Health Insurance
Health Insurance is Group Hospitalization insurance for the salaried Employees of the employer when the Employees need hospitalization due to accident and/or illness under the Health plan Insurance Contract.
For Health Insurance there are 3 Plan (options):
1 Supper plan- Sum Insured Tk.75, 000.00
2. Standard Plan- Sum Insured Tk 50,000.00
3. Basic Plan- Sum Insured Tk 25,000.00
Risk Covered – Hospitalization due to accident & Illness (at least 24 hour, Maximum 21 days.
Schedule of Compensation
|
Costs, charges and fees per confinement in respect of- |
Amount Payable |
||
|
Supper plan |
Standard Plan |
Basic Plan |
|
|
Hospital accommodation (including all room services and telephone charges) |
Actual or Max Tk. 1500 per day |
Actual or Max Tk. 1200 per day |
Actual or Max Tk. 600 per day |
|
Consultant’s fee |
Actual or Max Tk. 500 per day |
Actual or Max Tk. 500 per day |
Actual or Max Tk. 300 per day |
|
Routing investigations |
Actual or Max Tk. 1500 per day |
Actual or Max Tk. 1000 per day |
Actual or Max Tk. 1000 per day |
|
Medicine & Drugs prescribed by the Consultant |
Actual or Max Tk. 6000 * |
Actual or Max Tk. 4000 * |
Actual or Max Tk. 2000 * |
|
Intervention for : |
|
|
|
|
Major surgical operation |
Actual or Max Tk. 15000 per case |
Actual or Max Tk. 15000 per case |
Actual or Max Tk. 15000 per case |
|
Intcnnediate surgical operation |
Actual or Max Tk. 10000 per case |
Actual or Max Tk. 10000 per case |
Actual or Max Tk. 10000 per case |
|
Ancillary services as follows: Labour room service, Post operative care facilities, incentive Care, oxygen therapy, skill nursing service, blood transfusion, ambulance service, dressing, Tests other than routing investigation s |
80% of the Total amount(max Tk. 8000.00 |
80% of the Total amount(max Tk. 6000.00 |
80% of the Total amount(max Tk. 3000.00 |
Where there are no claims in Tk 12,000/ Tk 10,000/ Tk.5,000/
respect of surgical investigation this is increased to Facilities:-
Exclusion: Tk, 500 per claim, Pre-existing condition,(treatment within 12 Month)Pregnancy fist twelve weeks, willful abortion Routing examination of eye, hearing aids, Dental treatment, AIDS, HIV
Premium rate:
|
Age |
25,000.00 |
50,000.00 |
75,000.00 |
|||
|
|
Single |
couple |
Single |
couple |
Single |
couple |
|
Upto-35 |
425 |
783 |
809 |
1478 |
1043 |
1930 |
|
36-45 |
522 |
978 |
991 |
1861 |
1304 |
2412 |
|
46-50 |
739 |
1391 |
1404 |
2643 |
1826 |
3379 |
|
51-55 |
1065 |
1978 |
2026 |
3757 |
2609 |
4825 |
|
56-60 |
1500 |
2783 |
2852 |
5287 |
3652 |
6757 |
|
Child |
357 |
678 |
887 |
|||
EXCLUSIONS:
No benefit shall be paid under This Contract for expenses or losses resulting from or incurred in connection with or in consequence of the Followings any congenital infirmity
(a) any pre-existing Condition
(b) mental, emotional or psychiatric disorders, alcoholism or any other narcotic addiction
(c) Prophylactic and immunization procedures.
(d) any procedure which is experimental or not generally accepted by tlle medical profession (i.e. accupuncture)
( e) any cosmetic or plastic treatment/surgery unless required as reconstructive surgery as a consequence of an injury due to accidents or burns.
(f) rest, convalescence or rejuvenation cures, thermal bath or confinement for the purposes of slimming or beautification
(g) family planning purposes including termination of pregnancy during the first twelve weeks from the date of conception, sterility.
(h) Wilful abortion or any complication and/or sequel there from.
(i) Attempted suicide, violation or attempted violation of the law, injuries willfully or intentionally self-inflicted or due to insanity or under the influence of a drug.
(j) Routine examinations of eye and ear, fitting or replacement of eyeglasses (including contact lenses) or hearing aids.
(k) Routine physical examinations (health check-up), radiotherapy (X-ray, radium or radioactive isotopes treatment), chemotherapy or any form of treatment when not incidental or necessary to the treatment of the injury/illness which caused the hospitalization
(l) Any dental treatment
(m) Injury arising due to accident while participating in any unlawful activities (e.g. driving a car without a license)
(n) Non-surgical care for tuberculosis
(o) Injury or disease directly or indirectly attributed to or civil commotion
(p) Circumcision
(q) Injury, destruction or damage caused by nuclear fission, nuclear fusion or irradiation
(r) Treatment of a new born child upto the age of 3 months.
(s) AIDS and HIV related diseases.
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