Supreme Health Unlimited

Hospitalization Benefit (pre member, per year) Rs 500,000

exculuding USA & Canada
Name -: Mr.sampath
Family membar -: 3
Bill limit (withut noclame) 1,500,000
Per member Family

1 Hospitaliztion bill 100.%. 100.%.

2 OPD Cover (,max-50000 BSA 1% , Opion to include indiviual) Rs 5,000 Rs 15,000

3 Dental care(,7-16/20000,17-22/30000,23-.>50000) Rs 20,000 Rs 60,000

4 Optical cover(MAX 50000 for BSA 5%) Rs 25,000 Rs 75,000

6 Health check up (All plan-1%,(MAX 50000) Rs 5,000 Rs 15,000

7 Pre-hospitalization expenses Rs 25,000 Rs 75,000

8 Post-hospitalization expenses Rs 25,000 Rs 75,000

9 Ayuruwedic (Max-50000) Rs 25,000 Rs 75,000

10 Ambulance charges Rs 10,000 Rs 30,000

11 Hospitalization in a non-paying ward( max-20000, BSA 1%) Rs 5,000 Rs 15,000

12 cashlash 100% 100%

13 Day care treament benefit 136 136

14 No claim bonus (MAX-100%) 25% 25%

15 Re store Benefit Rs 1,000,000 Rs 3,000,000

16 Organ donor expenses Rs 500,000 Rs 1,500,000

17 Prosthesis & implants Rs 100,000 Rs 300,000

18 Overseas tretment (Daily Hospital Rome & Board) Rs 625,000 Rs 1,875,000

19 Accidental critical condition rider (Max 10M) Rs 500,000 Rs 1,500,000

20 Hospital admission charges(3-9/5000 , 10.>5% max 100,000) Rs 5,000 Rs 15,000

21 Maternity Expenses

Waiting period
Supremahealth max 90 days
Optical cover 02 year
Maternity cover 02 year
Common medical conditions 01 years
OPD 01 years
Dental cover 180 days
Day care surgery 01 years
Ayuruwedic 180 day

Accidental Critical Condition Rider

qCoverage:

coma
major head trauma
major burns
paralysis
deafness
loss of speech

Name D.K.Hashan Sandeep

Mobail number 076 72 11 907
Offce number 036 42 70 775

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