Health & Life Insurance
MAIN BENEFITS
In case of hospitalization (due to accident or illness)
Pre-hospitalization
Post-hospitalization
Hospital General Fee
Surgical Fees
In-hospital Doctor Visits
Daily Cash Allowance (Public Hospitals only)
Ambulance
Ordinary Room
Intensive Care Room
Outpatient Services for Accidental Injury
Outpatient Minor Surgery
Inpatient Minor Surgery
Food Allowance
Accidental Damage to Natural Teeth
personal Accident Benefit
Accidental Death/ Disability
term life benefit
Non-Accidental Death
optional coverage
(for groups with more than 10 employees)
Option Birth Benefit
Option Maternity
Option Outpatient Service
Option Medical Check-up
Dental Treatment
Optical Treatment
Cesarean Section
ENROLLMENT ELIGIBILITY
Adult: between 18 (eighteen) and 65 (sixty-five) years old – applied to staffs and dependents
Child: between 1 (one) and 17 (seventeen) years old – applied to dependents only
EXCLUSIONS
General Exclusions
- Consequences of suicide and self-injury;
- Death, disability causes by intentional actions of insured’s legal heir;
- Consequences of war, terrorism, riots/demonstration, commit criminal act;
- Consequences of quarrel;
- Consequences of drugs or alcohol consumption. Note: based on police or health facility reports;
- Consequences of Natural catastrophes, epidemics and pandemic declared by relevant authorities;
- Death related to Human Immunodeficiency Virus (HIV);
- Death related to pregnancy;
- Professional sport related death, disability and injuries;
- Traffic accident due to abusing country traffic rule.
Specific Exclusions for Health risk benefits
- Inpatient treatment at a cabinet or nursing cabinet;
- Physiotherapy, Cosmetic surgery, Plastic surgery, Skin diseases;
- Congenital abnormally;
- Chronic conditions and any complications thereof;
- Blood transfusion/ Hemodialysis and Organ transplant;
- Eye and dental treatments unless accidental injury;
- Treatments performed by traditional healers;
- Artificial Fecundation and infertility treatment;
- Mobility aids or assistive devices for disabilities;
- All services related to Maternity unless the benefit is subscribed;
- Mental illness;
- Sexual Transmitted Diseases, HIV/AIDS;
- Preventive treatment/Prophylactic, Vaccination and medical check-ups;
- Any services covered by national programs. E.g. (currently HIV, Tuberculosis, Leprosy);
- Admission for Para-clinical Examination.