|
|
|
| product portfolio > health insurance |
| |
| Health Insurance |
| |
Good organizations are built through satisfied employees. Lucrative health benefits have always been a great means for attraction and retention of valuable resources. Adamjee Group Health Insurance is one of the finest health coverage that can be provided to organization for the betterment of its employees. Through magnetically encoded Catch Card, the utilization of these benefits has become efficient and hassle free.
As established leaders in Pakistan?s health insurance industry, we have the winning combination you need for long lasting success. Our accomplishment is only a measure of yours and we dream of making you come out the winner. We believe in maintaining our position through strong systems and processes while regularly adapting to technological advances. Our financial strength along with our customer centric approach enables us to achieve our prime objective of fulfilling our customers? needs efficiently. We promise to deliver more, stay ahead and take you right along with us!
Why Adamjee Health Insurance
Adamjee has an ever expanding customer base of reputable companies, including top national and multinational groups. We are backed by extensive experience of tailoring health insurance products to suit your particular needs and our objective is to keep providing customized services that make our health plans the fitted ones for your corporation.
- Magnetic Health Cards
- 27/7 Call center (0800-00242)
- No pre-authorization requirement
- Pre/Post hospitalization coverage for 30 days
- Complimentary Enhancement of limits in Accidental Emergencies
- Relationship Management Concept
- Ensuring a balanced underwritten portfolio
- Strongest relationships with all service providers
CORE BENEFITS COVERED DURING HOSPITALIZATION
- Physician / Surgeon Visits
- ICU / CCU
o Surgery Charges
- Prescribed Drugs
- Operation Theatre Charges
- Anesthetist?s Fee
- Pathological and Radiological Investigations
- ECG?S, EEGs
- Prescribed ETT, Echo, Thallium Scan
- Angiography / Angioplasty
- M.R.I, CT Scan
- Ultrasound or any other diagnostic tests
- Daycare Surgeries
- Ventilator and Incubator
- Diagnostic or therapeutic endoscopic procedures
- Pre & Post Hospitalization
- (30 days prior & post Consultation, Investigation & Medication).
- Blood Transfusion
- Physiotherapy
- Radiotherapy and Chemotherapy
- Kidney Dialysis and Transplant
- Trauma & Accidents
- Breast and Colorectal Cancer Screening
Download Benefit Details
INTRODUCING ADAMJEE CATCH MAGNETIC CARD
Our emphasis on technological innovations has enabled us to provide integrated solutions to our customers over the years. To provide you and your employees with more convenience we now introduce the Catch Card, the first magnetic card to be offered by any insurance company in Pakistan. The magnetic technology gives your employees peace of mind as they get easily verified and can avail medical services at any of our panel hospitals instantly, without making any payments. The Magnetic strip at the back of the card holds insurance information related to coverage details of insured/dependants.
Download Catch Welcome Booklet
How does it work?
As soon as a Catch Card is swiped on to a POS machine, the holders information including individual limits held by him are displayed. The expected amount of registration/treatment/ hospitalization is entered on the POS machine and the system automatically verifies the policy holder, his available limit and prints a genuine approval from Adamjee for the hospital to start treatment.
Why is it Reliable?
Catch Card has a magnetic strip which cannot be tampered. The front of the card contains the insured?s name and CNIC number. The Approvals for limits are granted by Adamjee on a printed slip bearing Adamjee logo, insured?s name, hospital name and the amount.
PANEL HOSPITALS AND MEDICAL PERSONNEL
We have the largest panel of network providers with more than 130 hospitals all over Pakistan, which make us more accessible, especially during emergencies. All our panel hospitals have been assessed by our quality assessment team, ensuring that they provide health care services which are up to your desired standards.
Not only we choose hospitals that offer exceptional safety standards and outstanding expertise, we also consider their efforts towards continuous improvements in technology and training of staff.
Download Panel Hospital List
|
|
Exclusions:
This insurance policy does not cover claims arising directly or indirectly from or consequent upon the following:
- Birth / congenital defects or illness of any nature whatsoever unless specifically agreed under a separate endorsement attached with this policy.
- Costs resulting from self?inflicted injury, attempted suicide, abuse of alcohol, drug addiction or abuse and treatment of sexually transmitted diseases.
- Psychotic, mental or nervous disorders (including any neuroses and their physiological or psychosomatic manifestations) or sexual reassignment (whether or not for psychological reasons) or psychological disturbance, anxiety or mental stress.
- Pre-existing conditions prior to the effective date of an insured person?s inclusion in this policy cover unless the condition has been declared to and accepted by the company in writing.
- Treatment or investigation of fertility, infertility, sterilization or contraception and any complication relating thereto or hormone treatment and investigations.
- Participation in or training for any dangerous or hazardous sport, pastime or competition or any professional sport.
- Injuries as a result of an illegal act by the insured person.
- Injury or treatment resulting from war, riots, invasion, act of foreign enemies, hostilities or warlike operations (whether war be declared or not), civil war, mutiny, civil commotion assuming the proportions of or amounting to a popular uprising, military uprising, insurrection, rebellion, military or usurped power or any act of any person acting on or on behalf of or in connection with any organization actively directed towards the overthrow or to the influencing of any government or ruling body by force, terrorism or violence.
- Ionizing radiation or contamination by radioactivity from any nuclear fuel or nuclear waste, from the process of nuclear fission or from any nuclear weapons material.
- Services or treatment in any spa, hydro clinic, sanatorium, nursing home or long term-care facility that is not a hospital.
- Acquired immune deficiency syndrome (AIDS), AIDS related complex syndrome (ARCS) and all diseases caused by and or related to HIV virus or any other sexually transmitted disease.
- Experimental or unproven treatment.
- Dental examinations, X-rays, extraction, filling, general dental care / treatment and orthodontic treatment or oral surgery except as a result of emergency accidental dental treatment.
- Cost of correction of refractive errors of the eye and procedures such as Radial Keratotomy and Excimer Laser.
- Routine medical examinations or check-ups including charges arising out of any hospital confinement or admission primarily for diagnostic purposes, unless specifically authorized by the Company, routine eye or ear examinations, vaccinations, medical certificates, examination for employment or travel, spectacles, contact lenses, hearing aids and any treatment that is not considered medically necessary.
- Cosmetic or plastic surgery, unless it is re-constructive surgery necessitated by an injury that occurred during the period whilst the insured person was covered under this policy and subject to the limits and sub-limits stated in the benefits table.
- Any increase in the expenses incurred for treatment on account of the insured person being admitted to a more expensive room than allowed by his daily room and board limit.
- Pregnancy and complications thereof, childbirth (including surgical delivery), miscarriage, abortion and/or any related prenatal or postnatal care unless covered under a separate optional rider under this policy.
- Any outpatient treatment, except that arises out of an accident, unless covered under a separate optional rider under this policy.
- Any charges in respect of the donor for organ transplant claims.
- Cost of limbs or supporting equipment for revival or correction of the function(s) of body.
- Riding or driving in any racing competition operational duties as a person of armed forces, mountaineering or rock climbing, engaging in aviation except for traveling by-air as a passenger on any fully licensed passenger carrying aircraft.
- Personal comfort items such as, charges for telephone, meals for other than the patient or other items not medically necessary.
- Treatment received in a location other than the insured person?s geographical area of coverage.
- Natural catastrophes including, but not limited to, flood, earthquake, avalanche and cyclone.
|
| |
|
|