Common use of Benefit Package Clause in Contracts

Benefit Package. The Benefits within this scheme, to be provided on a cashless basis to the Beneficiaries up to the limit of their annual coverage, package charges on specific procedures and subject to other terms and conditions outlined herein, are the following: a. The scheme shall provide coverage for meeting expenses of hospitalization for medical and/or surgical procedures including maternity benefit, to the enrolled families for up to Rs.30,000 per family per year subject to limits, in any of the empanelled hospitals across India. The benefit to the family will be on floater basis, i.e., the total reimbursement of Rs.30,000 can be availed individually or collectively by members of the family per year. b. Pre-existing conditions/diseases are to be covered from the first day of the start of policy, subject to the exclusions given in Appendix 1. c. Coverage of health services related to surgical nature for defined procedures shall also be provided on a day care basis. The Insurance Company shall provide coverage for the defined day care treatments/ procedures as given in Appendix 2. d. Provision for transport allowance of Rs. 100 per hospitalization subject to an annual ceiling of Rs. 1000 shall be a part of the package. This will be provided by the hospital to the beneficiary at the time of discharge in cash. e. Pre and post hospitalization costs up to 1 day prior to hospitalization and up to 5 days from the date of discharge from the hospital shall be part of the package rates. f. Maternity and Newborn Child will be covered as indicated below: I. It shall include treatment taken in hospital/nursing home arising out of childbirth, including normal delivery / caesarean section and/ or miscarriage or abortion induced by accident or other medical emergency subject to exclusions given in Appendix 1. II. Newborn child shall be automatically covered from birth upto the expiry of the policy for that year for all the expenses incurred in taking treatment at the hospital as in-patient. This benefit shall be a part of basic sum insured and new born will be considered as a part of insured family member till the expiry of the policy subject to exclusions given in Appendix 1. III. The coverage shall be from day one of the inception of the policy. However, normal hospitalisation period for both mother and child should not be less than 48 hours post delivery. Note: i. For the ongoing policy period until its renewal, new born will be provided all benefits under RSBY and will NOT be counted as a separate member even if five members of the family are already enrolled. ii. Verification for the new born can be done by any of the existing family members who are enrolled in RSBY through the same smart card as that of the mother. g. Domiciliary treatment: Not Covered

Benefit Package. The Benefits within this scheme, to be provided on a cashless basis to the Beneficiaries up to the limit of their annual coverage, package charges on specific procedures and subject to other terms and conditions outlined herein, are the following: a. The scheme shall provide coverage for meeting expenses of hospitalization for medical and/or surgical procedures including maternity benefit, to the enrolled families for up to Rs.30,000 per family per year subject to limits, in any of the empanelled hospitals across India. The benefit to the family will be on floater basis, i.e., the total reimbursement of Rs.30,000 can be availed individually or collectively by members of the family per year. b. Pre-existing conditions/diseases are to be covered from the first day of the start of policy, subject to the exclusions given in Appendix 1. c. Coverage of health services related to surgical nature for defined procedures shall also be provided on a day care basis. The Insurance Company shall provide coverage for the defined day care treatments/ procedures as given in Appendix 2. d. Provision for transport allowance of Rs. 100 per hospitalization subject to an annual ceiling of Rs. 1000 shall be a part of the package. This will be provided by the hospital to the beneficiary at the time of discharge in cash. e. Pre and post hospitalization costs up to 1 day prior to hospitalization and up to 5 days from the date of discharge from the hospital shall be part of the package rates. f. Maternity and Newborn Child will be covered as indicated below: I. It shall include treatment taken in hospital/nursing home arising out of childbirth, including normal delivery / caesarean section and/ or miscarriage or abortion induced by accident or other medical emergency subject to exclusions given in Appendix 1. II. Newborn child shall be automatically covered from birth upto the expiry of the policy for that year for all the expenses incurred in taking treatment at the hospital as in-patient. This benefit shall be a part of basic sum insured and new born will be considered as a part of insured family member till the expiry of the policy subject to exclusions given in Appendix 1. III. The coverage shall be from day one of the inception of the policy. However, normal hospitalisation period for both mother and child should not be less than 48 hours post delivery. Note:. i. For the ongoing policy period until its renewal, new born will be provided all benefits under RSBY and will NOT be counted as a separate member even if five members of the family are already enrolledenrolled . ii. Verification for the new born can be done by any of the existing family members who are enrolled in RSBY through the same smart card as that of the mother. g. Domiciliary treatment: Not Covered

Benefit Package. The Benefits within this scheme, to be provided on a cashless basis to the Beneficiaries up to the limit of their annual coverage, package charges on specific procedures and subject to other terms and conditions outlined herein, are the following: a. The scheme shall provide coverage for meeting expenses of hospitalization for medical and/or surgical procedures including maternity benefit, to the enrolled families for up to Rs.30,000 per family per year subject to limits, in any of the empanelled hospitals across India. The benefit to the family will be on floater basis, i.e., the total reimbursement of Rs.30,000 can be availed individually or collectively by members of the family per year. b. Pre-existing conditions/diseases are to be covered from the first day of the start of policy, subject to the exclusions given in Appendix 1. c. Coverage of health services related to surgical nature for defined procedures shall also be provided on a day care basis. The Insurance Company shall provide coverage for the defined day care treatments/ procedures as given in Appendix 2. d. Provision for transport allowance of Rs. 100 per hospitalization subject to an annual ceiling of Rs. 1000 shall be a part of the package. This will be provided by the hospital to the beneficiary at the time of discharge in cash. e. Pre and post hospitalization costs hospitalizationcosts up to 1 day prior to hospitalization and up to 5 days from the date of discharge from the hospital shall be part of the package rates. f. Maternity and Newborn Child will be covered as indicated below: I. It shall include treatment taken in hospital/nursing home arising out of childbirth, including normal delivery / caesarean section and/ sectionand/ or miscarriage or abortion induced by accident or other medical emergency subject to exclusions given in Appendix 1. II. Newborn child shall be automatically covered from birth upto the expiry of the policy for that year for all the expenses incurred in taking treatment at the hospital as in-patient. This benefit shall be a part of basic sum insured and new born will be considered as a part of insured family member till the expiry of the policy subject to exclusions given in Appendix 1. III. The coverage shall be from day one of the inception of the policy. However, normal hospitalisation period for both mother and child should not be less than 48 hours post delivery. Note:. i. For the ongoing policy period until its renewal, new born will be provided all benefits under RSBY and will NOT be counted as a separate member even if five members of the family are already enrolledenrolled . ii. Verification for the new born can be done by any of the existing family members who are enrolled in RSBY through the same smart card as that of the mother. g. Domiciliary treatment: :Not Covered