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Health Insurance

 

INTRODUCTION OF ALFALAH HEALTH INSURANCE:

Health Insurance Scheme of Alfalah Insurance Company is an exclusive Group Medical Insurance Program specially designed for organizations to take care of Health related concerns of their employees & their family members. We offer diverse health plans designs pared with variety of innovation and consumer directed options. In addition to this, we have a well-established Health Insurance Department comprising of Doctors, Pharmacists and other supportive staff backed with a state of the art IT platform. The staff in the Health Insurance department has vast experience of health insurance and able to serve the insured members with best possible healthcare at affordable cost. You’ll find the right mix for your employees need to facilitate your organizations to maintain affordable Health care system with economy in efforts and cost.

Group Medical Insurance covers medical cost of Indoor patients (IPD), Outdoor patients (OPD), Surgical treatment, Maternity, Dread Diseases & Specialized Investigations as per organizations’ choice and requirements.

ALFALAH HEALTH INSURANCE COVERAGE:

Alfalah Insurance Company can help you by offering its health insurance products as mentioned here under to overcome health related unpredictable events of life.

1. Hospitalization Cover (Basic Cover)

Medical Expenses will be covered/ reimbursed as per policy terms & conditions incurred up to the specified limit as in the Table of Benefits on account of the following.

• Daily Room Charges & ICU/CCU Charges (inclusive of meal charges wherever applicable)
• Operation Theatre Charges
• Surgeons / Consultant’s fee
• Anesthetist fee
• Pharmacy / Surgical Items
• Diagnostic tests
• Endoscopies, Angiography, Thallium Scan, MRI & CT-Scan (on out-patient setting when advised by the relevant physician/surgeon).
• Day Care Surgeries (without the condition of 24 hours in hospital) e.g. cataract, Hernia, POP etc.
• Accidental Treatment including treatment of fractures & dressing of lacerated wounds etc
• Pre-admission and Post-hospitalization Benefits (expenses incurred outside the hospital lead to actual hospitalization, up to a limit specified, mentioned in the Table of Benefits).

2. Maternity Cover (Optional Cover)

Medical Expenses will be covered/ reimbursed as per policy terms & conditions incurred up to the specified limit as in the Table of Benefits on account of the following.

• Accommodation Charges
• Gynecologist’s fee for delivery & consultations
• Labor Room / Operation theatre charges
• Anesthetist fee
• Miscarriage, D&C
• Medicines or Drugs
• Diagnostic tests
• Pre-natal and Post-natal Expenses
• Baby’s Nursing Care
• Circumcision of baby boys up to a specific limit as mentioned in the benefit table.

Note: Daily Room Charges are inclusive in the Maternity Limit

3. OPD Benefits (Optional Cover)

• Consultations/Follow-Up Visits
• Laboratory tests
• Radiology/ Specialized Investigations
• Prescribed Medicines
• Dental Treatment (therapeutic)
• Vaccinations
• Ophthalmology services (therapeutic)

MAIN EXCLUSIONS:

Some (and not all) of the main exclusions are: –

• Mental illnesses, and any sickness or condition arising from and including drug abuse, alcoholism or a criminal act.
• Treatment or investigation of fertility, infertility, sterilization, contraception and any complication relating thereto or hormone treatment and investigations.
• General check-ups or rest cures or hospitalization only for evaluation and diagnostic purposes.
• Supply or fitting of eye glasses, contact lenses or hearing aids.
• Cost of limbs or supporting equipment for revival or correction of the function of body.
• Dental examinations, extraction or filling unless necessitated due to an accidental injury occurring during the insured period.
• Cost of radial keratotomy and excimer and lasik laser procedures.
• Cosmetic surgery, unless necessitated by an accidental injury occurring during the insured period.
• Personal comfort items such as, charges for telephone, meals for other than the patient or other non-medical items.
• Any outpatient treatment, except that arises out of an accident.
• In few hospitals, charges of certain treatment vary in different type of rooms i.e. private, semi private, general ward etc. individuals staying in higher than their entitlement will be responsible for payment of additional expenses for room rate plus any increase in other expenses as well.

Claims Reporting Procedure

 

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Abu Dhabi Group is represented in Pakistan by the following entities:
   
 
Copyright 2017, All Rights Reserved - Alfalah Insurance Company Limited - Powered by Alfalah IT Team Last Updated on 13/07/2017