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  Salient Features  
     
 

The Policy can be availed by employers in respect of their employees. Persons in the age group of 3 months to 60 years can be covered under the Policy. Employees can cover their Spuse/dependent children and dependent parents.

In the event of any claim becoming admissible under- this 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 mentioned below and as are reasonably and necessarily incurred thereof by or on behalf of such insured person.

  1. Room, Boarding Expenses as provided by the Hospital / nursing home

  2. Nursing Expenses

  3. Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees

  4. Anesthesia, Blood, Oxygen, Operation Theatre Charges, surgical appliances, Medicines & brugs, diagnostic Materials and X-ray.

  5. Dialysis, Chemotherapy. Radiotherapy Cost of Pacemaker, Artificial Limbs & Cost of organs and similar expenses.

  6. For claims arising out of persons aged more than 35 years, the expenses on following illnesses would be limited to :

 
 
Hospitalion Limits restricted to
Cataract 10% of SI or Max.Rs.25,000/-
Hernia 15% of the SI or Max.Rs.30,000/-
Hysterectomy 20% of the SI or max.Rs.50,000/-
Major surgery-Angioplasty 70% of the SI or Max.Rs.2 lacs
Pre c& Post Hospitalization Maximum 10% of the sum insured
 
 
    G.  In addition to the above, the following would apply to claims arising out           of persons aged more than 60 years
 
 
EXPENSES ON MAJOR ILLNESSES CHARGED AS TOTAL PACKAGE TO BE SETTLED WITH A CO-PAY ON 80:20 BASIS
 
 
 
  (N.B: Company’s Liability in respect of all claims admitted during the period of insurance shall not exceed the Sum Insured per person as mentioned in the schedule)  
     
     
 
 
 
 
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
 
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