BENEFITS TABLE (Service provider-Neco Insurance Company)
Table of Benefits :
Age Limit: Account holders of age group from 6 months to 65 years
Waiting Period: 30 Days
EXCLUSIONS
All above mentioned statements are subject to otherwise terms, conditions, limitations and exclusions in accordance with issued insurance policy.
- 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
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 |
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.