Kathmandu. The Nepal Insurance Authority (NEA) has issued a hospitalization micro-insurance policy. This insurance policy has been issued by the Authority to increase the scope of insurance targeting the low income and poor and disadvantaged sections.
This policy is issued by the small insurance company. In this policy, the insurance rate has been fixed at Rs 7 per thousand per person and Rs 15 per family. An additional per capita insurance rate for a family will be Rs 4 per thousand. Family means the insured living in one house will have a maximum of five members including husband or wife and children (unmarried).
If admitted to the hospital due to illness or illness or accident, the insured will get 30 percent of the sum assured as bed fee, 60 percent of the sum assured for treatment expenses (doctor fee, check-up and surgery), 10 percent of the sum assured for medicine expenses and the amount as bill for hospitalization due to pregnancy (including surgery) or a maximum of Rs 10,000.
Such are the conditions
- The insured must inform the insurer about his hospitalization through quick notice.
- The insurer shall not pay the claim if the insured makes a false, wrong decision or makes a fraudulent claim or violates the terms of the policy.
- Expenses of admission for treatment outside Nepal will also be borne as per the recommendation of the doctor.
- The insured’s age must be maximum 65 years or less.
- The insurer will not pay the expenses within 30 days of the commencement of insurance (except in the case of accident and hospitalization). However, this condition will not apply in the event of continuation of the policy.
- The insurer shall not pay more than the sum assured for a family within an insurance period.
- The insurer and the insured will have to keep a copy of the policy with them.
In such cases the insured will not get compensation
- Intentional self-inflicted injury, suicide attempt,
- Any beauty drug treatments,
- Any disease associated with sexually transmitted diseases, drug use,
- Vitamins and medicines, except for treatment expenses after discharge date and prescribed by the doctor during treatment,
- Voluntary abortion, expenses related to infertility,
- Diseases existing before the commencement of the policy.
