| A. |
HOSPITALISATION
BENEFITS |
| |
BENEFIT |
SILVER PLAN
(Limit of Reimbursement ) |
GOLD PLAN
(Limit of Reimbursement) |
| a. |
Room,
Boarding and Nursing Expenses as
provided by the Hospital /Nursing
Home. |
Not
exceeding 1 % of the Sum Insured
per day |
Not exceeding 1 % of
the Sum Insured per day. |
| b. |
Intensive
Care (IC) Unit Expenses as
provided by the Hospital /Nursing
Home. |
Not
exceeding 2% of the Sum Insured
per day. |
Not exceeding 2% of
the Sum Insured per day. |
| |
No of days of stay
under a and b above should not
exceed total number of days of
admission in the hospital. |
| c. |
Surgeon,
Anaesthetist, Medical
Practitioner, Consultants,
Specialists Fees |
As per
the limits of the sum insured. |
As per the limits of
the sum insured. |
| d. |
Anaesthesia,
Blood, Oxygen, Operation Theatre
Charges, Surgical Appliances,
Medicines & Drugs, Diagnostic
Material and X-Ray, Dialysis,
Chemotherapy, Radiotherapy, Cost
of Pacemaker, Artificial Limbs
& and similar expenses. |
As per
the limits of the sum insured. |
As per the limits of
the sum insured. |
| e. |
Ambulance
services charges as defined
hereinafter under |
Rs.1,000/-
per illness and limited to maximum
1% of the sum insured or Rs.
3,000/- whichever is less, for the
entire policy period. |
Rs.2,000/- per
illness and limited to maximum 1%
of the sum insured or Rs. 6,000/-
whichever is less, for the entire
policy period. |
| f. |
DAILY
HOSPITAL CASH ALLOWANCE, AS
DEFINED HEREINAFTER under |
NIL. |
0.1% of sum insured
per day per illness subject to a
maximum compensation for 10 days
per illness. The overall liability
of the Company during the policy
period will be limited to 1.5% of
the sum insured. |
| g. |
Attendant
allowance as hereinafter defined
under |
NIL |
Rs.500/- per day of
hospitalization per illness and
upto 10 days per illness. The
overall liability of the Company
during the policy period will be
limited to compensation for 15
days of hospitalization. |
| |
|
| B. |
DOMICILIARY
HOSPITALISATION (AS DEFINED
HEREINAFTER) |
| a. |
Surgeon,
Medical Practitioner, Consultants,
Specialists Fees, Blood, Oxygen,
Surgical Appliances, Medicines
& Drugs, Diagnostic Material
and Dialysis, Chemotherapy,
Nursing expenses. |
10% of
Sum Insured, Maximum Rs.25000/-
during policy period. |
Rs.50000/- during
policy period. |
| b. |
Treatment
for Dog bite (or bite of any other
rabid animal like monkey, cat
etc.) |
Reasonable
expenses limited upto Rs.5,000/-
actually incurred for immunization
injections in any one policy
period. |
Reasonable expenses
limited upto Rs.5,000/- actually
incurred for immunization
injections in any one policy
period. |
NOTE:
FOR THE PURPOSE OF THIS SECTION
THE PRE-REQUISITE CONDITIONS FOR
DOMICILIARY HOSPITALISATION CLAIM
SHALL NOT APPLY. |
