A NOTE ON INTERNATIONAL SECOND MEDICAL OPINION SCHEME

A NOTE ON INTERNATIONAL SECOND MEDICAL OPINION SCHEME

The Family Floater Medi Claim Policy for LIC employees / retirees envisages International Second Medical Opinion scheme from 2019-20 year policy. For the current year also the same has been continued. This facility is available FREE OF COST to the employee/retiree. This scheme is available

in the 1. 2.

Policy Document from Page 5 to Page 9. Let us discuss in brief about this service.

An insured under the Policy is entitled to have an expert opinion from World Leading Medical Center (WLMC) that specialises in the medical condition with which the member is diagonised. This year this facility is provided through MDIndia Healthcare Networx Pvt. Ltd., whose address and contact details are given below :

Name & Address of this Service MDIndia Healthcare Networx Pvt Ltd., Provider. S.No.46/1, E-space, A2 Building,

2nd Floor, Pune Nagar Road, Vadgaonsheri, PUNE-411 014. MAHARASHTRA.

For obtaining this facility the Service provider has to be contacted on the above mobile number or by Email to the above email address by the member, who is eligible to receive the facility during working hours of New India Assurance company.
Once intimation is received, the service provider with members diagnosis by attending Physician along with Qualifying Medical Condition, will list the best in the world THREE WLMC's who are expert in diagonising and treating that particular illness. The service provider will work directly with Attending Physician to collect and assemble all Medical Records for onward transmission to WLMC.

The expert in WLMC will verify the correctness of the Diagnosis on going through the Records presented. Also it will send the originally proposed treatment plan, treatment options, international standards of care, newly available and proven treatment approaches.
The Opinion will be sent to the Member and attending Physician in writing within 10 working days. If the service provider fails to obtain the required medical records, then it is the responsibility of the member to collect the same.

The service provider will pay for all costs of Medical Second Opinion process.
All benefits under this Program are available only when the Member (Insured) is diagonised with one or more of the following 17 Medical Qualifying Condition.
Medical Qualifying Conditions :
A. Open and Close Heart Surgery including CABG.
B. Cardiac ailments neessitating :

1. Pacemakers (including biventricular Pacemakers).
2. AICDs with or without biventricular pacemakers.
3. Radiofrequency ablation.
4. Device closures of ASDNSD/PDA etc. with Valvulopasty(BNV/BAV/BPU). 5. Valve replacements.

C. Angioplasties :

1. 1  Coronary and Peripheral (including Carotid/Renal/Aorto-iliac).

2. 2  Including Stent Implantation (with drug-eluding CCstents).

D. Cerebra or Vascular Strokes/Paralysis due to any cause.

EMAIL ID	2ndmedicalopinion@mdindianetwrox.com
Mobile No/Whatsapp No.	+91 9607017817

3. 4.

5. 6.

7. 8.

9.

E. Neurosurgery / Ailments requiring Brain Surgery.
F. Major operations of the spine and vertebrae including correction of congential spinal deformity.

G. H. I.

Renal diseases / Failure / Kidney transplants / Dialysis.

Malignancy including Leukaemia. Lung Surgery :
1. Lobectomy.
2. Pneumonectomy.

3. Decortication.
4. Removal of Mediastint Tumours.

J.
K. Gall Bladder / Pancreatic Calculi or Nesidioblastosis.
L. Diseases of the Liver leading to failure or transplantation. M. Surgery of portal hypertension.
N. Organ transplants.
O. Aplastic Anaemia.
P. Cerebral Palsy.
Q. Mysthenia Gravis.

10. Following Exceptions are there where International Second Medical Opinion is not available :

• When a Member has not received a Diagnosis – Member must receive official daignosis

  from his/her treating Physician. This is pre-requisite for reference to WLMC.

• Member has not been evaluated by treating Physician in the last 12 months. Recent

  Medical reports are required by WLMC to give treatment recommendations.

• If a member has developed an Acute or life threatening condition. There is no point in

  waiting for Second Opinion.

• Where physical evaluation of the patient is required. Certain cases require physical

  evaluation (eg. Mental illness) in such cases remote second medical opinion will not be given.

  This is only a gist in short. For further details policy document should be referred.

  Compiled by

  C T JOSHI. 06-05-2020 Mobile : +91 97319 55044

  Email id :joshi.chidambart@gmail.com

Encephalitis (viral), Visual / Hearing loss.