Health Insurance Product Details & T&cs

SERVICES

Health Insurance provides financial protection in case of Inpatient hospitalization, providing relief in the form of cash for medical and out-of-pocket expenses. Meticulously crafted with a focus on addressing the unforeseen cash demands that often accompany hospital stays, this insurance offers a valuable cushion by providing funds to cover medication, hospitalization, and associated expenditures.

BUNDLE SERVICES INCLUDE

  • Doctor Service: PMDC certified doctors available for unlimited audio and video consultations.
  • Lawyer Service: Lawyers available for unlimited audio and video consultation consultations.
  • Health Insurance: Heath insurance cover as per following details for hospitalization.

PACKAGES

Product

Daily Price Including Tax (PKR)

Product Type

     Variant 1          Variant 2           Variant 3          Variant 4          Variant 5

Health Insurance

3.60/-

7.20/-

9.00/-

14.30/-

23.90/-

Daily Premium

(PKR)

Daily Hospital Benefits

(PKR)

Daily ICU/CCU benefits

(PKR)

3.60/-

2,500.00/-

5,000.00/-

7.20/-

5,000.00/-

10,000.00/-

9.00/-

7,500.00/-

15,000.00/-

14.30/-

10,000.00/-

20,000.00/-

23.90/-

20,000.00/-

50,000.00/-

  • *Prices are inclusive of taxes
  • *Daily products can be offered in Weekly/Monthly plans
  • *Products is available for family insurance plans

DAILY COVERAGE

Daily price variants for health insurance coverage from PKR 2.5k to 50k per day as described under packages

Eligibility & Enrolment

Eligibility to be verified by contacting us either via a phone call on 9362 or through WhatsApp message (03119271928).

Applicants are eligible to apply for a Health Insurance Plan under the policy if applicants meet ALL the criteria set out below:

  • All eligible applicants shall be natural persons – human beings.
  • Corporations, partnerships, and businesses shall not be eligible for coverage under the policy.
  • All eligible applicants shall be a minimum of eighteen (18) years of age and a maximum of fifty-nine (59) years of age at the time of registration.
  • • If the applicant wishes to apply for and subscribe to a plan under this Insurance Policy, the applicant will be required during the registration process to:
    • Acknowledge that the applicant has read and understood the terms of the policy. Confirm that the applicant meets the eligibility criteria.
    • The Insurance Benefits payable are subject to the applicant's confirmations being true and correct; and if the applicant's confirmation is untrue or incorrect, no insurance benefits will be payable, and the End User Price paid by the subscriber will not be refunded.

TERMINATION OF INDIVIDUAL INSURANCE

The insurance of an insured shall automatically terminate at the earliest time below:

  • Upon payment of the claim
  • Upon cancellation or withdrawal of subscription

CLAIMS

Lodged through phone call on 9362 or WhatsApp message (03119271928)

End-to-end support and handholding to claimant

Claim will be settled on Pro Rata basis.

NOTICE OF CLAIMS

The company shall be notified of the occurrence of insured claim as soon as possible, but not later than 30 (thirty days) from the date of discharge from hospital, which it shall be treated as time-barred, and the company shall not be bound to pay the claim.

DOCUMENTS REQUIRED FOR CLAIM

  • Admission & Discharge Slip of Hospital
  • Hospital Bills
  • Lab reports, if any
  • Prescription/Doctor notes for admission
  • CNIC both Sides

INTENTIONAL FALSE STATEMENT OF THE INSURED

In the event of any concealment or misrepresentation the policy shall become null and void with respect to the relevant insured.

EXCLUSIONS

Payment of claims is subject to exclusions, as outlined below. Health Insurance Cover shall NOT cover:

  • Any preexisting conditions.
  • Any dental procedures
  • OPD of all sorts. Any admission less than 24 hours and no overnight stay is considered as OPD and day care.
  • Day care surgeries
  • Any cosmetic or any surgical procedures
  • Any regular medications such as insulin etc.
  • Any Special Investigations which are not due to admission or being inpatient.
  • War, strikes, riots, civil commotion and any natural or manmade perils (including chemical, nuclear, biological, and radiological) that results in the declaration of a state of emergency on a local or national level.

MISTAKE IN AGE

The company shall only pay Insurance Benefits based on the disclosed age of the insured. With the onus on the customer for incorrect disclosure the company shall not be liable to pay any benefit under this policy in that case.

CLAIM DISBURSEMENT

Claim amount will be transfer in the customer`s bank or Wallet Account If there is a dispute, suspected fraudulent activity on the claim or a unique situation which requires further clarification, the payment period can be extended but shall not exceed ten (10) working days, or as long as the dispute takes to resolve in the legal system.

DEACTIVATION

Dial 9362 for deactivation.

SERVICE TIMINGS

9am to 9 pm