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ENROLLMENT FAQs

1. How do I ensure that my dependents are covered in the policy?


During the start of the policy or its renewal, there is usually an open enrollment period within
which the employees are asked to declare the change in the dependents data. You are expected
to upload your dependents data on Vantage Connect within the specified timelines.
My enrollment Enrollments Add New Member a window will appear. Fill up the details for
your dependent and save it. Vantage representative will get the endorsement passed for the
enrollment.
You will be able to add your dependents only during the open enrollment period, post that if any
changes are required, you can request for an addition to Vantage and depending on terms and
conditions of policy, Vantage Account Manager will accept/reject the request.
2. Am I allowed to delete my dependent from the policy during the mid-term of the policy?
You cannot delete the dependents from the policy once the policy commences. It is only possible
in 2 cases death of the dependent or legal separation with the spouse.
Also you may delete the member till the time the enrollment window is open
My enrollment Enrollments DELETE button select the member and click on delete button.
Once the enrollment window is closed, the members declared gets freeze and employee will not
be able to delete. But you may send the request for deletion to Vantage and depending on terms
and conditions of policy, Vantage AM will accept/reject the request
3. Can I edit the details of my family members in terms of name, age, gender etc. during the
policy period if the details provided at the commencement of the policy are incorrect?
You need to intimate Vantage for required correction via Vantage connect Till the time the enrollment window is open, you may make the changes in data on Vantage
connect.
Once the window period is closed
Under My enrollment -> Enrollments - a window for correction is available, Please mention the
required correction in the available window and save it. Vantage representative will get the
endorsement passed for the change. You will get the updated card post the endorsement is
passed. You may need to submit proof for the change.
Please ensure that at the time of a claim, the details appearing on the prescriptions and
the medical bills should be same as the one appearing on the health card / insurance
records.
4. My actual age is 36 years. However, the health card shows 42 years. What should I do
now?
If the difference in your actual age and the one appearing on the card is more than 2 years , You
need to intimate Vantage for required correction via Vantage connect -

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Under My Enrollment -> Enrollments -> Edit a window for correction is available, Please mention
the required correction in the available window and save it. Vantage representative will get the
endorsement passed for the change in age. You will get the updated card post the endorsement
is passed. You may need to submit a valid age proof like birth certificate, school certificate, PAN
card etc. and get the endorsement passed for the age correction.
5. How do you define dependency and in whose case is it applicable?
Dependency means a person is financially dependent on the primary insured i.e., they are not
engaged in any kind of profession of earning their livelihood or are gainfully employed. They
should be dependent on the Employee. Dependency is only applicable in the case of children and
parents / parents-in-law.
6. Is dependency relevant in case of Spouse also?
No, dependency for spouse is not relevant under Health Insurance.
7. What happens if my family status changes during the policy?
If the family status changes (by reason of marriage or birth), the employee needs to enroll the
details of the new dependent within 15 days from date of marriage or date of birth as may be
applicable, provided there is scope to cover the members under the policy.
8. Will location of dependent family members matter?
No. Further, as the policy provides the coverage for treatment taken within India, employee and
dependent family member can avail benefit at any registered hospital in India.
9. I have been recently married. The family scope of my health insurance policy covers
spouse. Will my spouse be covered in the health insurance policy automatically?
The coverage for spouse will be granted provided you inform Vantage about the same by
uploading the details of your Spouse on Vantage Connect within 15 days from date of your
marriage.
You may need to submit a copy of marriage certificate as a proof.
10. I have been blessed with a baby last week. My son had jaundice right after his birth. I
need to now submit my spouse's maternity claim as well as the baby's claim for reimbursement. Will my baby be also covered in the health insurance policy now?
If the family scope in your policy allows you to cover children from day one, then your baby will be
covered. However, you have to upload the necessary details of your newborn (DOB, Gender,
Name) on Vantage Connect for inclusion under health insurance policy. This must be done within
15 days from the date of birth of your baby. In the meanwhile, please submit the claims for both
mother and baby separately within the claim submission timelines applicable for your policy.

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11. During the renewal of our Health Insurance policy, I had missed declaring my dependent's
details to my HR within the timelines given. My policy has run for only 2 months and there
has been no claim so far. Can I include them in the policy now?
No. Mid-term inclusion of dependents is not allowed in the policy. You can add new dependent (in
case the family scope of your policy allows) when your family status changes because of
marriage, birth or adoption of a child. Member must be declared within 15 days from date of
marriage or date of birth / adoption as may be applicable.
If you do not enroll within the specified / defined timelines, the next enrollment can be done only
at next renewal of the policy.
12. Is there any maximum age limit for enrolling dependents in the policy?
For spouse and dependent parents / parents-in-law, there is no maximum age limit mentioned in
the policy.
For children, it is 25 completed years.
13. The family scope of my family says I can cover Self, spouse and first 2 living children. I
had declared my spouse and my son so far in the policy. I have recently been blessed with
twin daughters. Can I cover them both in the policy?
No. You may cover only one of the twin daughters as the family scope in your policy allows only 2
living children.
14. What happens if I and my spouse are working in the same organization? Can both of us
declare each other in the respective policies and be covered for double the sum insured?
An individual can be covered in the policy only once. In such a case, you are advised not to
declare each other under the definition of family, and may cover your children, if any, only once
under any of the two families. In case of separation of you or your spouse from the organization,
kindly ensure that the member leaving the organization is declared as a dependent of the one left
working before the last working date in the organization.
15. My siblings (brother / sister) & parents are dependent on me. Can I cover them in the
health insurance policy?
No. The policy does not allow the coverage of siblings & parents in the policy. However, if your
policy specifies the coverage for siblings, you may include them, however, they rarely form part of
corporate policies.
Disclaimer:
To protect the confidential and proprietary information included in this material, it may not be disclosed or provided to any
third parties without the prior written consent of Vantage Insurance Brokers Private Limited. Vantage Insurance Brokers
Private Limited does not accept or assume any responsibility for any consequences arising from any person, other than
the intended recipient, using or relying on this material. Any breach of these conditions will be constituted as unlawful and
may invite legal action.

JLT Independent Insurance Brokers Pvt. Ltd