BENEFITS TABLE (Service provider-Neco Insurance Company)
 

• Group Personal Accident Insurance for Account Holders

• Sum Insured: NPR 1,000,000.00
• Sum Insured: NPR    500,000.00

 
Table of Benefits          :
 

Accidental Death	100% of the Sum Insured
Permanent Total Disablement
Loss of Sight of Both Eyes or Hands or Legs	100% of the Sum Insured
Loss of Sight of One Eye or One Hand or One leg	50% of the Sum Insured
Loss of Speech	50% of the Sum Insured
Loss of Hearing Power of Both Ears	50% of the Sum Insured
Loss of Hearing Power of One Ear	20% of the Sum Insured
Loss of Thumb of Hand	20% of the Sum Insured
Others	As specified in the policy.

 

• Group Medical / Hospitalization Insurance for Account Holders

This insurance covers the medical expenses of the insured person arising out of accidental injury and illness, where treatment is taken at hospitals /polyclinics only. The insured must be hospitalized for at least 24 hours to lodge any claim. The maximum liability in respect of one sickness for one-year period shall be as per Table of Benefits mentioned below.
 

	Sum Insured 1,00,000.00	Sum Insured 50,000.00
Benefits	Domiciliary	Hospitalization	Domiciliary	Hospitalization
	Rs.	Rs.	Rs.	Rs.
Room / Bed etc. Nursing expenses including Nursing Exp. Aggregate limit during the policy period (1500 per day)	-	25,000.00	-	12,500.00
Doctors / Anesthesia / Surgeon / Specialist fee Aggregate Limit during the policy period (Rs. 500 per visit)	10,000.00	15,000.00	5,000.00	7,500.00
Surgical Operation including Anesthesia charge, operation theatre charge and Surgeon's Charge for operation, Blood, Oxygen and other related materials and equipment charges including cost of Dialysis / Chemotherapy / Radio Therapy / Ventilator and similar expenses. Aggregate Limit	-	20,000.00	-	10,000.00
Pathology charge, X-Ray, MRI, CT Scan, Angiography and other investigative tests or charges. Aggregate Limit	5,000.00	7,500.00	2,500.00	3,750.00
Medicines / Drugs, injections, Artificial Limbs and Surgical appliances. Aggregate Limit	5,000.00	7,500.00	2,500.00	3,750.00
Cost of Physiotherapy during Hospitalization. Aggregate Limit	-	5,000.00	-	2,500.00
Total Rs.	20,000.00	80,000.00	10,000.00	40,000.00

Age Limit:  Account holders of age group from 6 months to 65 years
Waiting Period: 30 Days
 
 
EXCLUSIONS
 

• Pre-existing conditions. (It refers to any disease or health condition that exists before issuance of policy).
• Claim made during the Waiting period of 30 days. For maternity, waiting period is 9 months.
• War & related / War like operation / Nuclear weapons / materials.
• Preventive Treatment, Regular check-up or check up for Health Certificate or General Health check-up.
• Dental / Optical Equipment / Dental Filling & Scaling.
• Intentional Self-Injury.
• Cosmetic or Elative Surgery or Treatment or Plastic Surgery / Food / Vitamin not related to disease.
• HIV & AIDS
• Treatment not related to Allopathic Medicines.
• 10% of claim amount subject to minimum of NPR 1,000.00 on each & every hospitalization claim.
• Hospitalization expenses can be claimed for treatment in Nepal & India only. In case of reimbursement of hospitalization bill of India, patient should have been referred from Nepal’s National Level Hospital.        

 
All above mentioned statements are subject to otherwise terms, conditions, limitations and exclusions in accordance with issued insurance policy.