I am young and healthy. Do I really need health insurance?

Yes. You will need insurance. Even if you’re young, healthy and haven’t had to see a doctor in years, you will need coverage against unexpected events like accidents or an emergency.

Is Health Insurance the same as Life Insurance?

No. Life Insurance protects your family (or dependents) from financial loss that may arise in the event of your untimely death and/or permanent disability. The payout is made only post the death of the person insured or at the maturity of the policy. Health Insurance protects you against illness/diseases by covering the expenses you might incur (for treatment, diagnosis etc.) in case you are affected by disease or injury.

My employer provides me with health insurance coverage. Is it advisable to take another policy on my own?

It is strongly advised to have health insurance on your own as well because of reasons of continuity. Firstly, if you change your job, you might not necessarily get health insurance from your new employer. In any case you will be exposed to health costs in the transition period between jobs. Secondly; the track record that you have built in health insurance at your old employer will not transfer to the new company policy.

It will also help in case your limit has exhausted in first policy, you need to pay from your own pocket. In this case, you can use your second policy to pay your remaining medical bills.

Therefore to avoid the above problems, it is advisable to take a private policy in addition to your company provided group health insurance policy.

Are Maternity / Pregnancy related expenses covered under Health Insurance plans?

Yes. We offer maternity coverage as an optional  benefit which pays Maternity / Pregnancy related expenses.

Is a medical checkup necessary before buying a policy?

No, we do not require policyholder to undertake medical checkups.

What are the minimum and maximum policy duration?

Health insurance policies are issued for a period of 1 year only. At the end of expiry date of your insurance policy, you must renew your policy to continue the health insurance coverage without any interruption

What is coverage amount?

Coverage amount is the maximum amount payable in the event of a claim. It is also known as “ Annual Limit”. The premium of the policy is dependent on the age, insurance coverage and annual limit.

My wife and children are residing separately from where I am located. Can I cover all of us in one policy?

Yes, you can cover your entire family under one policy in case all of you live in Pakistan. Your health insurance policy is in force across Pakistan. Our policy does not cover coverage outside Pakistan.

Does health insurance cover diagnostic charges like X- ray, MRI or Ultrasound?

Health Insurance covers all diagnostic test like X- ray, MRI, blood tests etc as long they are associated with the patients during  stay in the hospital for at least one night. Any diagnostic tests which have been prescribed in the OPD are generally not covered. However, in case of above test done within 30 days before and after hospitalization, the expenses incurred will be paid to you.

What do you mean by cashless hospitalization / cash less card?

In the event of hospitalization, the patient or their family will have a bill to pay the hospital. Under Cashless Hospitalization the patient does not settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by the health insurer. This is for your convenience. However, prior approval is required before the patient is admitted into the hospital. In case of emergency hospitalization, approval can be obtained post-admission.

Can I buy more then one Health Insurance policy?

Yes, you can buy more than one Health Insurance policy. In case of a claim, claimant will avail the best coverage option or can use additional coverage for first coverage is fully used.

For example, Customer was billed Rs 400,000 from insurer A his coverage was Rs. 1 lakh and then the second policy( Insurer B) can help him out to cover the excess amount for paying the billed amount upto Insurer B coverage amount .

What happens to the policy coverage after a claim is filed?

After a claim is filed and settled, the policy coverage is reduced by the amount that has been paid out on settlement.

For Example: In January you start a policy with coverage of Rs. 5 Lakh for the year. In April, you make a claim of Rs 2 lakh. The coverage available to you from May to December will be the balance of Rs. 3 lakh.

What is the maximum number of claims allowed over a year?

Any number of claims is allowed during the policy period. However the sum insured is the maximum limit under the policy.

What are the documents required for buying a health insurance?

All we need to process your application is a copy of your CNIC, no documents are required for purchasing health insurance.

What are exclusions in a health insurance policy?

Every health insurance policy has a set of exclusions, which can vary plan to plan. However, there are some standard  exclusion which remain same in all health insurance plans/options

What are the factors which determine the premium payable for health insurance?

In health insurance, the age, insurance coverage  and  annual benefit amount of cover are the factors that decide the premium. Usually, younger people are considered more healthy and thus pay lower annual premium. Older, people pay a higher health insurance premium as their risk of health problems or illness is higher.

How does the insurance company decide whether a disease was a pre-existing one or not?

While filling up the proposal form for insurance you need to provide details of the illnesses you have suffered during your lifetime. At the time of insurance, you should be aware whether you have any disease and whether you are undergoing any treatment. The insurers refer such health issues to their medical panel to differentiate between pre-existing and newly contracted illnesses.

Note: It is important to disclose any disease you might be suffering with before buying the health insurance policy. Insurance is a contract based on good faith and any willful non-disclosure of facts might lead to problems in future.

What happens when I cancel the policy?

If you cancel the policy, your cover will cease to exist from the date of cancellation of policy. Additionally, your premium should be refunded to you on short period cancellation rates, as per the terms and conditions of the policy and you will find these terms and conditions in the policy document. However, no refund will be applicable if you have any claim availed during the covered period of the cancelled health insurance policy.

Can I seek treatment at home and be reimbursed for it under health insurance?

No, our health insurance policy is only allowed to avail treatment in the hospitals. We have a network of Panel Hospitals across the country where our insured can avail cashless medical treatment.
Incase of treatment availed in non-panel hospital (not at home), insurance company will reimburse the claim amount as per policy terms and condition.

What do you mean by coverage amount? Is there is a minimum or maximum limit?

Coverage amount is the extent to which the insurance company will make payment for the medical expenses incurred by you.