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Agreement-Insurance-Somalia
1. Ph No: 0124-4205625/9873028500
Website: www.medcrest.in
E-Mail: medcrest.healthness@gmail.com
MedCrest, C1/2799A, Sushant Lok-1, Near Paras Hospital, Gurgaon-122002, Haryana, India
MEDICAL SERVICES
Entered into by the MEDCREST, hereinafter referred to as ‘The Executive Party’, represented by
_____________________, on the one hand, and ____________________________, hereinafter
referred to as ‘the Customer’, the company represented by _______________________, on the
other hand, hereinafter jointly and separately referred to as ‘the Parties’, as follows:
1. SUBJECT OF THE AGREEMENT
1.1. The Executive Party shall provide advisory services and diagnostic, out- and in-patient
medical care as well as the emergency medical care to holders of medical insurance
policies of the Customer’s contractual insurance companies (hereinafter referred to as
‘the Insured’) in medical institutions on the territory of India.
1.2. The Parties shall agree on the types of medical care and the prices of the medical
procedures. The Customer will send the medical reports of the Insured and the
Executive party will send the Performa Invoice as treatment cost based on the medical
procedure.
1.3. Medical services should be provided to the Insured on the basis of the Payment
received in the account of the Executive Party as per the Performa Invoice.
2. OBLIGATIONS OF THE CUSTOMER
2.1. To acquaint the Insured with health services, terms and conditions of services to be
provided and with the operating procedure of the Executive Party.
2.2. To submit the information on the Insured (location, medical problem, and insurance
terms) necessary for provision of medical care to the Executive Party by telephone
and/or email.
3. OBLIGATIONS OF THE EXECUTIVE PARTY
3.1. To provide to the Insured out- and in-patient services in contractual clinics with the use
of the most up-to-date diagnostic equipment and modern methods of medical
treatment in the most recent dates.
3.2. To issue to the Insured any necessary medical documents drawn out in due form
(discharge summary, certificates, prescriptions for purchase of medicines, etc.)
3.3. By request of the Customer, to submit information related to the course of works
completion, to keep statistical and medical records on the Insured.
3.4. Medical and medical transport assistance shallbe rendered by the Executive Party
based on written request of the Customer.
2. Ph No: 0124-4205625/9873028500
Website: www.medcrest.in
E-Mail: medcrest.healthness@gmail.com
MedCrest, C1/2799A, Sushant Lok-1, Near Paras Hospital, Gurgaon-122002, Haryana, India
4. COST OF WORKS AND SETTLEMENT PROCEDURE
4.1. All medical services provided by the Executive Party to the clients of the Customer
under this Agreement shall be paid by the Customer in advance as per the Performa
Invoice sent by the Executive Party.
4.2. The Executive Party will offer 10% discount on the cost of the treatment for the medical
procedures.
5. DURATION
5.1. This agreement shall come into full force and effect upon its signature by the Parties
and shall remain valid within 1 (one) year; and shall be tacitly extended for each
subsequent year, unless it is prematurely terminated one month prior to its term or by
mutual consent of the Parties.
5.2. Any amendment or cancellation of this Agreement by the Parties must be effected in
written form.
5.3. Termination of this Agreement shall imply the discharge of obligations of the Parties.
6. LIABILITIES OF THE PARTIES
6.1. The Parties shall assume responsibilities for maintenance of confidentiality in matters
related to conduction of medical treatment and diagnosis.
6.2. If the matters of any dispute cannot be settled by the Parties, the dispute must be then
submitted to be settled in the country on the location of the respondent under laws of
the country where such dispute shall be considered.
7. FORCE MAJEURE CIRCUMSTANCES
7.1. Each party shall be absolved of its liabilities for complete or partial failure to meet its
obligations under this Agreement if such default is due to the effect of force majeure
circumstances. Such circumstances include elemental forces, armed confrontations,
issuance by public authorities of statuary acts making impracticable the performance of
the agreement in full or in part and other events beyond any reasonable prediction or
control by the Parties.
3. Ph No: 0124-4205625/9873028500
Website: www.medcrest.in
E-Mail: medcrest.healthness@gmail.com
MedCrest, C1/2799A, Sushant Lok-1, Near Paras Hospital, Gurgaon-122002, Haryana, India
8. LEGAL ADDRESSES
The Executive Party
MEDCREST
The Customer
Address: Address:
For the Executive Party For the Customer
Authorized Signatory Authorized Signatory