TULIZO THABITI POLICY :: Accidental, Emergency, Hospitalisation Policy.
(A) SCOPE OF COVER
Accident Medical Inpatient Hospitalisation expenses including Surgeons, Physicians, Doctors & Anaesthetist fees, Operating Theatre & ICU charges, Diagnostic services, Prescribed drugs, Dressings, Surgical Appliances.
Funeral expenses cover - K.shs. 25,000/= per person
Emergency Evacuation [within East Africa only]
included in limits of benefits.
(B) TERRITORIAL LIMITS
Kenya - but this limit will not apply to any Insured Person temporarily abroad and requiring inpatient treatment arising from accidental injury provided that the stay abroad does not exceed six weeks in any one period of insurance.
(C) ELIGIBILITY
Age - 6 months to 65 years. Any dependant over the age of 21 years will be considered as a separate member.
(D) COVER CONFIRMATION
Subject to acceptance of duly signed and completed proposal form along with two photographs and premium cheque.
(E) CLAIMS
The Insured is free to take in-patient treatment following an accident in any registered Hospital in the country and submit documents pertaining to the said admission to get reimbursement. The Company has credit arrangements with certain Hospitals in the country and the admission procedure is:
Emergency: - the Insured can be admitted by using his photo identity card and then our office should be intimated within 24 hours by the hospital staff to get preauthorization.
In the event of an emergency call:
AAR AMBULANCE SERVICES
TELEPHONE : 0734 225 225 / 0725 225 225
NAIROBI : 2717374 / 5 / 6
MOMBASA : 312405 / 6
EXCLUSIONS
• General Health check-up.
• Cosmetic surgery unless caused by accident.
• Pre-existing conditions.
• Age related senility, general debility.
• Congenital defects and chronic conditions.
• Chiropractic, Acupuncture, Herbalist treatment.
• Intentional self injury, drunkenness, drug addiction.
• Naval, Military or Air Force operations, civil war, rebellion.
• Expenses recoverable under any other insurance (or any other medical reimbursement scheme).
• Immunization / vaccination.
• AIDS and related diseases and veneral diseases.
• Contamination by radioactivity from nuclear fuel waste or fission.
• Family planning / infertility, being pregnant or or undergoing childbirth.
• Eye testing or the cost of eye glasses or contact lenses, hearing tests or the cost of deaf aids, dental treatment except resulting from an accident involving physical injury to an insured person.
• Dangerous / Professional sports activities.
• Expenses arising from general illness.
NB : This Policy covers inpatient hospitalization expenses due or necessary following an accident only.
ACCIDENT HOSPITALIZATION INSURANCE PREMIUM RATING
A. Professionals and Administrative staff not involved in manual and extra harzadous activities
|
LIMIT KSHS |
M KSHS |
M+ 1 KSHS |
M+2 KSHS |
M+3 KSHS |
M+4 KSHS |
|
500,000 |
3,000 |
4,500 |
5, 250 |
6,000 |
9,000 |
|
1 000,000 |
5,000 |
7,500 |
8, 750 |
10,000 |
12,500 |
B. All other than the above Occupations - loading of premium will be between 25 % to 50% at the discretion of the Company.
NOTE : 0.2 % Training Levy +0.25 % PHC Fund Levy + KShs 40/= Stamp Duty to be added to the above premiums.
NB: This Policy covers inpatient hospitalization expenses due or necessary following an accident only. Our Emergency Hotline: 0720 717 580
Please refer to Policy Terms, Conditions and Exclusions. The above Terms and Exclusions are illustrations.