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The Minimum Group Size is 100 persons.
The Policy comprises III Sections and the broad coverage is
as follows :
SECTION I : HOSPITALISATION
EXPENSES
1.
The policy covers reimbursement for illness /
diseases contracted or Injury sustained the Insured person.
2.
In the event of any claim becoming admissible under
the scheme, the company will pay through TPA to the
Hospital/Nursing Home or Insured person the amount of such
expenses as would fall under different heads subject to
limits mentioned below :
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Hospitalisation Benefits : |
Limits |
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A |
(i) Room, Boarding expenses as provided by the
Hospital/Nursing Home.
(ii) If Admitted in IC Unit |
Rs.150/- Per Day
Rs.300/- Per Day |
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B |
Surgeon, Anesthetist, Medical
Practitioner, Consultants, Specialists Fees, Nursing
Expenses |
Rs.4,500/- Per illness/Injury |
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C |
Aneaesthesia, Blood, Oxygen, OT
Charges, Surgical appliances, Medicines, Drugs,
Diagnostic material and X-ray, Dialysis, Chemotherapy,
Radiotherapy, Cost of pace maker, Artificial Limbs |
Rs.4,500/- per illness/injury |
N.B. Total expenses incurred for any
one illness is limited to Rs.15,000/- and Company’s
liability in respect of all claims admitted during the
period of Insurance shall not exceed the Sum Insured of
Rs.30,000/- per person or family as mentioned in the
Schedule.
SECTION II : Accidental Death
Coverage for Earning Head of the Family
This section covers death due to
accidental Injury and the company will pay to the Insured a
sum of Rs.25,000/-.
SECTION III : Disability
Compensation for earning Head of the Family.
Disability compensation at the rate of
Rs.50/- per day up to maximum of Period of 15 days in a
policy year with a time excess of 3 days is payable if the
earning Head of the family is hospitalized due to
accident/diseases/illness for which there is a valid claim
admitted under Section I of the Policy.
Age
limit : 3 months to 65 years
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