Health Insurance

Brief Product Description

Health Insurance is an exciting product that provides good value to Zong customers who get financial protection in case of In-Patient hospitalization, providing relief in the form of cash for medical and out-of-pocket expenses.

PRICES AND COVERAGE

Eligibility & Enrolment

• Available to Zong customers who are Pakistani citizens, hold a valid CNIC and meet the approved eligibility age of 18 to 59 years.
• The subscription must be registered against the customer’s own CNIC and Zong mobile number.
• Coverage applies to the subscribed customer only.
• Enrolment requires the customer’s consent and successful deduction of the applicable premium.
• Only one active subscription per customer under this product is permitted.
• Coverage commences after successful activation and completion of the applicable waiting period of 7 days.

CLAIMS

• The product provides a hospital cash benefit for eligible inpatient hospitalization due to a covered illness or injury.
• Hospitalization must involve a formal inpatient admission lasting at least 24 consecutive hours.
• The benefit is calculated according to the eligible hospital nights, the selected plan’s per-night limit and the remaining total coverage.
• The stated total coverage is equivalent to a maximum of 30 payable nights at the full per-night benefit, subject to policy terms.
• Outpatient consultations, emergency visits without qualifying inpatient admission and observation-only stays are not covered.
• All claims are subject to document verification, policy eligibility and the applicable exclusions.

NOTICE OF CLAIM

• The customer must notify the designated claims team as soon as reasonably possible and submit the claim within 15 days after discharge.
• Claim notification must include the customer’s name, CNIC number, registered Zong number, hospital name, admission date and discharge date.
• Claims must be submitted through the designated helpline, portal or other officially communicated channel.
• Any delay in submission must be explained and will be assessed under the policy terms.

DOCUMENTS REQUIRED FOR CLAIM

• Clear copy of the insured customer’s valid CNIC.
• Hospital admission record and discharge summary showing the diagnosis and admission/discharge dates.
• Itemized hospital bills and payment receipts.
• Relevant prescriptions, investigation reports and treatment records.
• Bank account or supported mobile wallet details for payment, with account-holder verification.
• Accident-related records, including a medico-legal report or FIR, where applicable and reasonably required.
• Any additional documents reasonably required to establish eligibility and verify the claim.

EXCLUSIONS

Subject to the approved policy wording, the following are excluded:

• Hospitalization before coverage begins, during the applicable waiting period or after coverage ends.
• Pre-existing medical conditions and related complications.
• Maternity, childbirth, miscarriage and related complications.
• Outpatient treatment, routine check-ups, screening and diagnostic admission without medically necessary inpatient treatment.
• Cosmetic or elective procedures without medical necessity.
• Dental treatment and vision correction, unless expressly covered.
• Intentional self-inflicted injury or attempted suicide.
• Illness or injury directly resulting from alcohol or substance misuse.
• Injury sustained while participating in criminal activity.
• Admissions solely for rest, rehabilitation, custodial care or non-medical reasons.
• Fraudulent claims, fabricated admissions or falsified documents.
• Any other exclusion expressly stated in the approved policy.

Terms and Conditions

• All prices are in PKR and include applicable taxes. The premium deduction frequency is daily and weekly.
• Premium must be paid in advance for coverage activation and continuation.
• Benefits apply within the approved coverage period of 30 days.
• Coverage is subject to successful premium deductions. Failed deductions, grace periods and reinstatement will be handled according to the approved policy rules.
• Pro-rata entitlement: Where applicable, the payable benefit will be adjusted according to the premium successfully collected during the 30 days immediately preceding the claim date, against the full premium due for that period.
• Eligible hospitalization must take place at a duly registered hospital providing inpatient treatment.
• Benefits cannot exceed the selected plan’s per-night limit or remaining aggregate coverage.
• Multiple eligible claims may be submitted within the coverage period, subject to the remaining limits.
• The insurer may verify hospital records and investigate claims before approval.
• Customers must provide complete, accurate and truthful information. Fraudulent or misleading claims may result in claim rejection and policy termination under the policy terms.
• Any plan change takes effect only after confirmation and successful collection of the applicable premium.
• The approved policy wording governs eligibility, benefits, exclusions and settlement.

CLAIM DISBURSEMENT

• Approved claims will be paid to the insured customer’s verified bank account or supported mobile wallet.
• Payment will be processed within 1–3 working days after receipt of complete documentation, completion of verification and claim approval.
• The payable amount will reflect eligible hospital nights, applicable pro-rata entitlement and remaining policy limits.
• The customer will be informed of the claim decision. Any rejection or reduction will be communicated with the relevant reason.

DEACTIVATION

• Customers may request deactivation through the designated Zong service channel.
• Deactivation will stop future renewals and premium deductions once processed.
• The effective end date of coverage will be communicated according to the paid coverage period and policy terms.
• Deactivation does not cancel an otherwise eligible claim arising during active coverage.
• Refunds, if applicable, will be handled under the policy’s cancellation and refund provisions.
• Reactivation requires successful enrolment and premium deduction, with any applicable waiting period determined by the policy.

SERVICE TIMINGS

Monday to Saturday, 9:00 a.m. to 9:00 p.m. (Pakistan Standard Time).