1. What is Voluntary Parental Insurance Policy?

Voluntary Parental Insurance policy provides for medical coverage against hospitalization
expenses for illness, disease or injury sustained by parents of the employees of Wipro.
Expenses for hospitalization are payable only if a 24 hour hospitalization has been taken with
active line of treatment. (Except for select day care procedures, which do not require a
24hour hospitalization). This policy is not applicable for investigative/diagnostic procedures.
This Policy is a health insurance taken by Wipro for parents/in-laws of Wipro employees on
behalf of the Wipro Employees under a group insurance program that covers in-patient
hospitalization expenses but subject to certain exclusions, co-pay and limits. You can contact
the TPA help desk or customer care numbers given at the end of this document for further
clarification.

2. Who can be covered under Voluntary Parental Insurance Policy?

Employee has the option to cover his/her parent(s) and/or parent(s)-in-law.

3. What is active line of treatement?

Active Line of Treatment is a continuous medical treatment provided by a medical practitioner to a
patient suffering from a specific ailment under life threating situations. Tests and diagnostics of all
kinds with or without hospitalization for <24 hrs or > 24 hrs would not be considered as active line of
treatment.

4. What is the validity of the group policy?

The group policy period is effective from 01-Dec-2019 & ends on 30-Nov-2020. The details of the
policy are available in myWipro - myWipro ► App Store ► Information ► My Policies ► India ►
My Financials ► Voluntary Parental Insurance Policy

5. Who is my Insurance Company (insurer)?

United India Insurance Company Ltd is the Insurer who will be providing medical insurance
Coverage to employees’ parents and in-laws (if enrolled).

6. Who is Medi Assist India Pvt. Ltd?

Medi Assist India Pvt. Ltd is your service provider - Third Party Administrator (TPA). The TPA
facilitates administration of employees Medi-claim Policy (Medical Insurance) and assists you
by providing quality health care. It is not an insurance company; it acts as a liaison between
Wipro and United India Insurance Company Ltd.

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7. Policy coverage is applicable even when the enrolled member is hospitalized outside India?

No, this coverage is not applicable when the enrolled member is hospitalized outside India.

8. What is pre-existing condition in health insurance policy?

Pre-existing condition is a medical condition/disease that existed before you obtained health
insurance policy. Any condition, ailment, injury or relation condition(s) for which the patient had
signs or symptoms, and/or was diagnosed, and/or received medical advice/treatment is
considered as Pre-existing disease.

9. What is cashless facility?

Facility that allows policyholder or his/her dependents (enrolled) to take treatment at any of
our network hospitals without having to pay the hospital bills as the payment is made to the
hospital directly by your Third Party Administrator (Medi Assist), on behalf of the insurance
company. However, expenses beyond the limits or sub-limits allowed by the insurance policy
or expenses not covered under the policy have to be settled by you directly with the
hospital. Cashless facility shall not be available if treatment in taken at a non-network
hospital.

10. In which situation employee will undergo claim reimbursement process?

a. If employees chose to pay the hospital bill on his own.

b. Employees will have to claim pre and post hospitalization expenses as
reimbursement.
c. If cashless is denied employee can pay the bills and resend for a review as
reimbursement with all the papers in Original.

11. What is the Standard and Comprehensive Cover?

The Standard cover does not include pre-existing ailments and Comprehensive cover includes
pre-existing ailments. Employees in standard policy for 4 continuous years (from the date of
taking the policy) without any claim history will automatically get their pre-existing diseases
covered, from the 5th year of renewal.

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 Benefits Standard cover Comprehensive cover
Available for a limited period
 during the renewal cycle every
Enrollment year
Available throughout the year
window  30 days from the date of
joining/return for new
hires/onsite returns
Standard
Covered Covered
Hospitalization
Pre & Post
Relevant expenses covered (30 days Relevant expenses covered (30 days
hospitalization
pre- and 60 days post hospitalization) pre- and 60 days post hospitalization)
expenses
Pre-existing
Not covered Covered
diseases
First 30-days &
First Year Waiting period applicable Waiting period waived off
Waiting Period
Internal
congenital Covered Covered
ailments
External
Only in case it is Life threating or impacting regular life
congenital
ailments
Genetic Disorder Only for in-patient treatment
Covered (INR Covered (INR
1,000 per claim for 1,000 per claim for
Emergencies only) Emergencies only)
Emergency is defined as urgent Emergency is defined as urgent
Emergency
treatment at hospitals that is required treatment at hospitals that is required
ambulance
by an insured who is immobile due to by an insured who is immobile due to
services
some illness or accident and cannot take some illness or accident and cannot take
the strain of traveling in a vehicle other the strain of traveling in a vehicle other
than ambulance. Such need must be than ambulance. Such need must be
certified by your consulting doctor. certified by your consulting doctor.
Covered (Only list of select procedures Covered (Only list of select procedures
like Dialysis, chemotherapy, like Dialysis, chemotherapy,
radiotherapy and other such specified radiotherapy and other such specified
Day care
treatments taken in the hospital/ treatments taken in the hospital/
procedures
nursing home where the insured is nursing home where the insured is
discharged on the same day. Refer discharged on the same day. Refer
Policy Terms & Conditions for details Policy Terms & Conditions for details
Surgical dental Covered (INR 10,000 per family). Out of
Not covered
treatment this, the sub limit for Root canal

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 treatment is INR 5,000 per tooth
inclusive of cost of the crown. (Cosmetic
treatment like filling, capping, polishing,
dentures, scaling, cleaning and
treatment of similar nature are not
payable. Detailed prescription, nature of
treatment, procedures done, pre-
numbered receipts are a must for dental
treatment claims. In addition, Post RCT
X-ray film is mandatory for justification
of admissibility of claim.)
Limited to INR 2,400 per day in A-class Limited to INR 2,400 per day in A-class
cities & INR 1,750 in B-class cities. A- cities & INR 1,750 in B-class cities. A-
Room rent
class cities include metros, Bangalore, class cities include metros, Bangalore,
restriction
Hyderabad, Pune & Gurgaon. Rest of the Hyderabad, Pune & Gurgaon. Rest of
cities are B-class cities. the cities are B-class cities.
Covered (INR 5,000 per employee).
Expenses related to external aids used
Mobility
Not covered for mobility (like walker, crutches) upon
extension
the prescription of the treating doctor
and admissibility of the main claim.
Covered, if required for correction of power +-7.0 and above. (ICL, FEMTO Lasik and
Lasik treatment SMILE surgery restricted to conventional procedure cost). Only spherical power is
admissible
Co-pay (10%) Applicable for all claims Applicable for all claims
Co-pay (10%)
and additional
2% co-pay
applicable for
Applicable for all claims
employees who
do not pre-
intimate in case
of a planned
hospitalization
Maternity claims Not covered Not covered
Limited to 25% of lower limit of room Limited to 25% of lower limit of room
Nursing charges
rent rent

12. What is a Floater policy?

Floater policy is one single policy that takes care of the hospitalization expenses of both your
parent(s) and parent(s)-in-law. The policy has one single sum insured, separately for parents

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 and in laws, which can be utilized by any/all insured persons in any proportion or amount
subject to maximum of overall limit of the policy sum insured.

13. What is Co-Payment? Is Co-Payment applicable in this policy?

A co-payment is a cost-sharing requirement under a health insurance policy where
policyholder/insured person will bear a specified percentage of the admissible costs.
Copayment of 10% will be applicable for the claims for parent(s) and/or parent(s)-in-law. The
copayment is applicable on the total admissible claim amount, pre and post hospitalization for
himself or any other family member (covered in the Policy) till the policy is expired.

There will be an additional 2% co-pay (in addition to the 10% co-pay) for employees who do
not pre-intimate (myWipro > My Medical Claim > Medical Insurance Claim > Proceed to
Medibuddy portal) in case of a planned procedures.

13. How and when can I change my cover?

• An employee can change the cover during a renewal cycle.

• Change of cover from Standard to Comprehensive is allowed upon completion of 3 years
in Standard cover
• In case an employee has completed 4 years in comprehensive plan and wants to opt for
Standard plan then waiting period is not waived off in standard plan.
• Change of sum insured would be restricted to the next higher slab (2L to 4L/ 4L to 6L).
You can reduce your sum insured if you have completed the lock in period.

14. I had taken parental insurance for both my parents, however one of them has passed
away? Will I be refunded the premium?

The same sum insured will be maintained for the single parent, till the end of the policy period
for that year, with no refund. However, for the subsequent years an employee can renew the
policy under single parent premium during the renewal cycle.

15. I have got transferred from DO&P to IT Services? What happens to my Parental insurance?
The policy is common for DO&P and WT employees.

16. How can I claim the premium paid for Parental Insurance?

Employees can claim the premium paid for Parental Insurance under MAS/ MAP, upto a
maximum limit of INR 10,000/-. This reimbursement can be made only for dependent parents
who are enrolled in Wipro provided Parental Insurance Policy. Parental Insurance Policy
taken from outside will not be eligible for reimbursement. Parent-in-laws medical insurance
policy premium cannot be claimed under MAS. An employee can claim for reimbursement

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 only post the premium has been paid. In DO&P only employees in Band C1 and above who
have MAP can avail this.

17. I am a WASEian. How can I claim the premium paid for Parental Insurance?

We regret to inform you that WASE/WIMS/ SIMS/WiSTA employees cannot claim the
premium through MAS.

18. If I take parental/parental-in-law insurance this year, then can I opt out of this next year?

No, if you take parental/parental-in-law insurance this year then you cannot opt out of this
cover for the next 3 years.

19. If I opt-out of parental/parental-in-law insurance this year, then can I opt out-in next year?

No, in case you opt-out of parental cover, you cannot opt for the same for the next 3 years.

20. What are the timelines for adding my parent(s) and/or parent(s)-in-law details on myWipro
to ensure Insurance coverage for them?

New joinees should update family details in myWipro > My Data and apply for Parental
insurance on myWipro > Appstore > Finance > My Benefits > Group Insurance > Parental
Insurance within 30 days of joining. Other employees need to fill their parent(s) / in-law
details on the portal and apply during the renewal window

21. How do I pay the premium for insurance policy?

The premium will be deducted in equal monthly installments basis your selection of deduction
frequency (1, 2 or 3 months) on myWipro from the December 2019 salary. If new joinees
select the option post 20th of a month, the premium deduction will start from the next month
and will be pro-rated basis the number of months remaining in the policy.

22. What are reimbursement claims? And what is the procedure for claim reimbursement?

In the event where cashless hospitalization in not availed, you need to submit all the original
bills along with the claim form available on myWipro->Finance->My Medical Claim>Insurance-
>Submit Claim. Kindly fill in the details and take a print and attach the printed claim form along
with medical reports and prescriptions and drop it to the nearest HRSS dropbox in your
location. Expenses will be reimbursed to you after deducting the basic nonmedical expenses
and applicable co-pay.

23. Is there any restriction on ICU Charges?

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 In case of hospitalization in ICU, actual charges shall be paid.

24. Is non-medical expense covered under the policy?

Your health insurance policy pays for reasonable and necessary medical expenditure. Of the
amount claimed by you, admissible (medical) expenses shall be payable. Non-admissible
expense (non-medical expense) shall not be paid.

25. What is mobility extension, up to what amount can it be claimed?

Expenses related to external aids used for mobility (like walker, crutches) upon the
prescription of the treating doctor and admissibility of the main claim is covered up to INR
5,000 per Employee, if the employee has opted for Comprehensive Cover. This is not
covered in Standard Plan.

26. What happens to my coverage when I decide to move out of Wipro?

Employee will have the option to continue the coverage for parent(s) and/or parent(s)-in-law till
the end of the policy period, i.e. Nov 30, 2020. In case you wish to port the policy post expiry you
may write to parentalinsurance.helpdesk@marsh.com.

27. Is there any restriction on the age of parent(s) and/or parent(s)-in-law under this policy?

Parent(s) and/or parent(s)-in-law up to 90 years of age can be covered under this policy.

28. Is Out Patient Expenses covered under this policy?

Outpatient expenses are not covered under the Policy.

29. What are the benefits covered under this policy?

The policy covers reimbursement of reasonable and necessary expenses for treatment of
illness / disease / injury contracted during the policy period like room rent, nursing care,
consultation fee, investigations charges, medicine charges, operation theatre and related
expenses, which fall within the available Sum Insured during the 12 months’ policy period.
30. What do you mean by hospitalization and what are the conditions in which you pay my
hospital bills?

Involuntary event caused either by internal or external means due to which we seek medical
advice in hospital is Hospitalization. Only expenses on hospitalization for minimum period of
24 hours with an active line of treatment are admissible. However, this time limit does not
apply to specific treatments defined under day care list i.e., dialysis, chemotherapy, radio

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 therapy, eye surgery, lithotripsy (kidney stone removal), tonsillectomy etc. taken in the
hospital/nursing home and the insured is discharged on the same day. In these cases the
treatment will be considered as taken under Hospitalization benefit.

31. What is Domiciliary Hospitalization Expenses and is it covered under this policy?

Medical Treatment for a period exceeding 3 days for such illness/disease/ injury which in the
normal course would require care and treatment at the Hospital /Nursing Home but actually
taken whilst confined at Home in India under any of the following circumstances:
Condition of the patient is such that he/she cannot be moved to the hospital /nursing home

Or

The patient cannot be moved to the hospital/nursing home for lack of accommodation
therein. Domiciliary Hospitalization is covered under the policy.

32. What are the exclusions under the Policy?

Policy has certain permanent exclusions. Details of such exclusions are separately available
in the exclusions list in the policy available on myWipro My Policies.

33. Is Ayurveda treatment covered under this policy?

Policy covers Ayurveda treatment if it is taken at Government recognized Ayurveda
Hospital/Medical College.

34. Alternative treatments like Homeopathy, Naturopathy, Unani, etc. covered under this
policy?

Treatment under Naturopathy, Unani and other experimental therapies are not covered.
35. Are physiotherapy treatments covered?

Physiotherapy treatments shall be covered if deemed necessary by the treating doctor. This
can be part of pre or post hospitalization expenses.

36. Can I avail ambulance services? Is it payable?

Ambulance expenses are covered up to INR 1,000 per claim for Emergencies only for taking
Patient from Home to hospital and Inter Hospital. Air Ambulance is covered for INR 1 Lakh in
case of emergencies when patient needs to be airlifted due to medical condition for
treatment.

37. What happens when an employee has joined & there is a parental/parental-in-law
hospitalization during the period when the cards are yet to be received?

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 Employee’s parent(s)/in-law(s) are covered from date of enrolment; In case of emergency
employee can make the payment out of pocket and claim for a reimbursement. Else,
employee can use the temporary ecard available for first 60 days and then download
permanent E card from Medibuddy.

38. If the hospital does not recognize my MAID (Medi Assist ID), what am I supposed to do?
MAID is a unique ID given by Medi Assist to its customers. Kindly make sure that you mention
your employee id on all correspondence sent by the hospital we shall be able to retrieve all your
details.

Alternately, if you are consulting a non-network hospital, wherein Medi Assist has not empaneled
the provider then you may not be able to avail the cashless facility. In such event, the hospital
will not be in a position to acknowledge or recognize the Medi Assist ID that you furnish. Please
refer website https://www.mediassistindia.com/insured/#networkhospital to know the list of
Medi Assist network hospitals.

39. Under what circumstances, my claim may get denied?

A claim may be denied under few of the following circumstances:

If disease for which a claim is put forward falls under the permanent exclusions of policy.
If the treatment is taken as an Out Patient
If hospitalization expense is mainly involving investigation charges and there is no active
line of treatment given to the patient
If hospitalization was for a duration less than 24 hours (unless listed under day care)
If hospitalization is not required for treating the medical condition and the treatment could
have been administered as an outpatient.

40. Can I submit photo copies of the documents?

All original documents are required to be submitted in original as photo copies are not
accepted.

41. How can I understand if the diagnosis and procedure in case of a planned hospitalization is
covered under the policy?

For planned hospitalizations employees are requested to write to

wiprocoverage@mediassistindia.com to get TPA clearance on coverage, check if the
diagnosis and procedure recommended by doctor is covered as per policy or not

42. Who is my first point of contact in case of a claim or query?

Medi Assist TPA Contact:

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Primary mail ID for all wipro@mediassistindia.com Operating from MediAssist
queries office
Dedicated Voice Support 1800-419-1164 24 / 7 * 365 days support

Dedicated number for 8152850999 24 / 7 * 365 days support

cashless and emergency
hospitalization
Mail ID for confirmation wiprocoverage@mediassistindia.com 24 / 7 * 365 days support
on coverage of procedure

HRSS Contact Centre

For any other queries, please contact the HRSS Integrated Contact Centre by raising a
ticket via helpline.wipro.com or call the Toll Free No 1800 266 6867

43. Can I get ‘hospital discount’ reimbursed if I go for reimbursement in a network

hospital?

If an employee opts for treatment in a hospital which is in the TPA network list of
hospitals, then the payment mode opted should be cashless. We strongly advice against
selecting reimbursement in place of cashless in a network hospital as a payment mode.
In an event for any reason whatsoever, the employee has to select reimbursement mode
in a network hospital, then there may be a charge under the header of ‘hospital discount’
which will be deducted from your final reimbursed amount. This hospital discount value
covers the difference in agreed tariffs between the hospitals and TPA for cashless and for
non-cashless payment mode. Hence, to avoid having to pay the hospital discount out of
pocket, we advise you to opt for cashless in place of reimbursement in a network
hospital as a payment mode.

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