Frequently Asked Questions
What are the services offered by FHPL to its beneficiaries?
FHPL is the service provider for required Health care service to corporate through its activities like - Cashless services at over 4300+ Network Hospitals, Member Reimbursement facility for Non-Network hospitals, Personalized client servicing, Enrollment and Claims administration.
How different is FHPL from Health Insurance Company?
FHPL is a Third Party Administrator (TPA) in health Insurance Sector servicing all subsidiaries of GIC and Private Insurance Companies. Group Mediclaim Policy of Insurance Companies is the basic product on which FHPL adds its value-addition like network of hospitals, medical care standardization, claims management, client servicing expert opinion etc. Thus FHPL administers a `healthcare package' for its clients with customized healthcare delivery.
What does an Insurance Policy cover? Is maternity covered under Insurance Policy?
The policy is with United India Insurance Company Ltd. (UIIC) and coverage is for In-patient hospitalization with both network and out of network hospitals for various diseases.
Maternity (Normal and Cesarean) is covered under the corporate policy up to INR 50,000/- per delivery restricted to first 2 living children.
Are emergencies / ailments that happen on overseas trips covered by FHPL?
No. FHPL has arrangement only with Indian insurance companies. These companies do not extend cover outside India; Separate Policy needs to be taken.
Whether Out Patient / Outdoor services covered under the insurance policy?
Out Patient / outdoor services are not covered under your Insurance policy.
Any treatment which can be done on OPD Basis will not be covered. Exceptions
are Dialysis, Chemotherapy, Cataract, Radiotherapy, Lithotripsy etc. for more details contact helpdesk personnel of FHPL.
What is the helpline number for FHPL ?
The toll free helpline number for FHPL is 1800-425-4033.
What are the timings for the FHPL Helpline?
The dedicated FHPL helpline is accessible 24/7.
Is there a mail id where the associates can write to FHPL ?
Yes, associates can write to and
Who is the contact person in case of any queries regarding medical
insurance-related.
1st Contact Person
Mr. Syed Anwar
Mobile: 92472 19359
Email:
2nd Contact Person
Ms. Kavitha Mallavarapu
Mobile: 9542499978
Email:
How to enroll newborn babies / newly wedded spouse in middle of the
policy?
Newborn Baby / Newly wedded spouse can be enrolled subject to registration of the details with FHPL through online enrollment tool, within 30 days of the event (Marriage / Newborn).
Please follow the below steps to access the Online Tool for registration.
Step 1 - Log on to our website www.fhpl.net/catechnologies
Step 4 - Key in the PMF Key and the Password given to you.
Step 5 - Click on Login Tab.
Step 6 - You can print the Health Plan Benefits or Click Next to upload the dependent details.
Step 7 - Add Dependent details & Upload Photo (optional) of each member.
Step 8 - Click on Confirm after updating all the details.
Once you have clicked on Confirm there would be an automated e-mail sent to you with the dependent data as provided by you.
Your access details for Online Registration:
Corporate ID :
PMF Key : «employee id»
Password : «password»
Whom to contact for any queries regarding E-Card access? What if I forget my user id and Password?
Please write to and
I am a New joinee, I have updated my dependent details through online window but I am not able to view my dependents E-Cards. In case of any hospitalization requirement, How do I or my dependent avail the cashless benefits?
The time limit to update dependents is 15 days, up on completion of the time limit, We (FHPL) would retrieve the data and forward to Insurance co for endorsement.
Upon receipt of the endorsement, the dependents are enrolled and a welcome mail is sent by FHPL with E-Card Login Details. However, dependents are covered in the policy from the date of joining of associate. In case of any hospitalization please share your CA employee ID card and photo ID proof of the patient to network hospital to avail the cashless benefits as per merits.
How do I access and print my E-Card?
Please follow below mentioned steps to access your E-Card and other information regarding your mediclaim policy:
E-Card Access.
E-Cards will be available online for all the covered associates and their dependents. Please follow these simple steps to download / print the same:
Step 1: Log on to FHPL website www.fhpl.net
Step 2: Click on Login and then Ecard Login.
Step 3: Key in the Corporate ID, PMF Key and the Password (given to you) .
Step 4: Click on the name of the member to view e-card.
Corporate ID :
User Name : «employee id»
Password : «password»
For Printing of E-Card
Select 'Tools' on the Internet Browser
Go to 'Internet Options'
Go to 'Advanced'
Check printing with back ground and Colors
The Card can be printed in B/W or Color
How do I check my Claim status.
Details of all claims, which are submitted to FHPL for the current policy period can be accessed through www.fhpl.net an associate can check the claim status and other essential details by logging to FHPL site (ecard Login).
Where can the member avail the required services?
Cashless facility can be availed at the Network Hospitals. In case member gets admitted in any Non - Network hospitals in India then the member has to pay the amount first and have to submit the bills along with complete documents to FHPL for re-imbursement.
What is a Network Hospital?
A Network Hospital includes all hospitals, nursing homes, clinics and other healthcare providers accredited and intimated to the Member Organization by FHPL from time to time, to deliver hospitalization facility.
How does claim process work for a network hospital ?
When you are admitted to the network hospital you need to show the FHPL Card to the Billing / Insurance desk. The Network Hospital would contact the responsible TPA (Third Part Administrator, mentioned on the card i.e. FHPL) and fill up the pre-authorization form. Then the hospital would send the same to TPA with estimation of expenses. The TPA checks the policy conditions, sum-insured and approves the estimate. Co pay for Parent Claims and inadmissible expenses as stated, to the hospital needs to be paid by the associate, once the hospitalization is authorized by FHPL. FHPL settles the claim directly with the hospital.
Which are the list of network hospitals?
List of Network Hospitals in FHPL is available in FHPL website.
https://www.fhpl.net/NetworkHospitals/NWHospitals.aspx
What is a Non-Network Hospital? What is the basic criteria of a hospital for reimbursement in a Non-Network Hospital?
It includes all hospitals that are not on the FHPL Network.
Hospital means any institution in India (including nursing homes) established for Medical Treatment which:
Either:
(a) has been registered and licensed as a hospital with the appropriate local or other authorities competent to register hospitals in the relevant area and is under the constant supervision of a Medical Practitioner and is not, except incidentally, a clinic, rest home, or convalescent home for the addicted, detoxification centre, sanatorium, home for the aged, mentally disturbed, remodeling clinic or similar institution.
(b) Or
(i) is under the constant supervision of a Medical Practitioner, and
(ii) has fully qualified nursing staff (that hold a certificate issued by a recognized nursing council) under its employment in constant attendance , and
(iii) maintains daily records of each of its patients, and
(iv) has at least 10 Inpatient beds, and
(v) has a fully equipped and functioning operation theatre.
How does the claim process work for Non Network hospitals for both planned and emergency hospitalization?
Associate has to make upfront payment at the hospital and submit all bills with supporting documents to FHPL representative during the help desk with in 30 days from the date of discharge from the Hospital.
The documents that need to be submitted are: -
ñ Claim Form of UIIC duly filled and signed by claimant.
ñ Original detailed discharge summary.
ñ Original investigation reports along with bill.
ñ Original Hospital Bill - consolidated and with detail breakup with the patients signature on it.
ñ Original Cash paid receipts.
ñ In case of surgical packages – detail breakup of the package.
ñ Medicine bills with prescriptions.
FHPL will scrutinize the documents for completeness. Once the documents are complete, payment will be made directly to the associate within 15 days.
Note:The final amount settled would be less the co-pay value for parent claims.
Is cashless facility available at all the hospitals?
The cashless facility is available only at the hospitals which are on FHPL network.
Are all the major corporate hospitals on network?
Most of the corporate hospitals are a part of our network.
Will I get cashless at government institutions like AIIMS/TMH/ARMY Referral hospitals?
No, government hospitals doesn’t extent cashless facility
Who all are covered under the insurance policy and what is the total coverage amount?
The policy provides coverage for a family of 6 Members - Employee, Spouse, 2 Children, and Dependent Parents.
ñ Dependent Coverage A:
Members Covered: 1+ 3 (Employee + Spouse + 2 Children)
Sum Insured : INR 500, 000/-
ñ Dependent Coverage B:
Members covered: 1+1 [Dependent Parents or In Laws] In Laws will be covered for female and male associates.
Sum Insured : INR 300, 000/- (20% co payment upto maximum of Rs 10000/- shall be applicable for each and every claim).
ñ Dependent Coverage C: Top Up Policy (OPTIONAL and SELF FUNDED)
Members Covered: 1+1 Dependent Parents or In Laws who are enrolled in
in the base policy only. This is optional cover where employee will have to pay the premium. Terms and Conditions for top up policy are same as of base policy. INR 4281 per anuum if opted for Single Parent / In Law, INR 4329 if opted for Two Parents / In Laws.
Sum Insured : Additional INR 300, 000/- under top up policy in excess to base policy (20% co payment upto maximum of Rs 10000/- shall be applicable for each and every claim).
What are the benefits covered in the policy?
ñ Pre existing diseases.
ñ 1st Year Exlcusions.
ñ 1st 30 Days Exclusion.
ñ Pre-Post Hospitalization Expenses.
ñ Maternity benefits up to Rs.50,000/- per delivery restricted to 2 children.
ñ Pre & Post Natal Expenses covered up to (up to INR 5 % per occurrence, sub limit of Maternity benefits on OPD basis). Expenses on New Born Baby Prior to discharge from Hospital, covered up to 5 % of the Maternity sub limit.
ñ Baby Cover day 1 coverage.
ñ Day Care Procedures covered
ñ Ambulance charges covered upto 1% of the Sum Insured subject to maximum of Rs.2000 per person per policy.
What is a Pre existing disease?
Pre Existing ailments such as diabetes, hypertension, etc or related ailments for which care, treatment or advice was recommended by or received from a Doctor or which was first manifested prior to the commencement date of the Insured Person’s first Health Insurance policy with the Insurer.
What is a 1st Year Exclusion?
During the first year of the operation of the policy the expenses on treatment of diseases such as Cataract, Benign Prostatic, Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital Internal diseases, Fistula in anus, Piles, Sinsutitis and related disorders are not payable. If these diseases are pre-existing at the time of proposal they will not be covered even during subsequent subsequent period or renewal too.
What is a 1st 30 Days Exclusion?
Any Illness diagnosed or diagnosable within 30 days of the effective date of the Policy Period if this is the first Health Policy taken by the Policyholder with the Insurer. If the Policyholder renews the Health Policy with the Insurer and increases the Limit of Indemnity, then this exclusion shall apply in relation to the amount by which the Limit of Indemnity has been increased
What are Pre and Post Hospitalization Expenses?
Pre and Post hospitalization expenses - covered for all relevant medical expenses incurred 30 days prior to hospitalization and expenses incurred during 60 days after hospitalization. By RELEVANT EXPENSES we mean all expenses pertaining to the disease for which he/she is hospitalized, prior to hospitalization or after discharge.
For Example: A person may be required to undergo certain tests to confirm the disease for which he is eventually hospitalized. The Doctor's consultation fees for this, the expenses on tests and medicines 30 days prior to hospitalization for that particular disease are covered. RELEVANT EXPENSES for post hospitalization
60 days after being discharged from the hospital, e.g. the subsequent follow up consultations with specialists, medicines and test expenses are covered.
What are the pre hospitalization formalities that an associate needs to complete to avail of cashless transactions for a planned hospitalization in a network hospital?
Associate needs to approach a network hospital at least 7 days in advance of the admission to the hospital with the FHPL E card. The advance notice may be reduced depending on the criticality of the situation and on case to case basis. The network hospital approaches FHPL for authorization. FHPL authorizes the treatment and employee gets to know about it through the hospital / FHPL helpline/FHPL representative / SMS alert provided the contact no is mentioned on the pre-authorization form.
What is a Maternity benefit?
The maximum benefit allowable will be Rs.50,000/- for both normal delivery as well as C-section within the Sum Insured limit, max up to 2 children. There are special conditions applicable to the Maternity Expenses Benefits as below:
ñ These benefits are admissible only if the expenses are incurred in Hospital/Nursing Home as in-patients.
ñ Claim in respect of delivery for only first two children and/or operations associated therewith will be considered in respect of any one Insured Person covered under the Policy or any renewal thereof. Those Insured Persons who already have two or more living children will not be eligible for this benefit.