Health Insurance Plan
Overview – Taking all health worries off you
- Comprehensive branded scheme offering value added features and complete solution for all health worries.
- A vital tool in hassle free delivery of health care services; we will be there when you need someone to help.
- Off setting huge medical expenses that have large bearing on health and its maintenance.
- Well conceived and customized plan uniquely designed to address all health exigencies requiring hospitalization.
- Among very few national companies to cover around the world with direct settlement of medical expenses worth Rs 2.3 million abroad.
- Fulfills all requirements envisioned in government policy of healthcare for all.
- Insurance arrangements with world’s top re insurers.
- Curtails administrative and financial burden of the employer.
- Because of branding we offer more than the market.
- Employer wins loyalty of the employees thereby enhancing efficiency and productivity …motivating to work more proactively.
- Extensive nationwide branch network of over 95 branches; almost every reputable hospital is on our panel in every town.
Who is “Covered”
- Corporate sector employees up to the age of 65.
- Special modules are designed to cover dependent parents.
- Age of daughter can be relaxed up to her marriage.
- Age of son can be relaxed up to till 25.
What is “Covered” – OPD Benefits
- G P and Specialist Consultation fees.
- Prescribed medicines.
- Laboratory and other Investigations. (e.g. X-Rays, ECGS & Ultrasound etc).
- Dental care benefits.
- Besides doctors, Consultations with registered Hakims and Practicing alternative medicine specialist is also admissible.
What is “Covered” – Hospitalization
- Hospital Expenses Per Person Per Confinement Per Ailment. (Pregnancy & Dreaded Diseases excluded ).
- Room Rent, Nursing expenses.
- Hospital Expenses includes Surgical expenses, Anesthesia.
- O.T. Charges, Consultation Fee, Nursing Charges etc.
- Investigation and Medicines, Blood, Oxygen Supplies, Dialyses Chemotherapy / Radiotherapy cost of pacemakers ( subject to Hospitalization Unit).
- Miscellaneous Expenses Pre & post hospitalization expenses.
Note: 24 Hrs. In-Patient confinement as a resident Patient is compulsory.
What is “Covered” – Specialized Investigation
Specialized investigation on outpatient basis on recommendation of a specialist only, which does not require hospitalization.
These include the following tests only:
- NUCLEAR SCANS
- EEG, EMG, ETT & ECHO
What is “Covered” – Dreaded Diseases
- Management of acute Myocardial infarction (Heart Attack)
- By-pass grafting
- CVA- Stroke
- Kidney Failure
- Renal and other major organ transplants
- Major burns
- Knee joint replacement
- Multiple Fractures
- Hip bone Replacement
What is “Covered” – Dental Cover
Following are the benefits under ‘Dental Care’ cover.
- Dental care is included in the prescribed OPD (Per family).
- Dental Care include consultation and medicine, treatment of acute dental conditions and diseases of gums.
- All orthodontic procedures, making & placement of prosthesis (e.g. dentures), scaling & polishing are excluded.
- Total payable cumulative dental bills should not exceed 40% of the total OPD limit (per family).
What is “Covered” – Maternity Benefit
- Gynaecologist fee
- Anaesthetic fee
- Diagnostic tests
- Baby’s Nursing Care
- Labour Room charges
- Operation Theater charges etc.
Value added features
- Dreaded diseases.
- (Cancer, Heart Attack, Kidney Failure, Stroke, Cirrhosis, of Liver, AIDS – due to blood transfusion).
- Pre & Post hospitalization benefits – Any expenses incurred on medical consultation or tests within 15 days prior to or after Hospitalization would also be covered.
- Death repatriation within Pakistan.
- Funeral expenses and arrangements.
- Service at your doorstep with elaborate network of 105 branches.
- Win-win-win position —- employee-employer & company.
Claim Settlement Procedure
- All claims are filed on a simple easy to fill Performa by the employee duly endorsed by the employer or nominee.
- Original prescription bills, receipt etc should be attached.
- Direct settlement of claims with panel hospital.
- All claims should be filed within four (4) weeks.