After the expiry of the earlier cashless GMP policy under MAFS taken from New India Assurance company Ltd. on August 14, 2020, RBI has placed the policy with Iffco Tokio General Insurance Co. Ltd. for the period of one year (15-8-20 to 14-8-21) on the mutually agreed terms and conditions.

As there is a change of Insurance company, new TPA cards will be issued to the members during the year.

There is change in the grade-wise per hospitalization limit which is given here. There is no change in room charges and ICU limit.

There is no change in the Third Party Administrators (TPAs) View/download the list.

All claims pertaining to the MAF members  will be settled by the designated TPA, irrespective of the place where the treatment is taken.
The centers allocated to the TPAs and the new policy will be effective for all hospitalizations commencing on or after August 15, 2020.

The name, contact number and e-mail id of the  representatives of the Insurance Consultants are listed here.

140+ day care surgeries are given in the day care list .  Any new advancement in treatment modalities to be covered if it is a part of Day Care.


Cataract operation with a cap of Rs. 60,000/- per eye uniform for all. PPN charges are not applicable for cataract claims and to be processed as per specified limit of Rs. 60,000/-

The expenses for Oral & Adjuvant chemotherapy will be covered subject to sum insured on cumulative basis.
In case, where physiotherapy is postponed due to plaster, benefit will be extended from next day of plaster removal date.
All Organ transplants, including stem cell transplants/ therapy are covered, provided the treatment is approved by Indian Medical Association.
Coverage of injections like but not limited to Zolendronic Injection, Bortezomib Injection & Terifrac Injection administration, Injection Firmagon, injection Gemitide & Injection Rituximab administration covered under day care procedures subject to sum insured on cumulative basis.
Investigation charges and medicines charges levied during hospitalization will be reimbursed in full irrespective of room occupied. Pro-rata deduction will not be applicable on investigation charges and medicines.

Settlement of Claims:
The policy will pay in respect of the hospitalization expenses as per the limit of per hospitalization.
If the insured is diagnosed with an illness or suffer accidental body injury, which necessitates his hospitalization, the insurer will reimburse the insured person’s consequent hospitalization expenses for medical expenses reasonably and necessarily incurred including but not limited to:
Room and Board charges as per indicated limit. In the event of the insured utilizing room rent higher than his/ her limits then following procedure will be followed in settling the claim.

  1. a) If the hospital maintains the tariff depending upon the room rent then claim will be settled on the rates specified therein for all charges incurred.
    b) If such list is not available, then the charges will be settled on pro-rata basis.
    c) In any case the pro-rata claim cannot be below the procedure charges of such treatment.
    d) In case of death also the claim will be settled on prorata basis if insured is utilizing room rent higher than his/her Limit.
    e) Claims will be settled on proportionate basis if higher room rent is opted, however the minimum payment will be made as per PPN tariff irrespective of higher room rent.
  2. Doctor’s fees
  3. Intensive care unit
  4. Nursing expenses
  5. Surgical fees, operating theatre, anaesthesia & oxygen & their administration
  6. Physiotherapy
  7. Drugs & medicines consumed on the premises
  8. Hospitalization miscellaneous services (such as laboratory, x-ray, diagnostic test)
  9. Dressing, ordinary splints & plaster casts
  10. Cost of prosthetic devises
  11. Organ transplantation including the treatment costs of the donor but excluding the cost of organ.

For any guidance/clarification/ feedback etc. relating to the GMP  respective TPA representative  may be contacted.
In all cases, the members may invariably provide their mobile telephone number for receiving SMS for pre-authorisation sanction and carry their MAF (photo) Card along with the TPA Identity Card for verification at the time of hospitalization, which may be required for identification.

In case of prolonged hospitalization where the claim is on reimbursement basis, the member should inform the designated TPA during the period of hospitalization.
There is no change in the other instructions issued in this regard from time to time.
Your may view complete List of Salient Features / Bank’s forwarding letter dated August 14, 2020.
Aditya Birla Insurance Brokers Limited Communication Matrix as per the Zones and TPA allocation.View

Wishing  all members, supporters, friends and their families a Happy Independence Day. -AIRBIOPF

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