalisation expenses and 60 days of posthospitalisation expenses
- Internal and external congenital ailments, subject to policy terms and conditions
- Infertility treatment up to ₹90,000 per year
View details in the group mediclaim employee benefits manual [PDF].
Cover includes a single AC room (entry level) for all hospitals. If you opt for a higher room category, you bear the difference in the room rent and associated charges. Find a Bajaj Allianz network hospital.
For expenses incurred up to 30 days prior to hospitalisation and up to 60 days after hospitalisation relating to the illness for which you are hospitalised, you must pay the expenses and then put forward a claim for reimbursement.
Enrol your baby
Your newborn baby is covered from day one. Ensure you add your baby within 30 days of birth through the Workday benefits portal, and then raise a SupportNow request to enrol your new dependant.
Parental mediclaim
Parents who access care under Gen’s mediclaim benefit are subject to a cost share. Gen’s medical insurance will cover 80% of the cost, and the member will be responsible for the remaining 20%.
How to make a claim
Benefits are available on a cashless basis with preauthorisation, or you can be reimbursed for expenses you’ve paid.
Reimbursement claims are subject to extensive review and validation, which can take several weeks. We encourage you to follow the preauthorisation process ahead of treatment, whenever possible, to receive cashless coverage.
Preauthorisation for cashless benefit
Preauthorisation for cashless benefit
The Bajaj Allianz hospital helpdesk will provide you a preauthorisation form, which must be filled by your treating doctor and completed with the doctor’s signature and hospital seal. Along with the preauthorisation form, send the first consultation paper from your doctor, including:
- Duration of your present illness
- Previous history of similar illness
- Any treatment taken in the past for this or a related illness
Send the form and consultation paper to Bajaj Allianz by email or through the Bajaj Allianz portal. Your network hospital will have access to the Bajaj Allianz portal; please contact the hospital insurance desk for instructions.
Bajaj Allianz will extend credit for your hospitalisation only after the preauthorisation is complete and your admissibility and eligibility are determined. You will then be issued a letter of credit that should be carried along with your ID card to receive credit for your treatment. If the admission is for your parent, they will be covered for 80% of the eligible hospitalisation cost. The remaining 20% must be paid to the hospital by cash or credit card at the time of discharge.
In case of an emergency, go directly to the hospital for treatment. After admission, you must complete the preauthorisation procedure.
In case of a medical emergency, you can contact the Bajaj Allianz team: Rasika Mohol at 7767009620 or email, or Sunil Hoval at 7767009619 or email.
For any escalation regarding your insurance claim, reach out to the Marsh team: Nehal Gujar at 9823068400 or Hemant Arivale at 9881092603, or send an email to nortonlifelock@marsh.com.
Reimbursement
Reimbursement
If you visit a nonnetwork hospital, you will have to bear the expenses at the time of hospitalisation and then put forward a claim for reimbursement. Claims for expenses before and after hospitalisation also must follow this process.
Claim procedure
- Fill the advance claim intimation form [doc] as soon as possible, and email it to the Marsh team.
- Submit these claim forms within 30 days after discharge:
- Refer to the claim form instructions [PDF] for help in filling the Bajaj Allianz claim form.
- Reimbursement claims can be submitted using the Caringly Yours app from Bajaj Allianz. Refer to the Caringly Yours claim instructions [PDF] for the claim submission process.
- Provide all required documents with your claim:
- Photocopy of the hospital registration certificate or hospital registration number printed on discharge card and main paid bill
- Employee name and ID
- Original hospital discharge card or discharge summary
- Main hospital bill with detail breakups
- All payment receipts (advance, part, and final) with revenue stamp on payment receipts
- Original medical bills with doctor’s prescriptions
- Original pathological and other medical investigation reports with bills and prescriptions
- All investigation reports supporting aliment
- If hospitalisation is more than four days, provide attested photocopy of indoor case papers (if easily available)
- Statement of total expenses
- Photo ID proof of patient, along with Aadhar Card and PAN card copies of employee
- Canceled cheque
- Obstetric history from treating doctor (for maternity claims)
- FIR copy and alcoholic or MLC report (for accident claims)
- Clearly write this note on all supporting documents before scanning: Claimed with Bajaj Allianz General Insurance Company ltd. The note should be handwritten and not printed.
Additional notes
- The insurer may ask you to submit original documents in physical form.
- Additional documents may be required, based on specific treatments.
- If there is a deficiency in submitted documents, it can be addressed within 15 days of the date you are notified.
- If there is a delay in claim submission, you must attach a letter citing the reason for the delay along with the claim documents. The admissibility of the delayed claim is entirely dependent on Bajaj Allianz’s decision.
- After submitting a claim through the Bajaj Allianz portal or app, email the reference number or claim number to Bajaj Allianz and Marsh.
In case of a medical emergency, you can contact the Bajaj Allianz team: Rasika Mohol at 7767009620 or email, or Sunil Hoval at 7767009619 or email.
For any escalation regarding your insurance claim, reach out to the Marsh team: Nehal Gujar at 9823068400 or Hemant Arivale at 9881092603, or send an email to nortonlifelock@marsh.com.
Corporate buffer
If your expenses exceed the base medical policy insured cover of ₹6,00,000 (or ₹5,00,000 for parents), you may avail funds from the corporate buffer, which is an additional ₹6,00,000 (or ₹5,00,000 for parents).
Request approval for the corporate buffer by sending an email to the Marsh team at nortonlifelock@marsh.com.
- Marsh will authenticate the corporate buffer request and notify the Gen People & Culture team in India.
- The People & Culture team will inform Marsh whether the request is approved or denied.
A request will be denied if the total claim is higher than the base policy sum insured plus the corporate buffer limit. A request also will be denied if the hospitalisation expenses are above the cover amount because luxury facilities, such as suites, were used.
Exclusions
The insurance company will not reimburse for these diseases or treatments:
- Dialysis
- Eye surgery
- Radiotherapy
- Chemotherapy
- Lithotripsy
- Tonsillectomy
- Naturopathy
- Medical expenses for an organ donor
- Circumcision, unless necessary for treatment of disease
- Dental treatment of any kind, unless requiring hospitalisation
- Congenital diseases, defects, or anomalies
- HIV and AIDS
- Hospitalisation for convalescence, general debility, intentional self-injury, or use of intoxicating drugs or alcohol
- Venereal disease
- Injury or disease directly or indirectly caused by or arising from or attributable to war or warlike situations
- Injury or disease caused directly or indirectly by nuclear weapons
- Spectacles, contact lenses, or hearing aids
- Cosmetic or plastic surgery, except for correction of injury
- Hospitalisation for diagnostic tests only
- Vitamins and tonics, unless used for treatment of injury or disease
- Voluntary termination of pregnancy during first 12 weeks
- Nonmedical expenses; you are responsible for these expenses at the time of discharge:
- Food and diet
- Charges for attendants
- Telephone charges
- Registration charges
- Visitor pass charges
- Discharge summary charges
- Attendant’s bed charges
- Toiletries and linen
Medical benefits FAQs
When does the policy start?
When does the policy start?
Cover begins on the day you start at Gen.
When does the policy end?
When does the policy end?
The policy ends when you leave Gen or on the policy annual renewal date—whichever is earlier. In case of your demise, your dependants’ cover will continue until the expiry of the current policy.
Can I be admitted into the hospital and get treatment with only the E-card?
Can I be admitted into the hospital and get treatment with only the E-card?
No. The E-card is only for identification—it is not a credit card. To get admission to the hospital on a credit basis, follow the preauthorisation procedures.
Do I need to pay any money at the time of discharge?
Do I need to pay any money at the time of discharge?
Bajaj Allianz will extend credit for all medical expenses billed by a network hospital for the treatment of your illness, subject to preauthorisation. You must pay for nonmedical expenses at the time of discharge.
For a parental hospitalisation, you also must pay for 20% of the medical expenses at the time of discharge.
Can I claim for reimbursement if I go to a nonnetwork hospital?
Can I claim for reimbursement if I go to a nonnetwork hospital?
Yes. You must bear the expenses at the time of hospitalisation and then put forward a claim for reimbursement.
What if I have two hospitalisations for enrolled family members (e.g., spouse and parent) at the same time?
What if I have two hospitalisations for enrolled family members (e.g., spouse and parent) at the same time?
If expenses for both hospitalisations are within the insured limit, both will be covered.
If expenses are above the limit, you can decide which hospitalisation expenses to claim. Else, Bajaj Allianz will settle the claims on a “first claimed, first settled” basis.