GROUP MEDICLAIM SCHEME FOR THE YEAR 2009

FOR

RETIRED EMPLOYEES AND

THEIR SPOUSES OF STEEL AUTHORITY OF INDIA

LTD.

MDIndia Healthcare Services (TPA) Pvt.Ltd, HEAD OFFICE

S.No-46/1,E-Space,A2-Wing,3rd Floor, Pune Nagar Road, Vadgaonsheri, Pune-411014

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Dear Mediclaim Member of SAIL, Welcome to the MDIndia Family. MDIndia Healthcare TPA Services has been appointed by United India Insurance Company, to provide healthcare insurance services to you. These services include ID card issuance, Cashless Hospitalization and Settlement of claims on behalf of the UIIC. This guide book gives a preview of various services provided by MDIndia. The guidebook also contains a list of hospitals/nursing homes in the SAIL/MDIndia network where you can avail OPD and Hospitalization treatment. For any clarifications or information, please contact us on our enquiry numbers as mentioned on the reverse side of your member ID card. You can also visit ‘www.mdindiaonline.com’ for more information. We, the MDIndians, look forward to a long-lasting relationship with you. It will be our constant endeavor to provide all services to you with high quality and minimum turnaround time. Wishing you a healthy and happy life

Rajnish Sharma

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CONTENTS

1. Objectives 4

2. Reimbursement Services 8

3. Cashless Services 9 4. OPD Services 10

5. Customer Care services 11

6. Details of SAIL Plant Officials 12

7. MD India Branch Details 13

8. Claim Forms (Annexure A-F) 14- 21

9. Network Hospitals OPD 22 - 31

10. Network Hospitals IPD 32 - 46

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MEDICAL SCHEME FOR THE RETIRED EMPLOYEES OF SAIL AND THEIR SPOUSES (2009)

1. OBJECTIVES OF THE SCHEME To extend the Medical Benefits to the retired employees of SAIL and their spouses 2. PERSONS COVERED

i) Retired employees of SAIL (including IISCO) and their spouses. ii) The employees who have taken voluntary retirement and their spouses. iii) The employees who cease to be in employment on account of permanent total

disablement and their spouses iv) The spouse of an employee who dies in service.

This scheme is optional and those who opt for this scheme, will hereinafter be referred to as “members"

3. SCHEME

The members will be covered through Group Insurance Mediclaim Policy of the Insurance Company and will be operated through The United India Insurance Co. Ltd., Divisional Office- XI, E 85, Himalaya House, 8th Floor, K.G. Marg, New Delhi-110001. The period of the policy is 1/1/2009 to 31/12/2009.

MDIndia Healthcare Services (TPA) Pvt. Ltd. (Headquartered at Building A 2, 3rd Floor, E Space, VadgaonSheri, Nagar Road, Pune-411014) has been authorized to offer TPA (Third Party Administrator) services for the Group Mediclaim Policy issued for the retired employees of SAIL and their spouses. MDIndia would work out of 9 locations for the purpose of claim settlement. For the purpose of claim settlement, the bills & other related documents should be directly sent to any of the opted centers of MDIndia (vide page no. 13). 4. PROCEDURE FOR JOINING THE SCHEME

i) As per the arrangement with SAIL, all retiring employees shall be given an enrolment form by the respective offices of plants/units handling the Mediclaim Scheme.

ii) This enrolment form should be filled in by the employee and his spouse desiring to join the scheme. Answer to all columns should be given specifically. No Column should be left blank.

iii) All retiring employees should get themselves enrolled under the scheme before their retirement. Under no circumstances applications for enrolment received after the retirement will be entertained. However, a grace period of 30 days will be allowed in case of retirement & 90 days in case of death of employee.

iv) The postal address should be mentioned in CAPITAL LETTERS.

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v) The enrolment fee is Rs. 925/- per member for the policy period, who in turn shall send the enrollment data to SAIL Corporate Office for onward transmission to the insurance company.

vi) On receipt of complete enrolment form by the plant/Unit of SAIL, the Plant/unit shall allot a Mediclaim Index No. (MIN).

Note: Any change of address must be immediately intimated to the concerned Plant/unit and

Insurance Company giving the Mediclaim Index No. (MIN). 5. POLICY COVERAGE

The policy covers reimbursement of Hospitalization (and also Cashless Facility) and/ or Out-Patient Department (OPD) expenses within the prescribed limits under the policy for illness/diseases contracted or injury / sustained by the insured person. In the event of any claim becoming admissible under the policy, the company will pay to the insured member the amount of such expenses as reasonably and necessarily incurred anywhere in India, but not exceeding in any one period of insurance of amounts under the respective category in the TABLE OF BENEFITS mentioned at clause 8 of this booklet.

6. DEFINITIONS

a) Hospital/Nursing Home means any institution in India established for Indoor care and treatment of sickness and injuries and which has been registered either as a Hospital or Nursing Home with the local authorities and is under the Supervision of a registered and qualified Medical Practitioner.

Or Hospital/Nursing Home should comply with minimum criteria as under, (i) It should have at least 15 inpatient beds, however, in class 'C' towns, condition of Number

of beds be reduced to 10. (ii) Fully equipped operation theatre of its own wherever surgical operations are carried out. (iii) Fully qualified nursing staff under its employment round the clock. (iv) Fully qualified Doctor(s) should be in charge round the clock.

For the purpose of O.P.D. treatment, "Hospital" shall mean: 1. A Government Hospital, 2. Dispensaries/Clinics run by local Government authority/Municipalities, 3. SAIL Plant Hospitals/Dispensaries 4. SAIL /Approved Hospitals/Nursing Homes (List of SAIL Hospitals Refer Page 22 to 31 ) 5. Franchisee of major Hospitals viz. Apollo, Max, Escorts, Fortis, etc. anywhere in India.

Note:The terms "Hospital" shall not include an establishment which is a place of rest, a place for the aged, a place for drug addicts or alcoholic, a hotel or a similar place.

b) Surgical Operation means manual and operative procedures for correction of deformities and defects, repair of injuries, diagnosis and cure of diseases, relief of suffering and prolongation of life.

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Note: 1. when treatment such as Dialysis, Chemotherapy, Cataract and Microsurgery is taken in the Hospital/Nursing Home and the insured is discharged on the same day, the treatment will be considered to be taken under Hospitalisation Benefit Section.

2. While Hospitalization facility can be availed of from any Hospital or Registered Nursing Home in India, OPD facility can only be availed of from any Govt. Hospitals/SAIL Plant Hospitals/Dispensaries or Hospitals listed in this Booklet (Page 22to 31).

c) O.P.D.Treatment: Means treatment taken as an out-patient in any Govt.

Hospital/SAIL Plant Hospital or SAIL approved Hospital/Nursing Home. The Charges incurred for treatment taken from Registered Medical Practitioners or other than SAIL approved Hospital/Nursing Home will not be reimbursed. The Medicine should be prescribed by the Doctors on the letter heads of the hospital. Even though a medical practitioner is attached to any of the Govt. / SAIL plant hospital or SAIL approved hospital and if the treatment is taken by him/her privately the OPD Claim amount will not be reimbursed, under any circumstances.

d) Anyone Illness: Anyone illness will be deemed to mean continuous period of illness and it includes relapse within 105 days from the date of last consultation with the Doctor /Hospital Nursing Home. Occurrence of same illness after lapse of 105 days as stated above will be considered as fresh illness for the purpose of this policy.

e) Medical Practitioner: Means a person who holds a degree / diploma of a recognized institution and is registered by Medical Council of respective State of India. The term Medical Practitioner would include Physician, Specialist and Surgeon.

f) Qualified Nurse: Means a person who holds a certificate of a recognized Nursing Council and who is employed on recommendations of the attending Medical Practitioners.

7. IMPORTANT EXCLUSIONS

Under Group Mediclaim Insurance Policy, the Company shall not be liable to make any payment in respect of any expenses whatsoever incurred by the insured person in connection with: 1. Any Disease/complication caused due to alcohol intake. 2. Any disease / injury caused by War/Nuclear Weapons/Radiations / Breach of Criminal

law. 3. Circumcision, cosmetic or Plastic Surgery unless necessitated by an accident or as a part

of any Disease / illness. 4. All health check - ups, routine eye examinations and cost of glasses and contact lenses. 5. Cost of dentures. 6. Convalescence, general debility, "Run-down" condition or rest cure, congenital diseases

or defects, sterility, venereal diseases, intentional self injury and use of intoxicating drugs.

7. Any expenses incurred for diagnosis etc. not consistent with treatment for injury / illness / disease. 8. Expenses on vitamins and tonics unless forming part of treatment for injury or disease as

certified by the attending physician.

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9. Treatment traceable to pregnancy / child birth, voluntary medical termination of pregnancy during first 12 weeks of conception.

10. Naturopathy Treatment .

8. TABLE OF BENEFITS 8.1 HOSPITALISATION BENEFIT

Hospitalization benefit, Reimbursement and/or cashless will be paid upto Rs. 1,50,000/- per member (with clubbing facility between the retired employee and his/ her spouse) as per policy terms and conditions. The clubbed ceiling under Hospitalization will be upto Rs. 3,00,000/- (Rs. 1,50,000/- x 2) per policy period.

8.1.1 Reimbursement: Reimbursement of actual charges upto Rs. 1,50,000/- per member per policy (with clubbing facility between retired employee & spouse) period spent on Room, IC Unit, nursing expenses, surgeon, anesthesia, medical practitioner, consultant, specialist fees, anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines & drugs, diagnostic materials, X-ray, dialysis, chemotherapy, radio-therapy, cost of pacemaker, artificial limbs of and similar other expenses. CLAIM UNDER HOSPITALIZATION BENEFIT IS ADMISSABLE ONLY WHEN THE PATIENT IS ADMITTED IN A HOSPITAL FOR A MINIMUM PERIOD OF 24 HOURS. Note: Pre-hospitalisation Relevant medical expenses incurred during the policy period upto 30 days prior to the hospitalisation on disease / illness sustained will be considered as part of claim under hospitalisation. HOWEVER MEDICINES BEING PRESCRIBED UNDER REGULAR OPD TREATMENT DURING PRE-HOSPITALISATION WILL NOT FALL UNDER HOSPITALISATION CLAIMS. Post-hospitalisation Relevant medical expenses incurred during the policy period upto 60 days after hospitalisation on disease / illness / injury sustained will be considered as a part of claim under hospitalisation. However, regular OPD treatment prescribed under post hospitalisation prescription will not fall under Hospitalisation claim.

8.1.2 Cashless: The member can also avail of the Cashless Facility in case of hospitalization in empanelled hospitals.

8.2 OUT-PATIENT DEPARTMENT (OPD)

1) The limit of reimbursement of OPD expenses would be Rs. 4000/- per member for the policy period.

2) The member can take treatment in the out-patient department (OPD) of any of the following Hospitals.

i) Government Hospital, ii) SAIL Plant Hospital/Dispensaries, iii) SAIL Approved Hospital/Nursing

Homes (List attached), iv) SAIL Doctors /Medical Consultants. 3) Retired employee and spouse will not be permitted under any circumstances to club the

individual limit\ of Rs. 4000/- per head per policy period.

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4) The members can avail of OPD treatment facility in the above Hospitals. In case, the OPD treatment is taken in the SAIL Plant Hospitals the members are not required to pay any expenses. SAIL Plant Hospitals will make claims with the Insurance Co. for the any Treatment given to the member. Para 6 (C) may also be referred to. In case OPD treatment is taken at approved Hospital other than SAIL Plant Hospital, the claim should be submitted to MDINDIA Health Care Services (TPA) Pvt.Ltd. at the opted centre. (Vide page no. page 18)

5) OPD treatment availed from the listed Hospitals should be necessarily claimed on the letterhead of the listed Hospital. Private OPD treatment wherein the prescription is on the letterhead of the doctor shall be treated as private treatment and will not be reimbursed.

9. CLAIM PROCEDURE

A. Reimbursement Hospitalisation i) Notice of the claim should be sent to the MDIndia at the centre of option, immediately

and not later than 7 days of the injury / hospitalisation indicating Mediclaim Index No, Name of the Insured Member, Nature of Injury/illness, Name of the Hospital/Nursing Home. Specimen of claim intimation letter is Annexure- A, at page 14.

ii) The claim form should be submitted duly filled in all respects and no column should be left blank. The specimen copy of claim form on pages 15-17, Annexure- B, Annexure- C may be used for the purpose.

iii) All bills, Medical Reports, test reports, Pathological test report along with original prescription, Hospital Admission & Discharge Certificates be submitted by Registered Post, to the specified office of MDINDIA Health Care Services (TPA) Pvt. Ltd . as per centre opted at the address given in this booklet in support of the claim along with prescribed claim form (specimen copy on page 15 to 17 ) immediately on completion of the treatment or on expiry of 60 days from the date of discharge from the hospital whichever is earlier. Do ensure that the treatment is taken from a Registered Medical Hospital. However, in case, the treatment is taken in non-registered hospitals on an emergency basis, the insured member should have valid reasons for doing so and should immediately inform the Insurance Company with full details. All claim papers should be submitted in original. No photocopy will be accepted. Further, it may be noted that in case the bills/report enclosed with the hospitalisation claim paper pertain to establishment other than the nursing homes/hospital where the insured was hospitalized and they are not supported by proper prescription/advice of the attending doctor, then such bills/reports must be duly certified by the attending Doctor.

iv) On receipt of completed claim form along with relevant document & discharge voucher, MDIndia shall process the claim. If the documents are found to be in order and other relevant information is complete, the claim will be settled and claim cheque would be posted as early as possible, normally within 15 days of the receipt of all claim documents mentioned by the Insurance Company. Cheques valuing more than Rs. 1000/- would be sent by Regd. Post. Cheques can also be collected in person by the claimant or by any person authorized by the claimant.

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B. Cashless Hospitalization

MDIndia offers Cashless Service to the Insured, where treatment can be obtained at any of MDIndia network hospitals without payment, subject to the terms and conditions of the policy. MDIndia will settle the hospital bills directly on behalf of insured. A list of network hospitals is attached for reference. (Ref to pages # 31-45).

**ID Cards Insured is requested to show the enclosed MDIndia ID card at the time of Cashless hospitalization. Please establish photo identification, as it is a non-photo ID card, by confirming it with a valid identity proof like driving license, Passport, Election Commission Card or Mediclaim Booklet issued by the SAIL plant, etc. The Request for Authorization along with the MDIndia card and a photo ID has to be faxed to MDIndia at Authorization # 1-800-2334505, within 72 hours before the admission. The filled up RAL form is faxed by the hospital authorities. The format of the RAL is attached for reference on Annexure F (ref to Page # 20). The information in this form is to be filled in by the Hospital Authorities and partially by the Insured.

When the policyholder is advised admission to one of the network hospitals for treatment: • Part I of “Request for Authorization” to be filled in by SAIL member (Ref page no 20). • Part II of the RAL to be filled by the attending doctor/surgeon/hospital • RAL to be faxed by the hospital to MDIndia Head Office at 020-25300030/1-800-2334505

On receiving the RAL, MDIndia will do one of the following: a. Authorize

MDIndia will fax an "Authorization Letter" (AL) directly to the hospital. In case the cost of hospitalization exceeds the sum insured in the policy, the policyholder will have to pay the difference to the hospital. MDIndia will not be liable for any amount in excess of the amount specified in the AL. The AL is valid only for the period of hospitalization as specified on the RAL.

b. Request Additional Information In case the information provided in the RAL is incomplete, unclear or insufficient, MDI will request clarification from the policyholder/hospital. RAL maybe approved or rejected subject to obtaining the Additional information and based on the terms and conditions outlined in the policy.

c. Denial MDIndia will fax “Denial of Authorization Letter” (DAL)* directly to the hospital. Cashless facility may be denied in some situations as mentioned below:

Any ambiguity in the policy terms and conditions with respect to the present ailment. Insufficient sum insured to cover the hospitalization expenses.

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RAL is not received by MDIndia in time. If the information sent to MDIndia is insufficient to confirm the coverage.

The policyholder or his/her relative must sign the claim form and hospital bills at the time of discharge from the hospital.

*Please note that DAL is only denial of cashless facility and is no way to be interpreted as denial of treatment. You retain the right to get treated, pay for the services and then submit the bills to us for reimbursement, subject to policy terms and conditions. In case of hospitals/cities not included in the list, call at the Authorization #. Each request would be dealt on a case to case basis.

EMERGENCY HOSPITALIZATION

In case the insured is admitted to one of our network hospitals in any emergency or accident, the RAL should be faxed to MDIndia Head Office or Branch within 24 hours of admission. MDIndia would authorize or deny the request as mentioned earlier. If the insured gets admitted to a non-network hospital, please refer to non-cashless hospitalization services section.

C. OUT-PATIENT DEPARTMENT (OPD) TREATMENT i) OPD claim should be submitted to the concerned office of MDINDIA Health Care

Services (TPA) Pvt.Ltd along with- 1) OPD claim Form (specimen at page 18) duly filled in. 2) All Doctor's Prescription 3) All Receipts for Drugs/Diagnostic Tests

4) All Diagnostic Reports All the above documents should be submitted in Original, in proper sequence, duly tagged/stapled.

ii) Dental Treatment can also be availed of within the existing limit of Rs. 4000/- per member for the policy under O.P.D. treatment. Cost of dentures will not be reimbursed.

iii) In case of expenses on Eye Treatment, cost of spectacles/contact lenses shall not be reimbursed. iv) OPD Claims should be submitted by the beneficiary to the concerned office of

MDINDIA Health Care Services (TPA) Pvt.Ltd .only when the expenses exceed Rs. 1000 per person per policy period, within 15 days from the date of completion of the treatment. In other words the minimum claim for OPD should be Rs. 1000/- For those members whose OPD expenses do not exceed Rs. 1000/- during the entire policy period, the bills should be forwarded by such members within 15 days from the date of expiry of policy period i.e. latest by 15th January of the succeeding year For claims not lodged within the stipulated time limit. the company shall not be liable for such claims.

v) In case of treatment of ear, cost of hearing aid is not reimbursable

C. In case of any dispute in a claim, a committee of SAIL, UIIC officials and MDIndia Health Care Services (TPA) Pvt Ltd will be constituted to resolve the dispute. The decision of the committee in this regard will be binding on

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the parties. It shall be compulsory for all members of the scheme to first refer any grievance that they may have to the committee and wait for a reasonable time for the decision of the committee. The committee shall give detailed reasons for the decision taken for each and every dispute or grievance referred to it by any member of the scheme.

Customer care services

In case you have any questions or require assistance during hospitalization / claims processing we offer complete support to you, 24/7, through our multi-lingual Customer Care Centre.

Toll Free Customer care Number : 1800-233-1166 Customer care Voice (UAN ) Number : 1860-233-4446

Toll Free Authorization Number :1800-233-4505 Authorization Fax Number : 020-25300030

Authorization Voice (UAN ) Number :1860-233-4448 Authorization Fax (UAN ) Number :1860-233-4449

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LIST OF OFFICIALS DEALING WITH SAIL MEDICLAIM SCHEME

PLANT CODE PLANT/ UNIT NAME OF THE

OFFICIAL DESIGNATION CONTACT NO. EMAIL ADDRESS

1 BHILAI STEELPLANT Vijay Kumar Sharma Sr.Mgr(P) 0788-2854928 vijaysharma@sail-bhilaisteel.com

0788-2853894

2 DURGAPUR STEEL PLANT Prabir Kr. Das Jr. Mgr (Pers-Wel) 0343-2562316 mddsp3882@dataone.in

3 ROURKELA STEEL PLANT A.Patnaik SR.MGR (PL)W&ES 0661-2448506 amarendra.patnaik@sailr

sp.co.in

4 BOKARO STEEL PLANT BP Barnwal Asstt. Gen Mgr (Pers-FSC) 06542-240273 bko_fsc@yahoo.co.in

5 IISCO STEEL PLANT Arup Kr. Banerjee JR. MGR

(PERS) 0341-2240313 a.banerjee94172@gmail.com

6 ALLOY STEELS PLANT A.P. Singh Sr.Mgr (Pers) 0343-

2545795 apsingh_dgp@rediffmail.com

7 SALEM STEEL PLANT A.Saifudeen ASSTT.MGR

(PERS) 0427-2382210 Saif_salem@rediffmail.com

8 CENTRAL MKTG.OFFICE Ambarish Chakraborty Dy.Mgr (Pers) 033-22888825 ambarishc@sail-

steel.com

9 SAIL CORP .OFFICE Y.P.Manchanda Dy. Mgr(PERS) 011-24300329 yp.manchanda@sailex.c

om

10 CENTRE FOR ENGG & TECH. SHIBAJI DEY DY MGR

(PERS) 0651-2411175 shibajidey@yahoo.com

11 GROWTH DIVISION KULTI BL DHAWAN SR.Mgr (PERS)

12 GROWTH DIVISION KOLKATA S.K.SARKAR ASSTT.MGR

(Law) 033-22263399 swapankumar.sarkar@rediffmail.com

13 VISL, BHADRAWATI H.S.MANJUNATH MANAGER (PERS)

08282-271621 vislpersworks@yahoo.com

Ext. 2011

14 MEL CHANDRAPUR PP Chakrabarty Asstt. Gen. Mgr (P&A) 07172-254368 ppchaku@hotmail.com

15 RAW MATERIALS DIVISION, KOLKATA V Kevin Ghose SR.MGR(PERS) 033-22827603 rmd_mediclaim@rediff

mail.com

16 RESEARCH & DEVELOPMENT CENTRE, RANCHI

A.K.Sinha SR.MGR

0651-2411128 clc@sail-rdcis.com (PERS)

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D. Details of dealing officers / office at the Nine centers & MDIndia HO is given below: 1. Kolkata Branch

MDIndia Healthcare Services (TPA) Pvt. Ltd 169 Sarat Bose Road, 2nd Floor, Kolkata – 700 026 Phone: 033-24669429 Fax : 033-24656633 Email : sailkolkata@mdindia.com

2. Chennai Branch MDIndia Healthcare Services (TPA) Pvt. Ltd 1402, 15th Main Road, Annanagar, Chennai - 600040 Phone: 044-26162386 044-26160370 Fax: 044-26164000 Email: sailchennai@mdindia.com

3. Delhi Branch MDIndia Healthcare Services (TPA) Pvt. Ltd E98, 2nd Floor, Lajpat Nagar, Part – II, New Delhi – 110024 Phone: 011-29811840 Fax : 011-29811838 Email : saildelhi@mdindia.com

4. Bhilai Branch MDIndia Healthcare Services (TPA) Pvt. Ltd 10th Street, Shanti Nagar, Opp. Dashera Maidan, Bhilai – Durg , Pin– 490023. Phone: 0788-2291860 Fax: 0788 - 2291860 Email: sailbhilai@mdindia.com

5. Durgapur Branch MDIndia Healthcare Services (TPA) Pvt. Ltd 22, Kabiguru Sarani, SAIL Co-Op, City Center, Durgapur- 713216 Phone: 0343 - 2605644 Fax: 0343 - 2605644 Email: saildurgapur@mdindia.com

6. Rourkela Branch MDIndia Healthcare Services (TPA) Pvt. Ltd BM-77, Basanty Colony, Near DL Chowk, Rourkela, Orissa – 769 012 Phone: 0661- 2420779 Fax: 0661 - 2420779 Email: sailrourkela@mdindia.com

7. Bokaro Branch

MDIndia Healthcare Services (TPA) Pvt. Ltd 1st floor, Mishra Market, Plot no. 7081, Near Vaibhav Hotel, By-Pass road, Chas, Bokaro, Pin- 827013 Phone:06542-236426 Fax: 06542-236426 Email: sailbokaro@mdindia.com

8. Salem Branch

MDIndia Healthcare Services (TPA) Pvt. Ltd 59 S.K. Nagar, Seelanaickenpatty, Pin Code – 636201 Phone: 0427-246686 Fax: 0427-246686 Email: sailsalem@mdindia.com

9. Asansol Branch

MDIndia Healthcare Services (TPA) Pvt. Ltd Room no.3 Shanti Niwas, 1st floor, Besides Income tax office, G.T. Road, Asansol , Pin No.- 713304 Phone: 0341-2250799 Fax: 0341-2250799 Email: sailasansol@mdindia.com

Pune HO Office MDIndia Healthcare Services (TPA) Pvt. Ltd S.No-46/1,E-Space,A-Wing,3rd Floor, Pune Nagar Road, Vadgaonsheri, Pune-411014 Phone: 020 - 25300030 Fax : 020 -25300003 Email : customercare@mdindia.com authorization@mdindia.com sailops@mdindia.com

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Annexure A

CLAIM INTIMATION LETTER To, Dated: ......................... MDIndia Healthcare Services (TPA) Pvt.Ltd ...................................................... ...................................................... ...................................................... Dear Sir, Sub: MIN No. . . ......................................... This is to inform you that I have been admitted to Hospital, details of which are as under: 1) Name of Insured Member: ................................................................................ 2) Phone No. : ................................................................................ 3) Nature of Injury/Illness: ................................................................................ 4) Name & Address of Hospital: .............................................................................. ........................................................................................................................................... ... 5) Date of Admission of Hospital: ................................................................................ Thanking You, Yours Faithfully Name: ___________________________ Full Address for Correspondence: _______ __________________________________ Phone No. : ________________________

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Annexure B: HOSPITALISATION BENEFIT POLICY CLAIM FORM Issuing Office: Specimen MDINDIA HEALTHCARE SERVICES (TPA) PVT LTD. HOSPITALISATION BENEFIT POLICY CLAIM FORM

Claim No. ………………… (For office use only) Please fill all columns without exception, put “N.A”, wherever the column is not relevant.

1) Name of the Insured: …………………………………. ……………………………. (In Capital Letters) SURNAME NAME 2) Detail of the person Undergoing treatment: a) Name : ………………………………………………………………… b) Date of Birth : ………………………………………………………………… c) Residential Address: ………………………………………………………………... d) Phone Number : ………………………………………………………………… 3) MIN No. (Self) : ………………………………………………………………… MIN No. (Spouse) : ………………………………………………………………… 4) Nature of Disease/ Illness/Injury Suffered : ………………………………………………………………… 5) a) Name and Address of the Hospital/Nursing

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Home :…………………………………………………………………. Registration No. :………………………. State/U.Territory…………………….. b) Date of Admission : ……………………… ………………………… c) Date of Discharge : ……………………… …………………………

I have incurred on the treatment of Disease/Illness/Accident referred to above, the expenses as per the details given by me in the Schedule of expenses given overleaf. In support of the above claim I enclose the following documents in Original. 1. Bill, receipt and Discharge Certificate/Card from the Hospital. 2. Cash Memos from the Hospital/Chemist/(s), Supported by the proper prescription. 3. Pathological Test Report. 4. Surgeon's Certificate stating nature of operation performed. 5. Attending Doctor's/Consultant's/Specialist/Anesthetist’s Report. 6. Discharge Voucher duly signed on Rs. 1/- Revenue Stamp (Specimen given on page 14). I hereby warrant the truth of the foregoing particulars in every respect. I further declare that, in respect of the above treatment, no benefit under any other scheme of insurance or from my present employer's if any, have been claimed by me. I also consent and authorize MDIndia/Insurance Company to seek medical information/collect documents from any hospital/Medical Practitioner who has any time attended on the insured person. Date: Signature of Claimant

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Annexure C: SCHEDULE OF EXPENSES INCURRED BY THE CLAIMANT

MIN NUMBER CLAIM NO

………………………. (If allotted)

SCHEDULE OF EXPENSES INCURRED BY THE CLAIMANT

(Attach separate Annexure for details of bills)

Details of expenses claimed under Hospitalisation

(To be supported by Bills/Receipt, Cash Memos etc)

Amount Claimed

1. Pre Hospitalisation Benefits

(Within 30 days prior to admission in the hospital)

2. Hospitalisation Benefits

3. Post- Hospitalisation Benefits

(upto 60 days from Date of Discharge)

Total

I also consent and authorize MDINDIA/ united India insurance /SAIL to seek medical information/documents from any hospital /provider who has any time attend on the insured person .

Date: Place: Signature of Claima

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Annexure D: O.P.D TREATMENT CLAIM FORM

MDINDIA HEALTHCARE SERVICES (TPA) PVT. LTD

O.P.D TREATMENT CLAIM FORM 1) Name : ……………………………………………………………………… 2) MIN : ……………………………………………………………………… 3) Address (IN BLOCK LETTERS): ……………………………………………………………………... 4) Phone Number : ……………………………………………………………………… 5) Nature of Illness : ……………………………………………………………………… 6) Period of Illness : ……………………………………………………………………… 7) Expenses Incurred Amount Bill No. Bill Date a) For Consultation : b) For Medicines : c) For Pathological & Other Diagnostic tests : I declare that the given information is correct and that I have not claimed reimbursement for the above expenses incurred by from any other source. I also consent and authorize MDINDIA/ united India insurance /SAIL to seek medical information/documents from any hospital /provider who has any time attend on the insured person . Place: ………………… Date : ………………… (Signature of Insured) Note : Please enclose the following documents in original along with the claim form : a) OPD Card of SAIL approved / Govt. Hospital. b) Chemist/Nursing Home Bills/Receipts. c) All Pathological & other test report and bills, if any. d) Discharge Voucher duly signed (specimen given on page 14). All the above should be in original. No Photocopies will be accepted.

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Annexure E: Payment Voucher MDINDIA HEALTHCARE SERVICES (TPA) PVT LTD (Regd Office and H.O., Building A 2, 3rd Floor, Payment No: E Space, Vadgaon Sheri, Nagar Road, Pune-411014) Payment Voucher : Date: Office: Doc. Code: Bank A/c Code: Pay to Towards : MIN NO. :

S.L Dept code

Policy Yr Number

Tr. Code

Endt / Ren Yr Number Tp

Amount Debit Credi

A/C Main

Code Sub

CL Code

Insp Code

NOL code

01.

02.

03.

04.

05.

Authorised By AAO AO Asst/Dy. MGR MGR AGM GM Received with thanks from MDIndia Healthcare Services(TPA) Pvt. Ltd A sum of Rupees (in words)

By Cheque No. Drawn On: Dated Cashier Signature of Recipient

Please affix Rs. 1/- revenue stamp if amount exceeds Rs. 5000/-

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Annexure F: Request for Authorization (RAL) for Cashless Hospitalization.

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Annexure “G”

Document Acknowledgement Form

MIN: ……………………. Name of Patient: ……………………………….. Date of Submission: ……………………………….. Branch of Submission: ………………………………. Type of Document:

a. OPD Claim b. Hospitalization Claim c. Additional Document Replies d. Pre/ Post Hospitalization Claim e. Deduction Payment f. Reconsideration Claim

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LIST OF SAIL APPROVED HOSPITALS FOR OPD TREATMENT UNDER SAIL MEDICLAIM SCHEME

ANDHRA PRADESH

City Name Hospital Name Hyderabad Apollo Hospital Hyderabad Aghava Ratna Towers, ChiragAli Lane Hyderabad Care Hospital Hyderabad Jaya Diagnostic & Research Centre Ltd. MEDWIN Hospitals Hyderabad LN Prasad Eye Hospital Hyderabad Yashoda Hospital & Medicity Hospital Hyderabad Maxvision Eye HospitalBegumpet , Hyderabad Kakinada Apollo Samudra Hospitals Kakinada Care Hospital Nellore Bollineli Ramanaiah Memorial Hospital Vijayawada Global Medical Centre Vijayawada Pinnamaneni Care Hospital Vijayawada Saumya Apollo Hospital Vijayawada St. Ann's Hospital Vijayawada Vijetha Hospital Visakhapatnam City Care Hospital Visakhapatnam K.G. Hospital ASSAM City Name Hospital Name Guwahati International Hospital BIHAR AND JHARKHAND City Name Hospital Name Bokaro Referral Hospital, P.O. Jainamore Darbhanga Ram Janki Hospital Darbhanga R.B. Memorial Hospital Dhanbad BCCL Hospital Dhanbad CCWO Hospital Sariadhella Dharbhanga DMCH Dhanbad Patliputra Medical College Giridih State Referral Hospital, Dumri Hazaribagh Mission Hospital Jamshedpur Cancer Hospital Jamshedpur Tata Main Hospital Jamshedpur Telco Hospital Patna Holy Family, Hospital, Kurji Patna Indira Gandhi Ayur Sansthan,Sekhpur

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Patna Patna Medical College Hospital Ranchi Apollo Hospital, IRBA Ranchi Gurunanak Hospital & Research Centre Ranchi Hospital for Mental DiseaseRanchi Ispat Hospital, MECON Ranchi Mahadevi Birla TB Sanatorium Ranchi Marwari Sewa Sadan Ranchi Mission Hospital, Bariatu Ranchi Nagar Mal Modi Seva Sadan Ranchi Rajendra Medical College Hospital Ranchi R.K. Mission TB Sanatorium Ranchi Raj Hospital Nidan - Main Road

DELHI

City Name Hospital Name Anand Vihar Swastik Medical Centre Ashok Nagar Tyagi Nursing Home Ashok Vihar, Phase-III Sunder Lal Jain Charitable Hospital Darya Ganj Sanjeevan Hospital Dwarka Ayushman Hospital Rohini Rajiv Gandhi Cancer Institute & Research Centre, East of Kailash National Heart Institute, 49, Community Centre East of Kailash, New Delhi - 24 R.G. Stone Clinic Urological Research Centre Greater Kailash, Part-I East West Medical Centre Pvt. Ltd. 23/7 Shakti Nagar,Delhi-7 Parmarth Misson Hospital Rohini Saroj Hospital & Heart Institute Jangapura, New Delhi-14 Sahi Hospital Madhuban Chowk New Delhi Bhagwan Mahavir Hospital Greater Kailash-II Retina Associates Eye Institute Greater Kailash-II South Point HospialGreen Park, Extn Mohindra Hospital Janakpuri Mata Chanan Devi Hospital Ring Road, Lajpat Nagar-IV The Heart Centre,

Greater Kailash –I Sukdha Hospital,

Delhi Max Hospitals

Qutab Institutional Area Sita Ram Bhartia Institute of Science & Research,

Qutab Institutional Area Rockland Hospital,

Pusa Road Jeevan Nursing Home & Hospital,

Panchuian Road, Delhi Heart & Lung Institute,

K.G. Marg & Kailash Colony Shroff Eye Centre Safadurjang Development Area Orthonova Institute of Advanced Surgery and Research Centre Lajpat Nagar Moolchand Khairati Ram Hospital Lajpat Nagar Dr. Patnaik Laser Eye Institute Laxmi Nagar Walia Nursing Home

Mandir Marg, Saket Gujarmal Modi Hospital & Research Centre For Medical Sciences

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Mathura Road, Near Sarita Vihar Apollo Indraprastha Hospital Mayur Vihar Jeevan Anmol Hospital Naveen Shahdara Dr. Gupta Nursing Home & Hospital Vasant Vihar Vasant Lok Hospital

Lajpat Nagar Vidhya Sagar Institute of Mental Health and Neuro Science (VIMHANS)

Okhla Road Batra Hospital and Medical Research Centre Okhla Road Escorts Heart Institute and Research Centre Okhla Road Holy Family Hospital Pandav Nagar, Naraina road Khera Hospital Paschim Vihar Bhatia Global Hospital Preet Vihar Anand Health Care Pvt. Ltd. Pusa Road Kolmet Hospital & Medical Research Centre Rajendra Nagar Sir Ganga Ram Hospital Rajpur Road Tirath Ram Shah Hospital Rohini Bhagwati Hospital Rohini Jaipur Golden Hospital Rohtak Road, Punjabi Bagh Maharaja Agrasain Charitable HospitalSarita Vihar Shri Ram Medical Centre Sham Nath Marg Sant Parmanand Hospital

Sheikh Sarai, Phase-II Pushpavati Singhania Research Institute for Liver, Renal & Digestive Diseases,

South Extn Arya Vaidyashala, (Kottakal) Sheikh Sarai Venu Eye Institute Tis Hazari St. Stephans Hospital Vasant Kunj Indian Spinal Injuries Centre Vasant Vihar Seth Prabhu Dayal Gupta Charitable Hospital Vasundhra Enclave Dharmshila Cancer Hospital & Research Centre Vikas Marg, Extn. Deepak Memorial Hospital & Medical Research Centre Vikas Marg, Extn. Shanti Mukund Hospital Village Khizrabad (Near Friends Colony) Lions Hospital & Research Centre, Lions Service Trust GOA

City Name Hospital Name Bonapavla Manipal Goa Cancer and General Hospital Margao Apollo Victor Hospital GUJRAT City Name Hospital Name

Ahmedabad Dr. Jeevraj Mehta Smarak Health Foundation Medical Research Centre

Ahmedabad M.P. Shah Cancer Hospital Ahmedabad R.G. Stone Clinic Vadodara Bhailal Amin General Hospital Vadodara Metro Hospital & Research Center

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HARYANA City Name Hospital Name Sector-51, Gurgaon Artemis Health Institute

Palam Vihar, Gurgaon Columbia Asia Hospital,

DLF City -IV Gurgaon Shri Ram Bhartia Clinic

Faridabad Escorts Hospital CentreGurgaon Ark Hospital Gurgaon MP Heart Research Institute Gurgaon Privat Hospital Gurgaon Paras Hospital Gurgaon Uma Sanjivini Heatlh Centre Pvt. Ltd Gurgaon Umkal Hospital Hissar Hospital attached to Jindal Steel Panchkula Alchemist Hospital Panchkula Dhawan Hospital Sonipat Bharat Hospital Sonipat Janki Das Kapoor Memorial Hospital Sonipat Sathya OmNethra & Maternity Hospital Yamuna Nagar JP Hospital Bahadurgarh Delhi Hospital & Nursing Home KARNATAKA

City Name Hospital Name

Bangalore Bangalore Institute of Dental Science & Hospital

Bangalore Central Institute of Neuro-Science Bangalore Chinmaya Mission Hospital Bangalore Innovative Dental and Medical Poly Care Centre Bangalore KMC Hospital Bangalore Mallaya Hospital Bangalore Manipal Hospital Bangalore Manipal Heart Foundation Bangalore Mental Hospital Bangalore Model Eye Clinic and Nursing Home Bangalore Nethradhama Superspeciality Eye Hospital Bangalore Shri Satya Sai Hospital Bangalore St. Marthas Hospital Bangalore The Bangalore Hospital Bangalore Vittala International Institute of Ophthalmology Bangalore Wochardt Hospital Bangalore Ramiah Hospital

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Bangalore St. John's Medical College and HospitalManipal Kasturba Hospital Mysore Basappa Memorial Hospital Mangalore A J Hospital & Research Centre KERALA City Name Hospital Name Alapuzha VSM Hospital

Melamur Palakkad-6 Karuna Hospital

Chittur Road, Palakkad-13 Lakshmi Hospital

Kollam Amrita Ayurveda Medical College Hospital & Research Centre,

Palakkad Diabetic Centre

Perinthalmanna-679322 EMS Memorial Co-operative Hospital & Research Centre

Alleppey St. Thomas Mission Hospital Calicut Bady Memorial Hospital Chengannur Christian Mission Hospital Kochi Amrita Institute of Medical Science & Research Centre Kochi Arya Vaidyasala (Kottakal) Kochi Ernakulam Medical Centre Kochi Indira Gandhi Co-op. Hospital Kochi KPM Eye Hospital Kochi Ojus Clinic & Nursing Home Kochi PVS Hospital Kochi Giridhar Eye Institute Kochi Lisie Hospital Kochi Lourdes Hospital Kochi Medical Trust Hospital Eraviperoor Kotakkattu Medicare Hospital Irinjalakuda Lal Memorial Hospital Kannur Cooperative Hospital Kannur Indira Gandhi Co-op. Hospital Kollam S.S.M. Hospital Kottayam Karithas Hospital Kottayam Mar Gee Varghese Dionysius Memorial Hospital Kottayam S.H. Medical Centre Kottayam, Kollam Holy Cross Multispeciality Hospital Kozhencherry Muthoot Medical Centre Mulakuzha Century Hospital Palakkad Palana Hospital Palakkad Palat Memorial Hospital Palakkad Thangam Hospital of PMRC Palakkad Welcare Hospital Pandalam N.S.S. Medical Mission Hospital Parumala St. Gregorios Cardio-Vascular Centre Pathanam Thitta Tiruvalla Medical Mission

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Pathanamthitta Marthoma Medical Mission Hospital Pathanamthitta Muthoot Medical Mission Hospital Perumbavoor San Joe, Hospital Trichur Amala Cancer Hospital Trichur Aswani Hospital Trichur Elite Mission Hospital Trichur Jublee Mission Hospital Trichur Trichur Heart Hospital Trichy Maruti Hospital Triuvalla Dist, Ernakulam Pushpgiri Hospital Trivandrum General Hospital Trivandrum Mental Hospital Trivandrum Mother Hospital Trivandrum Samaritan Hospital Trivandrum Shreechitra Tirumak Medical Centre Trivandrum Sree Uthradom Thirunal Hospital MADHYAPRADESH

City Name Hospital Name Bhopal Kasturba Hospital (BHEL) Gwalior G.R. Medical College Bhopal Ayushman Hospital Centre Indore Bombay Hospital Indore Choitham Hospital & Research Centre Indore M.Y. Hospital Jabalpur Jabalpur Hospital & Research Centre Raipur D.K. Hospital Raipur Modern Medical Institute Ujjain PSS Hospital & Research Centre Ujjain Pushpa Mission Hospital Vindyanagar Vindyachal Hospital (NTPC) MAHARASHTRA City Name Hospital Name Mumbai Bombay Hospital Vashi Navi Mumbai Sterling Wockhardt Hospital

Mumbai Lilavati Hospital & Research Centre

Mumbai B.J. Wadia Hospital

Mumbai G.T. Hospital Mumbai Hinduja Hospital Mumbai Jaslok Hospital Mumbai J.J. Group of Hospital Mumbai K.E.M. Hospital

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Mumbai NAIR Hospital Mumbai Nanavathi Hospital Mumbai R.G. Stone Clinic Mumbai Tata Cancer Research InstituteMumbai Tata Memorial Hospital Nagpur Central India Institute of Medical Science Nagpur Mental Hospital Nagpur Wockhardt Hospitals Navi Mumbai Dr. D. Y. Patil Hospital & Research Centre Navi Mumbai Sterling Hospital Pune Artificial Limb Centre Pune Sadhu Vaswani Mission Medical Complex Pune K.E.M. Hospital Pune Medipoint Hospital Pune N.M. Wadia Institute of Cardiology Pune Jehangir Hospital Thane Lok Hospital ORISSA City Name Hospital NameBerhampur M.K.C.G. Medical College Bhubaneshwar Apollo Hospital

Bhubaneshwar CDR Hospital

Bhubaneshwar Kalinga Hospital

Cuttack S.C.B. Medical College Sambalpur V.S.S. Medical College PUNJAB City Name Hospital Name Chandigarh Fortis Hospital Chandigarh Inscol Chandigarh CMC Hospital Ferozpur Anil Baghi Hospital Hoshiarpur Modern Hospital Jallandhar Patel Hospital Pvt. Ltd. Ludhiana CMC Hospital

Rajpura Soni Hospital

RAJASTHAN City Name Hospital Name Alwar Indraprastha Apollo Hospital Alwar Sinha Nursing Home

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Jaipur SMS Medical College Jodhpur Goyal Hospital & Research Centre Pvt. Ltd. Vasant Vihar , Alwar Seth Prabhir Dayal Gupta Charitable Hospital TAMIL NADU

City Name Hospital Name

Chennai Apollo Hospital

Chennai B.S.S. Hospital Chennai Shri. Ramachandra Hospital Chennai Cancer Institute Chennai General Hospital Chennai K.J. Hospital Chennai Malar Hospital Chennai Madras General Hospital

Chennai Railway Headquarters Hospital

Chennai R.S.R's Trinity Acute Care, Hospital

Chennai Shanker Netralaya Chennai Sundaram Medical Foundation Chennai Tamil Nadu Hospitals Chennai Vijaya Hospital Chennai St. Isabel Hospital Chennai Dr. Mohan’s Diabetological Institute

Chennai Madras Medical Mission

Chennai. Indian Medical Practitioners, Co-operative Society Hospital Chennai. Ramachandra Medical College & Research Institute Coimbatore Kottakkal Arya Vaidyasala Coimbatore Ganga Medical Centre & Hospital Pvt. Ltd. Coimbatore G Kuppuswamy Naidu Memorial Hospital, Combiatore Vijaya Hospitals Coimbatore Kennedy Hospital, Coimbatore K.G. Hospital Coimbatore Nataraj Hospital, Kanchi Kamakoti Trust Coimbatore Ram Krishna Hospital Coimbatore The Eye Foundation Coimbatore Coimbatore Aryu Viidyu (Pharmacy) Madurai Apollo Hospital Madurai Arvind Eye Hospital Madurai Bose Hospital Madurai Meenakshi Mission Hospital & Research Centre Pondicherry East Coast Hospital R.S. Puram Vedanayakam Hospital Salem Sri Gokulam Hospital Trichy Sea Horse Hospital Ltd Trichy Kavery Medical Centre (KMC) Trichy

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Vellore Christian Medical College & Hospital UTTAR PRADESH City Name Hospital NameAgra Jalma Insitute of Leprosy Trg. & Research Centre Aligarh Gandhi Eye Hospital Aligarh J.N. Medical College Allahabad MLN Medical College Ghaziabad Dr. R.S.G. (Indo German) Medical Centre Ghaziabad Ganesh Hospital Ghaziabad Narendra Mohan Hospital Ghaziabad Sarvodya Hospital Ghaziabad Yashoda Hospital Haridwar Dispensaries run under Divya Yog Mandir (Trust)

Kanpur Regency Hospital Ltd Kaushambi Jashoda Speciality Hospital Lucknow Vivekanand Polyclinic Lucknow OP Chaudhar Hospital & Research Centre, Lucknow Ramakrishnan Mission NOIDA Aggarwal Eye Hospital & Dental Care Centre NOIDA Kailash Hospital & Research Centre Ltd NOIDA Keerti Medical Centre NOIDA Metro Multi Speciality Hospital NOIDA Fortis Hospital, NOIDA Metro Heart Hospital, NOIDA NOIDA Medical Centre Sitapur Eye Hospital Varanasi B.H.U. Hospital UTTARAKHAND Dehradun Jolly Grant Himalaya Institute of Medical Sciences WEST BENGAL Barrakpore Disha Eye Hospital & Research Centre- Hooghly Aroga Niketan Howrah West Bank Hospital Burdwan Burdwan Medical College & Hospital

Kolkata Zenith Superspeciality Hospital,

Kolkata Nightingle Digonostic & Medicare Centre Pvt. Ltd,

Kolkatta Advance Medicare and Research Institute Kolkatta Anandlok Hospital Kolkatta Assembly of God Church Hospital

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Kolkatta Aurobindo Seva Kendra

Kolkatta B. P. Poddar Hospital & Medical Research Ltd

Kolkatta B.M. Birla Heart Research Insitute Kolkatta Bangur Institute of Neurology Kolkatta Behala Balananda Brahmachari Hospital & Research Centre Kolkatta Calcutta Medical & Research Insitute Kolkatta Cancer Centre and Welfare Home Kolkatta Calcutta Heart Clinic & Hospital Kolkatta Chittaranjan Cancer Hospital Kolkatta Dr. Rafi Ahmed Dental College & Hospital

Kolkatta Dr. Sudarsan Chakarborti Memorial Centre for Research and Treatment

Kolkatta Apollo Gleneagles Hospital Kolkatta Eskag-Sanjeevani Kolkatta Eye Care & Research Centre Kolkatta Harmoni Nursing Home Kolkatta ILS Multi Speciality Clinic Kolkatta Jitendra Narayan Ray Sishu Seva Bhawan Kolkatta Kothari Medical Centre Kolkatta K.P.C. Medical College & Hospital Kolkatta Microlap Nursing Home Kolkatta Paramount Hospital Pvt. Ltd Kolkatta Park Clinic Kolkatta North Bank Diagnostic Centre Kolkatta North City Hospital & Neuro Institute Kolkatta Peerless Hospital Kolkatta Ramakrishna Mission Seba Pratishthan Kolkatta Ruby General Hospital Kolkatta Rabindra Tagore International Institue of Cardiac Sciences Kolkatta SEBA Hospital Kolkatta Sahid Khudiram Bose Institute & Research Centre Kolkatta Silver Line Hospital & Research Institute Kolkatta Subodh Mitra Cancer Hospital & Research Centre Kolkatta Suraksha Hospital Kolkatta Susrut Eye Foundation & Research Centre Kolkatta Wockhard Medical Centre Kolkatta West Bengal Spastics Society Kolkatta Wockhard Hospital & Kidney Institute IIIA Kolkatta Woodland Nursing Home Purulia Netaji Eye Hospital Raniganj Anandlok Hospital

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LIST OF EMPANELED HOSPITALS FOR CASHLESS UNDER TPA

AHMEDABAD Location Hospital Name Dr Jivraj Mehta Marg Dr Jivraj Mehta Smarak Health Foundation Memnagar Sterling Hospital S.G. Highway Shalby Hospitals Ltd

Shahibag The Gujarat Research & Medical Institute (rajasthan Hospitals)

ASANSOL Location Hospital NameG T Road Asansol Metropolitan Nursing home G T Road City Nursing Home G T Road Kamalya Nursing Home G T Road (W) Asansol Mecdial center Lower chelidanga Life linemedicare Ranigung NH 2 AnandalokHospital Sen raligelh road Dodadil nursing Sen raligelh road HLG Hsopital (tertiary) Sen raligelh road Lion Hospital BALLABGARH

Location Hospital Name Ballabgarh Akash Hospital

BANGALORE Location Hospital Name 2nd Main Road Chiranjeevi Hospital and Maternity Home Agrahara Dasarahalli Sarvodaya Hospital Ashok nagar St Philomena Hospital Indira nagar Chinmaya Mission Hospital Sonde koppa Circle Harsha Hospital Vittal Mallya Road Mallya Hospital Bommasandra Industrial Area Narayana Hrudayalaya Mahalaxmi Layout Sangolli Nursing Home Airport Whitefield Rd Sankara Eye Hospital

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Bannergatta Road Wockhardt Hospitals Limited Bannerghatta road Apollo Hospitals Bangalore Basavanagudi Avadhani Nethralaya Basavesharanagar Panacea Hospitals (P) Ltd Below Railway Bridge Sundar Hospital Hanumantha Nagar Vishwabharathi Hospital Pvt Ltd Hebbal Bangalore Baptist Hospital Hosakerehalli Vittala International Institute of Ophthalmology Jayanagar Sagar Hospitals Jayanagar (Near Vivekanand School) Jayanagar Orthopaedic CentreKalyananagar Lokhande Hospital Kanakapura Main Road Bharath Nursing Home Kanakpura Main Rd Deepak HospitalLooft Ring Road Pulse Diagnostics & Specialist Care Centre Magadi Main Road Padmavathi Hospital Mahalakshmipuram Sneha Nursing Home Malleshwaram Columbia Asia Hospitals Pvt Ltd Malleshwaram Jupiter Hospital MSR Ngr M S Ramaiah Memorial Hospital Near Cantonment Rly Station Church Of South India Near Ulsoor Lake Lakeside Medical Centre & Hospital Tumkur Rd Sri Raghavendra Hospital Vidyalaya Rd The Bangalore Hospital Vijaynagar Vidya Eye Hospital BHILAI Location Hospital Name Mayura Talkies Revival Nursing Nehru Nagar BSR Apollo Nehru Nagar BSR Cancer Hospital Nehru Nagar C M HospitalNehru Nagar KGH Hospital(Cardiac) Nehru Nagar Suraj Hospital Opp Mayura Talkies Bhilai Nursing HomeSupela Gayathri Hospital Supela Sparsh Hospital BHOPAL Location Hospital Name Kolar Road Harsiddhi Hospital M P Ngr N M R Hospital

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Opp Dushehra Maidan Career Institute Of Medical Sciences Opp Nermal Meera School Chirayu Health & Medicare Pvt Ltd Shahpura Ayushman Hospitial BHUBANESHWAR Location Hospital Name BBSR Panda Nursing Home (P) Ltd Kharelnagar Near BBSR Rly Station Neelachal Hospital Pvt Ltd Ekamra Marg Maa Shakti Hospital Nr. Muncipal Kalyan Mandap Aditya Care Hospital Saheednagar Deepak Clinic - N - Nursing Home BOKARO Location Hospital NameBokaro Dr K K Das B.S. City Mother Care City Centre, Sec-4 Sri Sai Hospital Birla Dental College Campus Om Sri Sai Hospital & Research Centre Doctor's Clony Shanti nursing hospital Chas K M memorial hospital Chas MuskanHospital Chas Nilam hospital CHANDIGARH Location Hospital Name Bhind grudwara Oxford heart & Multispeciality Hospital Chandigarh Kapoor's Kidney And Urostone Centre Pvt. Ltd Chandigarh Omni Hospital Sec - 34 A Inscol Hospital Sector 15-c Dharam Hospital CHENNAI

Location Hospital Name 19,Cathedral Road, Dr.Agarwal Eye Hospital Ltd. 21, Greams Lane Apollo Hospitals Enterprise Ltd 45, G A Road CSI Rainy Multispeciality Hospital Adayar Malar Hospitals Limited Alwarpet Harvey Healthcare Ltd Anna Nagar KHM Hospital

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Baracks road GKM Hospital Pvt. Ltd. 58 LB Road Adyar P M Hospital & Research Ctr P Ltd. Naid Colony Aminjika M R Hospital Poonamallee High Road New Hope Medical Centre Valasaravakkam Opp Rakshit Hospital Chromepet Royal Balaaji Hospital College Road Medical Research Foundation Jaganathan Street Balaji Hospitals (P) Ltd. Kaladipet Rohit Hospital Kattankuluthur SRM Medical College Hospital & Research Centre Kelampakkam Chettinad Hospital & Research Institute Kilpauk Apollo First Med Kilpauk Deepam Eye HospitalKilpauk The Guest Hospital Medavakkam Global Hospitals & Health City Mogappair Frontier Lifeline Pvt Ltd Mogappair Madras Medical Mission Mount Poonamallee Road Miot Hospitals Limited Mylapore Sampat Nursing Home Mylapore Chennai Meenakshi Multispeciality Hospital Ltd

Mylapore RSR Trinity Acute Care Hospital Mylapore St Isabel Hospital Nandanam Apollo Specialty Hospital Nandanam Venkataeswara Hospitals Nanganallur Hindu Mission Health Services Near Valluvarkottam Rajan Eye Care Hospital Nungambakkam Kanchi Kamakoti Childs Trust Hospital Pallikaranai Dr Kamakshi Memorial Hospital Peravallur (Perambur) Abhijay Hospital (P) Ltd Porur Sri Ramachandra Medical CentrePurasawalkam Noble Hospital Raja Annamalaipuram Andhra Mahila Sabha Raja Annamalaipuram Chennai Kaliappa Hospital Saidapet Vasan Eye Care Hospital Shenoy Nagar Billroth Hospitals Sowcarpet Apollo Hospitals Sowcarpet St Thomas Mount St Thomas Hospital T.Nagar Bharathi rajaa speciality Hospital Tambaram (W) Bethesda Medical Mission Thiruvotriyur Sugam Hospital Tondiarpet Apollo Hospitals Tondiarpet Vadapalani Vijaya health centre Vadapalani Vijaya Heart Foundation

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Vadapalani Vijaya Hospital West road Vijais Nursing home COCHIN Location Hospital Name Alwave Carmel Hoapital Diwans Road Ernakulam Lakshmi Hospital KMK Jn Don Bosco Hospital M.G.Road Kochi Hospital Pachalam Lourdes Hospital COIMBATORE Location Hospital Name Alam Nagar Road Ashwin Hospital Avinashi Road Lotus Eye Care Hospital Ltd Mettupalayam Road V G Hospital Peelamedu Psg Hospital Sundarapurah Sree Abirami Hospital (P) Ltd CUTTACK Location Hospital Name Telengapenth N H - 5 Panda Curie Cancer Centre DELHI Location Hospital Name Adjacent to Moolchand Flyores Moolchand Khairati Ram Hospital

Anand Vihar Swasthik Medical Centre

Bali Nagar Khetarpal Hospital

Budh Vihar Brahm Shakti Hospital & Research Centre Pvt

Darya Ganj Sanjeevan Medical Research Centre (P)Ltd

Daryaganj Dr Shroffs Charity Eye Hospital

Delhi Mathura Road Indraprastha Apollo Hospitals

East of Kailash National Heart Institute

G. T Karnal Highway Bhatia Hospital

Greater Kailash - II Talwar Medical Centre

Janakpuri Mata Chanan Devi Hospital

Janakpuri Hemraj Jain Hospital & Maternity Home

Jeewan Nagar Jeewan Hospital & Nursing Home

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Kailash Colony Dr Sharma Nursing Home

Kailash Colony Shroff Eye Centre

Kalkaji Banarsidas Chandiwala Institute Of Medical Sciences

Kirti Nagar Kalra Hospital

Krishna Nagar Ganesh Ortho Trauma & Medical Centre

Lajpat Nagar Vimhans Hospital

Madhuban Chowk, Rohini Saroj Hospital & Heart Institute

Main Panchkul Geetanjali Road Sunil Hospital and Nursing Home

Malviya Nagar Aakash Hospital

Mayur Vihar Jeevan Anmol Hospital

Mayur Vihar Kukreja Hospital

Najafgarh Ortho Plus Hospital

Nangloi Bimal Hospital

Near Janak Puri West Metro Anand Hospital

Near Keshnopur Bus Depo Park Hospital

Near Popular Apt & Mother Dairy Bhagwati Hospital

Near Sir Ganga Ram Hospital Mohan Eye Institute

Near Sunlight Colony Jeewan Nursing Home

Okhala Rd Escorts Heart Institute & Research Centre

Panchkulan Rd Delhi Heart & Lung Institute

Paschim Vihar Sri Balaji Action Medical Institite

Patparganj Max Balaji Hospital

Phase-3 Sunder Lal Jain Hospital

Preet Vihar Metro Hospital & Cancer Institute

Priyadarshini Vihar Makkar Medical Centre

Punjabi Bagh Maharaja Agrasen Hospital

Punjabi Bagh MGS Hospital

Pusa Road Jeewan Nursing Home & Hospital

Rajinder Nagar Sir Ganga Ram Hospital

Rajouri Garden Kukreja Hospital And Heart Centre

Rohini Family Hospital (P) Ltd

Rohini Jaipur Golden Hospital

Rohtak Rd Shree Jeewan Hospital

Safdarjung Enclave Centre For Sight

Saket Max Devki Devi Heart & Vascular Institute

Saket Sawan Neelu Angels Nursing Home

Sarva Priya Vihar Healing Touch Hospital

Sec – V Rajiv Gandhi Cancer Institute and Research Centre

Sec-16 Rohini Satyam Hospital Pvt Ltd

Sector - 14 Rohini Santom Hospital Pvt Ltd

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Shalimar Bagh Kesar Hospital

Tughlabad Batra Hospital & Medical Research Centre

Uttam Nagar Gandhi Nursing Home

Uttam Nagar Mata Roop Rani Maggo Mahindru Hospital

Vikas Marg Malik Radix Healthcare Pvt Ltd

Vikas Marg Pushpanjali Medical Centre

Vikas Marg Sharp Sight Centre

Yamuna Vihar Panchsheel Hospital (P) Ltd DURGAPUR Location Hospital Name A/1 Nandal Bishti Presidnecy Nursing Home Aldrin Path West Midland Nursing Home B-120 Aldrin Path Bidhan Niramoy HospitalCENTRAL PARK City Clinc and Nursing Home Pvt Ltd Dr Zakir Hossain Avenue Vivekanad Hospital ( Secondary Care) G T ROAD west end Nursing HomeManora Das Market Amader Nursing Home N1 Doctor's Colony Dr B C Roy Hospital Near Durgapur Station JeevanDeep Nursing Home Nera DurgapurStaion Dollar Nursing Home Nera DurgapurStaion Dr Vivek Nursing home Sector 2C Mission Hosiptal (tertairty Care) FARIDABAD Location Hospital Name 5R/5 ,NIT Surya Ortho & Trauma CentreNear Neelam Bata Flyover Escorts Hospital & Research Centre Neelam Flyover, Ajronda Chowk QRG Central Hospital Sector 16 Metro Heart InstituteSector 19, Gopi Colony Sarvodaya Hospital & Research Centre YMCA Road Sarvodaya Hospital & Research Centre GAZIABAD Location Hospital Name H-1, Kaushambi Yashoda Hospital & Research Centre Ltd Indirapuram Shanti Gopal Mohan Nagar Narendra Mohan Hospital Nehru Nagar Yashoda Hospital & Research Centre Ltd

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Plot No 481, Friend Society, Sector 12, Vasundra Param Jyoti Eye Care Rajnagar Shivam Hospital & Heart Centre Pvt Ltd. GURGAON Location Hospital Name 380, City Centre, Sector 29 Doctor Kares Health Care Pvt Ltd 877/12, Mata Road Mamta Hospital B Block, Sushant Lok 1 Max Hospital Mehrauli Road Kalyani Hospital Pvt Ltd Near Mayfield Garden Artemis Medicare Services Pvt LtdNear Shalom School Paras Hospital HYDERABAD Location Hospital Name Banjara Hills Care Hospitals Secretariat Road MediCiti Hospitals Jubilee Hills Apollo Hospitals L.B.Nagar Kamineni Hospitals Malakpet Yashoda Super Speciality Hospital Nampally Railway Station Medwin Hospital Sanath Nagar St Therasa Hospital Somajiguda Yashoda Super Speciality Hospital INDORE Location Hospital Name A B Road CHL Apollo Hospitals Dr Sarju Prasad Marg Gokuldas Hospitals Ltd Mainak Bagh Road Choithram Hospital & Research Centre Ring Rd Mayur Hospital & Research Centre Ujjain Road Sri Aurobindo Institute Of Medical Sciences JABALPUR Location Hospital Name Damoh naka Metro Hospital & Cancer Research Centre Gol bazar National Hospital Jabalpur City Hospital &Research Centre Near Gate No 3 Anant Institute Of Medical Sciences Opp. Wright town stadium Mahakoshal Hospital

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JAIPUR Location Hospital Name Ashok Marg Liberty Hospital Jaipur Sahai Hospital &Research Centre Jawaharlal Nehru Marg Bhagwan Mahaveer Cancer Hospital & Research Centre Malviya Nagar Fortis Escorts Hospital Malviya Ngr Apex Hospital (P) Ltd Mansarovar Dhanvantri Hospital & R Centre Mansarovar Saket Medicare & Reasearch Centre Pvt.ltd Sector 5 S K Soni Hospital

Vidhyadhar Nagar Ganadhipati Purushottam Shekhawati Hospital& Research Centre

Vidhyadhar Nagar Shekhawati Hospital And Research Centre JAMSHEDPUR Location Hospital Name Main Road Bistapur Life Line Hospital JODHPUR Location Hospital Name Residency Road Goyal Hospital & Research Centre(p) Ltd. KOCHI Location Hospital Name Chittor road, Sree Sudheendra Medical Mission Opp Adam Pillykadu Temple Vijaya Kumara Menon Hospital Panayappilly Gautham Hospital Ravipuram V. G. Saraf Memorial Hospital (P) Ltd. Vellikulam Rd Ccmk Hospital KOLKATA Location Hospital Name Albert Road Gamma Centauri Healthcare Pvt Ltd Andul Road West Bank Hospital APC Road Capitol Nursing Home Pvt Ltd Barsat Care & Cure Nursing Home Belgharia Sahid Khudiram bose Hospital

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Beliaghata Divine Nursing Home Pvt.ltd., Bose Road Lansdowne Nursing Home Bose Road Ramakrishna Mission Seva Pratishthan Deshpran Sasmal Road Rsv Nursing Home & Speciality Diagnostic Centre E M Bypass Ruby General Hospital Gariahat AMRI Hospitals Kasba Golpark Desun Hospital & Heart Institute Canal Circular Road Apollo Gleneagles Hospitals National Library Avenue B M Birla Heart Research Centre 1/3 Dover Place Dr. Nihar Munshi Eye FoundationRajdanga Main Road Genesis Hospital Rajarhat Road Swasti Eye &Super Speciality Nursing Home Diamond Harbour Road The Calcutta Medical Research Institute Alipore Road Woodlands Medical Centre Limited Dimond Harbour Road Behala Balananda Brahmachari Hospital & Research Centre Gorky Terrace Park Clinic Loudon Street Priyamvada Birla Aravind Eye Hospital Mallick Square, Sankar Netralaya

Mukandapur Rabindranath Tagore International Institute Of Cardiac Sciences & Armenian Church Trauma Ctr

Music World Park Street,Mocambo Restaurant Royd Nursing Home & Health Care Ltd Nagaland House Nightingale Diagnostic & Medicare Centre Pvt Ltd Near Alipore Zoo Kothari Medical Centre Near Vandoan Market Life Line Nursing Home Near WBSEB Office Hindustan Health Point Pvt LtdNew Alipore, Block-G B.P Poddar Hospital & Medical Research Ltd Nr Kamarhati Zenith Super Speciality Hospital Opp to Club Town Charnock Hospital Pvt LtdOpp Triangular Park N G Medicare & Calcutta Hope Infertility Clinic Opp. Medical College The Sherwood Nursing Home Opp.Traingular Park,Near Priya Cinema Wockhardt Hospital &Kidney Institute Panchasayar National Neurosciences Centre Panchasayar Peerless Hospitex Hospital And Research Centre Ltd. Park Street Mission of Mercy Hospital & Research Centre Paul Road Microlap Prannath Pandit Street Health Point S C Mullick Rd K P C Medical College & Hospital Jadavpur Salt Lake Columbia Asia Hospital Salt Lake Rotary Narayana Nethralaya Salt Lake city Ils Hospital

Salt Lake Stadium Susruta Clinic &Research Institute For Advance Medical Pvt Ltd

Saltlake Subodh Mitra Cancer Hospital & Research Centre

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Saltlake City Anandalok Hospital Sinthee More (Binayak Enclave) Binayak Multispeciality Hospital Sukanta Sadan Disha Eye Hospitals & Research Centre Pvt Ltd VIP Road Uma Medical Related Institute (P) Ltd VIP Road Vip Apex Medical Centre Private Limited KOTTAYAM Location Hospital Name Azad Lane Bharath Charitable Hospital Society Azad Lane Bharath Hospital Kollam Holy Cross Hospital Thellakom Matha Hospital Ponkunnam P N P Memorial K V M S Hindu Medical Mission Hospital LUDHIANA Location Hospital Name Field Ganj Market Christion Medical college & Hospital G T Road Sps Apollo Hospitals Model Town Deep Nursing Home and Children Hospital LUCKNOW Location Hospital Name37 Cantt Road F I Hospital Aliganj Crossing Neera Hospital Indiranagar Shekhar Hospital Pvt Ltd River Bank Colony K K Hospital Seva Nagar Sitapur Road Sewa Hospital & Research Centre MADURAI Location Hospital Name Chokkikulam Vadamalayan Hospital K K Nagar Apollo Speciality HospitalsAnna Nagar Aravind Eye Hospital Melur Rd Meenakshi Misson Hospital and Research Centre Narimedu Saravana Hospitals

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MUMBAI Location Hospital Name Andheri (E) Ashirwad Child & Surgical Hospital Andheri (W) BSES MG Hospital Andheri (W) Criticare Hospital & Research Centre Bandra - Kurla Complex Asian Heart Institute Chembur Inlaks General Hospital Chembur Joy Hospital Pvt Ltd Chembur Joy Hospital Pvt Ltd Chembur Surana Sethia Hospital & Research Centre Gandhi Market Smt S R Mehta & Sir K P Cardiac Institute Ghatkopar (E) Advanced Orthopaedic & Superspeciality Centre Ghatkopar (E) Parakh Hospital Pvt Ltd Ghatkopar (W) Kedia Nursing Home Ghtakopar (E) Bakul Parekh Children Hospital Govardhanbapa Chowk Sir Hurkisindas Nurrotumdas Hospital & Research CentreJogeswari (W) Mallika Hospital Kandivli (E) Asha Hospital Kandivli (E) Nupur Nursing HomeKoparkhairane Satyam Multi Speciality Hospital & Trauma Centre Kurla (W) City Hospital & Recearch Centre Malad (W) Life Line Hospital Malad (W) Riddhi Vinayak Critical Care And Cardiac Centre Marin Lines Bombay Hospital & Medical Research Centre Mulund (W) Holy Trinity Hospital Mulund Goregaon Link Rd Wockhardt Hospital Limited Mulund(W) Hira Mongi Navneet Hospital Near dahisar Shraddha Hospital Near Kemp's Corner flyover Cumballa Hills Hospital and Heart Institute Next to Maitri Park Best Bus Stop Niramaya General Hospital Panvel Ashtavinayak Hospital Panvel Dr Patil Hospital Panvel Dr Patil Hospital Panvel Gandhi Hospital Panvel Life Line Hospital Peddar Rd Jaslok Hospital And Research Centre Powai L H Hiranandani HospitalSantacruz (E) R.K.Hospital Vasai Cardinal Gracias Memorial Hospital Trust (Dir Mailer) Vikhroli (W) Godrej Memorial Hospital

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Vile Parrle(W) Bhartiya Arogya Nidhi Shet Kantilal C Parikh General Hospital

Ville Parle(w) Dr Balabhai Nanavati Hospital MYSORE Location Hospital Name Jayalakshmipuram Basappa Memorial Hospital Kuvempunagar B. G. S.Apollo Hospitals Kuvempunagar Kamakshi Hospital Nr Nazarbad Police Station Gopal Gowda Shanthaveri Memorial Hospital Siddalingapura post Bhagwan Mahaveer Darshan eye Hospital NOIDA Location Hospital Name E-3A, Sector 26 Icare Eye Hospital & Post Graduate Institute NH -1, Sector 27 Vinayak Hospital Sector 11 Metro Multispeciality Hospital Sec-18, Near Aatta Market Max Health Care Institute

Sector 27 Kailash Hospital & Heart Indistitute Ltd (a Unit Of Kailash Health Care Ltd)

Sector 35, Golf Course Road Surbhi Hospital PATNA Location Hospital Name Rajendra Nagar Magadh Hospital PUNE Location Hospital Name Chinchwad Aditya Birla Memorial Hospital Chincwad Lokmanya Care Hospital Erandawane Deenanath Mangeshkar Hospital & Research Centre Hadapsar Noble Hospital Karve Road Sahyadri Speciality Hospital Nigdi Lokmanya Hospital Rasta Peth K E M Hospital Sadashiv Peth Poona Hospital & Research Centre Sassoon Road Jehangir Hospital Sassoon Road Ruby Hall Clinic

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RANCHI Location Hospital Name Booty Road Alam Hospital & Reasearch Centre Pvt Ltd Main Road Raj Hospital & Reasearch Centre

Ranchi Abdur Razzaque Ansari Memorial Weavers Hospital(Apollo Hospital)

ROURKELA Location Hospital Name Civil town City ClincHsopital Jagatha CSW Hospital Civil town Life Linehsopital Udit nagar Meher Eye Hsopital Civil town OM Appollo Hsopital Civil town Rourkela Lifeline Pvt Ltd Udit nagar Shanti Memorial Hsopital Civil town Veagase Patel hospital SALEM Location Hospital Name Agraharam Sri Raam Hospital Alagapuram S K S Hospital Pvt. Ltd Ammapet S. Palaniandi Mudaliar Memorial Hospital Annathanapatti Sri Bharathi Nursing Home Ashram road, Nathan super speciality Hospital Behind Sarada College Hasthampatty Thambi Medical Surgical Eye Hospital Dadagapatty Shanthi Nursing Home Five Roads Kurinji Hospital Hasthampatti Salem Medical Center Hospital Pvt Ltd Main Road Arokya Hospital Meyyanur Road Sri Gokulam Hospitals (P) Ltd Near Gandhi Steadium Shri Shellapha Hospital Near Jothi Theatre bus stop Rajammal Hospital

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Near Old Bus Stand A C Hospital Omalur Road Nagarajan Nursing Home Opp DSP Office Sree Vasantham Hospital Opp New Bus Stand Vasan Eye Care Hospital Opp. New Bus Stand Pranav Hospitals Pvt. Ltd. Rajaji Road CKR Hospital Rajaji road Kiruba hospital Ramakrishna Road Salem Gopi Hospital (P) Ltd S.K.Nagar R P S Hospital Raghavachari Road Chellam HospitalSeelanaickanpatty Bye-pass Dharan Hospital Cheery Road Dr.Haneefa Polyclinic and Nursing Home Ramakrishna Park Ganesan HospitalSecond Agraharam Mohanraj Childrens Hospital Salem - Bangalore - Highway Manipal Hospital Sardar College Rd Shanmuga Hospital & Salem Cancer Institute Shankar Nagar M/s. Vidya Hospital Sree Krishna Complex Kamala Hospital Valapady Deepam Hospital Veerapandi Vinayaka Mission Hospital TRIVANDRUM Location Hospital Name Anayara Post Kerala Institute of Medical Sciences Peroorkada Punarjani Institute Of Medical Science Anayara P.D.Tvm Lords HospitalFort, SP Fort Hospital Venjara Moody Sree Gokulam Medical College & Research Foundation VELLORE Location Hospital Name IDA Scurrer Road Christian Medical College