PROSPECTUS LITERATURE SALES. What to do next. Employee First Health Insurance Plan. Disclaimer: Statutory Warning:

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1 What to do next If you wish to know more about Max Bupa s Employee First Health Insurance plan and/or would like a personal quote, speak to our specially trained sales team or your local advisor. They ll take time to fully understand your requirements and help you to select the right plan for you. Phone: (Toll Free) or Web: Disclaimer: This is only a summary of the product features and is for reference purpose only. The details of benefits available shall be as described in the Policy document, and will be subject to the policy terms, conditions and exclusions. Please call our customer service if you require any further information or clarification. Statutory Warning: Prohibition of rebates (under section 41 of Insurance Act 1938); no person shall allow or offer to allow either directly or indirectly as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating to life or property, in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectus or the tables of the insurer. Any person making default in complying with the provision of this section shall be punished with fine, which may extend to five hundred rupees. PROSPECTUS & SALES LITERATURE &TURE Max Bupa Health Insurance Company Limited Corporate Office: 2nd Floor, Salcon Ras Vilas, D-1, District Centre, Saket, New Delhi Registered Office: Max House, 1 Dr. Jha Marg, Okhla, New Delhi Max, Max Logo, Bupa and HEARTBEAT logo are registered trademarks of their respective owners and are being used by Max Bupa Health Insurance Company Limited under license. Insurance is the subject matter of solicitation. EF/SP/1210/V1.0 Employee First Health Insurance Plan

2 EMPLOYEE FIRST HEALTH INSURANCE PLAN Your employees Health comes first. Give them a Quality Health Insurance cover. Introducing Max Bupa Health Insurance Company Limited, a joint venture between Max India and Bupa, an international health insurance company have joined hands to bring to India Max Bupa Health Insurance. We believe in nurturing long-term relationship with our customers by providing the highest levels of quality in service. Our Parent Companies Max India Limited: A reputation for excellence Max Group brings expertise in insurance and healthcare with a strong presence in Life Insurance (through Max New York Life Insurance Company Limited), Healthcare (through Max Healthcare Institute Ltd.) and Clinical Research (through Max Neeman Medical International Limited). A Rs.7300 crore group, it has over 700 offices across more than 400 locations in India as well as 4 million customers, more than 20,000 employees and 80,000 agents, all focused on delivering customer satisfaction (Source - Bupa: 60 years of care Established in 1947 as the British United Provident Association, Bupa today has over 10 million customers in over 190 countries. (Source - Bupa Group brings in a wealth of experience in serving customers directly in health insurance across the world. In addition to quality health insurance, Bupa runs care homes for elderly people and the young disabled, health assessments and health coaching and workplace health programs for customers. Max New York Life was declared a Superbrand by Superbrands India in the 3rd edition of Consumer Superbrands 2008 CII-Exim Bank Award for Business Excellence awarded to Max New York Life in 2008 CIO 100 Award for technology implementation Bupa Recognition and awards Max India: The Health Insurance Company of the Year Award - awarded at the U.K. Health Insurance Awards 2009 Best International Private Medical Insurance Provider awarded at the U.K. Health Insurance Awards Best Medical Insurer Company (2008, Bupa Arabia) - awarded at the Jeddah Chamber of Commerce and Industry Health Committee Awards Best Healthcare Provider of the Year - awarded at the U.K. Corporate Adviser Awards 2009 Best Individual Private Medical Insurance Provider - awarded at the U.K Money Marketing Awards 2009 Start a healty relationship Employee First Health Insurance Plan is a corporate group oriented health insurance cover which is simple to buy and easy to understand. In addition to providing a core health insurance cover to suit your needs, this plan helps you proactively take care of the health of your employees and their dependants. We are here to build a long term healthy relationship with your organization and its employees. We believe in empowering you to choose the cover best suited for your group and that a healthy relationship is built by understanding your needs, through a continuous dialogue on what matters the most. Advantages of signing up with Employee First Health Insurance Plan: We talk directly to you: You talk to us directly, not through any third parties for claims. We will be there for you when you need us. Because your employees should concentrate on getting better or looking after their relatives, rather than focusing on settlement of claims. Cashless facility at quality hospitals: Your employees can access our cashless facility at quality hospitals, thanks to our relationship with them as part of our partner network. No age restriction for enrollment: We provide cover options for families across life stages from new borns to senior citizens of any age. High quality service: 1. 24/7 Healthline: Your employees can call us anytime for help on Our 24/7 health line for easy and friendly access to health advice when you need it. 2. Managing our relationship: As a customer, you can access your own page on the Max Bupa website for reviewing your claims history, to access coverage details by employee and manage policy audit calendar. You will also get aggregated periodic reports to better understand the medical needs of your employees. Responsible enrollment: To build a relationship that lasts a lifetime, We make all efforts to understand your health profile during enrollment, so that when you need us, we can provide speedy and efficient support. Policy carry forward: The employee has an option to convert his group policy to an individual personal cover, when he leaves his current employment. Tax saving: You may save tax under Section 36 (1) of the Income Tax Act when you buy a Max Bupa Health Insurance Policy (Tax benefits are subject to changes in the tax laws, please consult your tax advisor for more details). Policy Design Employee First Health Insurance Plan can cover your employee and her/his family under the same limit. The base cover includes the employee, employee s spouse and two children. Additional children can be included under the same limit, by paying additional premium. Family under the Employee First Health Insurance Plan includes the following: 1. Spouse (legally married) 2. Son 3. Daughter Besides this you can also include the following relations in the group cover, by paying additional premium. 1

3 4. Father 5. Mother 6. Father-in-law 7. Mother-in-law This policy covers persons of any age. There is no maximum entry age for the Insured. There is no maximum cover ceasing age in this policy. The tenure of the policy is one year. Sum Insured 2. Hospital Accommodation: Reasonable and Customary charges for Hospital accommodation. 3. Pre and Post hospitalization Medical Expenses: Medical Expenses incurred due to same Illness up to 30 days prior to admission and 60 days after an Insured Person s discharge from a Hospital. 4. Day-care Procedures: Medical Expenses for day care procedures where such procedures are undertaken by an Insured Person as an In-patient in a Hospital for a continuous period of less than 24 hours. Any procedure undertaken at the out-patient department of a Hospital will not be covered. We cover all Day-care procedures, not just 8. Health Check-up: We will cover the cost of a health check-up as per your plan eligibility as defined in the Product Benefits Table. We will only cover health check-ups arranged by Max Bupa through our empanelled service providers. Additional Cover/Loadings The Employee First Health Insurance Plan allows you to choose from a simple list of additional cover options and waiver that you can purchase to customize the cover according to your needs: Necessary termination of pregnancy subject to the conditions mentioned above. The following expenses are not covered under Maternity Benefit: a) Medical Expenses in respect of the harvesting and storage of stem cells when carried out as a preventive measure against possible future Illnesses. b) Medical Expenses for ectopic pregnancy are not covered under Maternity Benefit. However, these expenses are covered under the In-patient benefit. The sum insured options range from Rs.1 lac to Rs. 50 lacs depending on the plan you choose. The details of the plans are available in the Product Benefits Table. Reasonable and Customary Charges mean the charges for services or supplies, which are standard charges for the specific provider and consistent with the prevailing charges in the geographical area for identical or similar services among comparable providers, taking into account the nature of the Illness/injury involved. Product Features and Benefits The policy covers Reasonable and Customary Expenses incurred towards medical treatment taken during the Policy Period for an Illness or an Accident. We cover the following expenses: 1. In-patient Treatment: Medical Expenses for: (i) Doctor s fees, Diagnostics tests, Medicines, drugs and consumables, Operation Theatre charges, Intensive Care Unit, Intravenous fluids, blood transfusion, injection administration charges (ii) The cost of prosthetics and other devices or equipment if implanted internally during a Surgical Procedure. a select few. 5. Domiciliary Treatment: Medical Expenses for treatment taken at home if the treatment continues for an uninterrupted period of 3 days and the condition for which treatment is taken would otherwise have necessitated as long as either (i) the attending Doctor confirms that the Insured Person could not be transferred to a Hospital or (ii) you the insured employee satisfies us that a Hospital bed was unavailable. 6. Organ Donor: Medical Expenses for an organ donor s treatment for harvesting of the organ provided that the Insured Person has been medically adviced to undergo an organ transplant and the donation conforms to The Transplantation of Human Organs Act 1994 and the organ is for the use of the Insured Person. We will not cover: a) Pre-hospitalisation or post-hospitalisation Medical Expenses or screening expenses of the donor or any other medical expenses as a result of the harvesting from the donor. b) Costs directly or indirectly associated with the acquisition of the donor s organ. 7. Emergency Ambulance: Reasonable and Customary ambulance expenses incurred to transfer the Insured Person following an Emergency to the nearest Hospital, if we accept the In-patient claim. For Out of Network Hospitalisation our maximum liability for ambulance expenses is limited to Rs.2,000/- per event. 1. Maternity Benefits You can purchase maternity cover for all the group members by paying additional premium. We will cover Medical Expenses for the delivery of a child subject to the following: a) Maternity expenses shall be covered for female Insured Person only for the delivery of a child, either under sub clause below: i) This benefit is available for the Primary Insured or his spouse (if the spouse is named as an Insured Person). This benefit may be claimed only twice during the lifetime of the Insured Person. b) Cover will be available under Maternity Benefit only after 9 months of continuous coverage have elapsed since the inception of the first Policy with Max Bupa. However the group can purchase waiver of this waiting period by paying additional premium. This waiver is available for purchase only to groups with more than 75 Employees. c) Our maximum payout per pregnancy will be as per the specified sub-limit as shown in the Product Benefits Table. d) We will cover Pre or Post Hospitalisation Medical Expenses within the specified sub-limit. We will cover Medical Expenses related to a Medically 2. New Born Baby If the pregnancy is covered by Max Bupa then, We will, a) Cover Medical Expenses towards the medical treatment of the Insured Person s new born baby while the Insured Person is Hospitalised as an In-patient for delivery. b) Cover the new born baby as an Insured Person until the expiry date of the Policy without the payment of any additional premium. The new born baby will be covered within the existing limit of the Insured without any limit enhancement. c) Cover the Reasonable and Customary vaccination expenses of the new born baby for the vaccinations shown in Annexure I to this policy until the new born baby completes one year. If the policy ends before the new born baby has completed one year, then, We will only cover such vaccinations until the policy renewal, and after that only if we have accepted the baby as an Insured Person at the time of renewal and you have paid the premium accordingly. 2 3

4 3. Family Floater Benefits a) You can purchase coverage to include the group members parents in the group policy as Insured Person. The addition would not result in increase of the total sum insured for the Family Floater Benefit. b) You can purchase coverage to include the group members parents-in-law in the group policy as Insured Person. The addition would not result in increase of the total sum insured for the Family Floater Benefit. Additional Services: Health Card: Health cards will be issued to each group member. 24/7 Health-line: This facility has been put in place to offer you access to health advice when you need it. Relationship Doctor: We may assign at our discretion, to attend to in-hospital claims management for your employees. Reports and MIS: Standardized reporting for clients irrespective of size of account. Online Servicing: You get a personalized page on our website to manage your organizations health insurance needs. Account Manager: Person to manage account specific procedures and issues of the client. Health Camps: We may organize periodic health camps at your location(s), customized to your employee strength and profile. Direct Servicing: All claims are processed directly by our own customer services team. Waiting Periods and Exclusions Claims for the following are not covered: 1. Pre-existing Conditions: Benefits will not be available for Pre-existing Conditions until 48 months of continuous coverage have elapsed since the inception of the first Policy with Us Days Waiting Period: We will not cover any treatment taken during the first 30 days since the commencement of the Policy, unless the treatment needed is a result of an Accident or Emergency. This waiting period does not apply for any subsequent and continuous renewals of your policy. The employer can choose to extend this waiting period to 90 days to avail a discount on schedule premium. 3. Specific Waiting Periods: For all Insured Persons the conditions listed below will be subject to a waiting period of 24 months from the date of commencement of coverage for the Insured Person: 1. Stones in the urinary system 2. Stones in billiary system 3. Surgery on tonsils/ adenoids 4. Uternie Polyps 5. Any type of breast lumps 6. Treatment of Spondylosis/ Spondylitis - any type 7. Inter Vertebral Disc Prolapse (IVDP) and such other degenerative disorders 8. Cataract 9. BHP 10. Hysterectomy/ Myomectomy done due to Menorrhagia/ fibroids 11. Fistula in ano 12. Fissure in ano 13. Piles 14. Hernia 15. Hydrocele 16. Sinusitis 17. Knee/ hip joint replacement 18. CRF or end stage renal failure 19. Congenial cardiac ailments 20. Any type of Carcinoma/ sarcoma/ blood cancer 21. Osteo Arthritis of any joint 22. Gastric and duodenal Ulcers 23. Varicocele 24. Spermatocele 25. Dilatation and Curettage ( D&C) 26. Diabetic Nephropathy and Retinopathy 27. Mastoidectomy (operation to remove piece of bone behind the ear) 28. Tympanoplasty (Surgery to repair tympanic membrane i.e. eardrum) 29. Gout 30. Rheumatism 31. Varicose veins, Varicose ulcers Waivers for Waiting Periods: The group can purchase waiver of the following waiting period by paying additional premium: Day waiting period 2. Specific waiting period 3. Pre-existing conditions waiting periods However, these waivers are available for purchase only to groups with more than 75 employees. 1. Co-pay: To help your employees take care of their parents without making the costs unmanageable, we have enabled you to cover their parents and parent-in-laws. If any Insured Person is 60 years of age or over on the date of commencement of the current Policy Period, then Max Bupa will only pay 80% of claim under the policy made by that Insured Person and the balance will be borne by the Insured employee. Co-pay discount options: The group can avail a discount in premium calculation by opting for any one of the below co-pay options: a) 10% co-pay for all insured persons below the co-pay for insured persons of age 60 years or more. b) 20% co-pay for all insured persons in the group. c) 30% co-pay for all insured persons in the group. 2. Permanent Exclusions: Addictive conditions and disorders; Ageing and puberty; Artificial life maintenance; Circumcision; Conflict and disaster; Congenital conditions; Convalescence and rehabilitation; Cosmetic surgery; Dental/oral treatment; Drugs and dressings for outpatient or take-home use; Eyesight; Experimental treatment; Health hydros, nature cure, Wellness clinics etc.; HIV and AIDS; Hereditary conditions; Items of personal comfort and convenience; Non-allopathic treatment; Obesity; Out-patient Treatment; Neurological and Psychiatric Conditions; Self-inflicted injuries; Sexual problems and gender issues; Sexually transmitted diseases; Sleep disorders; Speech disorders; Treatment for developmental problems; Treatment received outside India; Unrecognised physician or facility; Unlawful Activity. For details of permanent exclusions please visit Cancellation/Termination: Cancellation by Us: We may terminate this Policy by sending 30 days prior written notice to your address shown in the Schedule without refund of premium if in our opinion: i. You or any Insured Person or any person acting on behalf of either has acted in a dishonest or fraudulent manner, provided false or incorrect information, or suppressed any important information, under or in relation to this policy; and/or ii. Continuance of the policy poses a moral hazard; age of 60 years along with the standard 20% 4 5

5 Renewal Information 1. Renewal Premium: The renewal premium is payable on the due as shown in the Schedule. The rates used for premium calculation may change on renewal (subject to IRDA approval). If the Policy is not renewed within the due date then we may issue a fresh policy subject to Max Bupa underwriting criteria but (a) and any new policy issued shall not benefit from any of the continuity benefits (for example for Pre-existing Conditions). 2. Maximum Age: There is no maximum cover ceasing age in this Policy. 3. No underwriting on renewal: There will be no underwriting on policy renewal for existing group members. New members added at or between renewals would undergo standard underwriting rules. The first year underwriting results will continue to apply and carry forward for any group members that continue in the policy group without break. 4. Disclosures on Continuity: If a Primary Insured ceases to be your employee during the Policy Period, then cover under the policy for that Primary Insured and his Dependants will immediately and automatically cease unless the Primary Insured gives Us a written request prior to or within 5 days of the date of cessation of employment, to issue a new health insurance policy to himself and his Dependents who were named as Insured Persons in the Schedule for cover up to his Sum Insured under the policy, on payment of premium in full for the new policy. The Primary Insured understands and agrees that: (i) The issue of a new policy shall be subject to our underwriting requirements; as applicable from time to time, and we may obtain additional information before issuing a new policy. (ii) We are not bound to continue all terms and conditions of the present cover under the policy of the Primary Insured and his Dependents under the new policy, however for calculation of waiting periods including for pre-existing conditions under the new policy, the time spent by Primary Insured and his Dependants under this Policy may be taken into account, provided the new policy is taken without any break from this Policy. Coverage under the new policy shall be available only for the period for which the premium has been received by us. Claims Procedure 1. Cashless Hospitalisation Facility for Network Hospitals: We will provide cashless hospitalisation facility at Our network hospitals. We pre-authorise all cashless In-patient and Day-care procedure, if intimated to us 72 hours before hospitalisation (within 48 hours after hospitalisation for emergency). Under cashless hospitalisation, claims are paid directly to the Network Hospital. In cases where co-pay is applicable, the co-pay amount will be collected by the provider from the customer. Co-pay will be applied on the amount authorised to the hospital. Additionally,it will be mentioned in the Letter of Authorisation that co-pay will be applicable on the final bill. CO-PAYMENT SCENARIOS CASHLESS CLAIM - SCENARIO 1 Sum Insured 2,00,000 Pre-Auth Requested Amount 1,00,000 Approved Amount (after deduction of 20% Co-pay) 80,000 Actual Final Bill Received 1,00,000 20% on Final Bill amount 20,000 Final Paid amount after deduction of Co-pay 80,000 Balanced Sum Insured 1,20,000 CASHLESS CLAIM SCENARIO 2 Sum Insured 2,00,000 Pre-Auth Requested Amount 1,00,000 Approved Amount (after deduction of 20% Co-pay) 80,000 Actual Final Bill Received 90,000 20% on Final Bill amount 18,000 Final Paid amount after deduction of Co-pay 72,000 Balanced Sum Insured 1,28, Out Of Network Hospitals and All Other Claims for information that we believe may be required. Reimbursement: We will reimburse expenses incurred outside network hospitals. To claim For any medical treatment taken from an out of reimbursements for any Illness or Accident or Network Hospital, we will pay Reasonable and medical condition that requires Hospitalisation, the Customary medical expenses. Delayed payments Insured Person should provide us the documents shall attract interest as per applicable regulations. listed below, within 30 days of the Insured Person s discharge from Hospital. 3. Nomination Facility: The employee can, at the time Duly filled claim form(s) supported by Investigation of joining or at any time before the expiry of the test reports, Original bills, receipts and discharge Policy, make a nomination for the purpose of certificate/card from the Hospital/Doctor/Chemists payment of claims. Doctor s referral letter advising hospitalisation in non-accident cases. Disclosure Details of any other insurance policy that may All cutomers personal information collected or repond to the claim. held by Max Bupa may be used by Max Bupa for processing the claims and analysis related to We might request for any other documents or insurance/reinsurance business. 6 7

6 Benefit Table - Employee First Health Insurance Plan Overall Sum Insured (SI) Rupees ($), (*) Baseline cover benefits In-patient treatment Surgical operations, including pre and post-operative care Nursing care, drugs and surgical dressings Doctors fees Operation theatre charges and intensive care Overall Sum Insured (SI) 1 lac 2 lacs 3 lacs 4 lacs 5 lacs 6 lacs 7 lacs 8 lacs 9 lacs 10 lacs 15 lacs 20 lacs 50 lacs Pathology, X-rays, diagnostic tests and therapies Prosthetic implants Hospital accommodation Single Private Room Single Private Room Upgrade to next level, subject to availability Pre and post-hospitalisation expenses including doctor's consultation, diagnostics tests, medicines, drugs and consumables All day care procedures Other benefits Health Check-up at time of renewal Organ transplant when medically necessary Emergency ambulance (**) Domiciliary treatment Rs. 5,000 Rs. 10,000 Rs. 15,000 Rs. 20,000 Additional Benefits that can be purchased for extra premium (availability as per annexure) Rupees Maternity and child care benefits (***) 1 lac 2 lacs 3 lacs 4 lacs Maternity cover for up to 2 deliveries New born baby cover Vaccinations new born baby for the first year (@) Rs. 30,000 and for specified list in annexure Extended family cover Inclusion of parents as insured in the group Policy Inclusion of parents-in-laws as insured in the group Policy Inclusion of additional children beyond 2 children covered in the baseline cover Waivers available for purchase 9 month waiting period for Maternity benefit 15% of SI Once in two years, tests as per annexure Covered at actual costs in Network hospitals up to SI Covered within the overall SI Rs. 25,000 20% of SI Annual, tests as per annexure Covered at actual costs in Network hospitals up to SI Rs. 30,000 Rs. 35,000 Rs. 40,000 Annual, tests as per annexure Covered at actual costs in Network hospitals up to SI Rs. 75,000 Rs. 1,00,000 Rs. 2,50,000 5 lacs 6 lacs 7 lacs 8 lacs 9 lacs 10 lacs 15 lacs 20 lacs 50 lacs Rs. 60,000 Rs. 1,00,000 and for specified list in annexure and for specified list in annexure Covered within the overall SI Rs. 45,000 Rs. 50,000 Covered within the overall SI 30 day no claim/waiting period from Policy inception 24 month waiting period for Specific Exclusions Available to all groups with more than 75 employees Available to all groups with more than 75 employees Available to all groups with more than 75 employees 48 month waiting period for pre-existing conditions Discounts available for customisation Cover available with an optional co-pay of 10%, 20%, 30% for all members Extension of 30 day waiting period to 90 days ($) Baseline cover includes a 48 month waiting period for pre-existing conditions & a 30 day no claims/waiting period from inception. (**) Emergency ambulance - Maximum of Rs. 2000/-per event for out of network. (*) A compulsory Co-pay of at least 20% applies to all insured older than 60 years. (***) A 9 month waiting period applies to maternity cover including all attached new born baby cover items. (@) Vaccinations would be covered till the next Policy anniversary after which the new born baby has to be included in the Policy for the coverage to continue. Note: Baseline cover benefits includes a maximum of 2 adult + 2 children on a family floater basis. 8 9

7 How to buy a Max Bupa Policy 1. The Max Bupa Policy is sold, through all the direct and indirect channels such as, Agency, Corporate Agency, Direct Sales Team and Tele sales. 2. Every Insured Person will be assigned a unique customer identification number on the Max Bupa system. 3. A Max Bupa proposal form is completed. The Customer will be required to provide: Insured s name, date of birth, designation and address, as necessary. As above for all dependants to be covered by the policy. Any existing health insurance Policy details and claims history, if applicable. Selection of Employee First Health Insurance Plan sum insured, waivers and additional cover. Disclosure of any pre-existing medical conditions with details. Medical history report for applicant and dependants, if necessary. Signature and date on application, wherever applicable. Premium payment collected and receipted. Medical Tests Grid: Age (completed birthday) Upto 50 years years > 55 years Upto 5 lacs Level 2 Level 2 Level 3 4. An underwriting process will be followed for every proposal form submitted, regardless of the distribution channel. Medical underwriting would be done based on Non Medical Limit (as mentioned in the below grid). Non Medical Limit would be dependent on the group size as mentioned below. For group upto 20 employees, medical underwriting would be done as per the below mentioned Medical Tests Grid. For all other groups, medical underwriting to be done only on the incremental Sum Insured over the Non Medical Limit. Pre policy medicals would be required for all the members wherein Sum Insured breaches the Non Medical Limit. Pre policy medical tests (as per the below mentioned grid) to be triggered only on the incremental Sum Insured over Non Medical Limit. Number of Employees Incremental Sum Insured (INR) lacs Level 2 Level 3 Level 4 >10 lacs Level 3 Level 4 Level 5 Note: Medicals to be triggered based on the incremental Sum Insured over Non Medical Limit. Non Medical Limit (INR) 0 5 lac 5 lac 7 lac 10 lac 10 lac Category Level 2 Level 3 Level 4 Level 5 MER, RUA, FBS, T. CHOL. GGT Tests MER, RUA, FBS, T. CHOL. GGT, HDL, TG, S. CREAT, SGOT, SGPT MER, RUA, FBS, T. CHOL. GGT, HDL, TG, S. CREAT, SGOT, SGPT, HbsAg, HbA1c, CBC, ECG MER, RUA, FBS, T. CHOL. GGT, HDL, TG, S. CREAT, SGOT, SGPT, HbsAg, HbA1c, CBC, TMT, HIV 1 AND 2 5. Upon full assessment of medical facts, the Underwriter, with possibly second opinion, has discretion to decide whether the applicants declared condition presents a future risk. Three potential options will be determined by the Underwriter. No Risk - accept application with no condition exclusion(s). Potential Risk accept application with special conditions/ exclusion(s) (Pre-existing exclusions). High Risk decline. The free cover limit would be offered to the proposed insured as per the group size. However, medical evaluation of the risk for the Incremental Sum Insured, above the free cover limit, would be the basis for determining no risk, potential risk & high risk. Medical evaluation will be done for Incremental Sum Insured only. Additionally the following rules will apply: In the event of the risk getting declined post medical underwriting then the life would be given a minimum cover equal to his/her Non Medical Limit and higher cover (incremental cover) would be declined. In the event of pre policy medicals getting triggered then liability with Max Bupa is equivalent to the Non Medical Limit until medical underwriting is completed. The Sum Insured eligibility of the employee and his/her dependents would be equal to the Non Medical Limit or the Sum Insured approved by the underwriter post medical underwriting. For all those members who are accepted post medical underwriting, endorsement to the policy would be done as and when final medical underwriting decision is done The underwriting decisions will be uploaded in the lead management system and the core system. The systems store the underwriting data for each person insured. It captures the pre existing disorders as ICD 10 codified exclusions which have a waiting period of up to four years as per the product definition. 6. All proposals accepted by Max Bupa are internally processed and enrolled onto the Max Bupa system, and premium payments are cleared. 7. Every Insured Person receives a welcome kit where the proposed risk has been accepted by Max Bupa 8. The welcome kit will be delivered direct to the Company

8 NOTES: NOTES: