Who Is Eligible For This Scheme? How Can I Enroll Myself Under This Insurance Coverage Scheme?
This plan covers all new NPR saving accountholders who are natural person with good health and age 16 years completed and not reached 59 years, who maintain minimum daily balance of Rs. XX,000 in whole month, who signs “Health Declaration”. The critical illness coverage for eligible saving accountholders commences only after the Waiting Period of 60 days from the effective date of individual coverage commencement. All eligible new saving deposit account holders - after the Policy is in effect – can enroll himself or herself into this insurance scheme commencing the coverage from the first day of the following month (Bikram Sambat) of account opening month subject to meeting above criteria or requirements. Please contact or visit our branch offices for detail of this scheme.
What Is Waiting Period?
Critical Illness coverage shall not be effective for the first 60 days from the effective date of individual coverage commencement. However, such waiting period does not apply to Accidental Death, Dismemberment, Permanent Total Disability and Term Life.
What Is The Insurance Coverage And Exclusions Under This Scheme?
- This covered Critical Illnesses under this plan are :- Major Cancers, Strokes, First Heart Attack, Serious Coronary Artery Disease, Heart Valve Surgery, Primary Pulmonary Hypertension. (Coverage amount equal to Rs. 100,000)
- The covered Critical Illnesses under this plan are listed and defined in the Policy "Definition of Critical Illness".
- Accidental Death, Dismemberment & Permanent Total Disability (AD, D, & PTD) (Coverage amount equal to Rs. 100,000)
- Term Life (Coverage amount equal to Rs. 50,000)
Pre-existing medical conditions related to critical illnesses are excluded in addition to other exclusions stated in the policy. For detail of the insurance coverage and exclusions, please refer to "Summary of Coverage"
Is Coverage Effective At Work, At Home Or During Vacation And Traveling In & Out Of Country?
Yes. The coverage under this scheme provides 24 hours a day and 365 days a year Worldwide protection.
Should The Account Holders Submit The Critical Illness Treatment Bills For Reimbursement Of Medical Expenses?
No bills are required. Only diagnosis document and physician statement are required for claim. It’s simple. Claim payment is lump sum 100% of insured amount for Critical Illness treatment.
Should The Account Holders Pay For Enrollment Under This Insurance Coverage Scheme?
No. Eligible Account holder should not pay any cost.The Bank itself will pay the premium for insurance coverage on behalf of eligible Account holders.
I Have Already Purchased Life And Critical Illness Policies. Am I Still Eligible For The Coverage Under This Scheme?
Yes. You are eligible for the Insurance coverage.
Is The Joint Account Holder Also Eligible For Insurance Coverage?
No. Joint account holders are not eligible for the Insurance coverage.
Will My Family Be Covered Under My Insurance Coverage From My Account?
No. Family members are not eligible. The family members who are eligible as mentioned above (1) can participate under this scheme opening separate new saving account on their names.
Are Account Holders Who Have Been Already Suffering Or Receiving Treatment From Cancer, HIV / AIDS, Kidney, Liver Or Lungs Disorder, Brain Diseases, Heart Or Blood Diseases Or Other Covered Critical Illness Of Which Any Signs Or Symptoms Already Occurred Eligible For This Coverage Under This Scheme.
No. Such account holders are not eligible to signs the Health Declaration Form and not eligible to enroll under this scheme.
Will My Insurance Coverage Continue If Account Holder’s Balance Falls Below Rs.XX,XXX/- In Any Single Day Of Month Or In Case Of Account Closure?
No. The coverage discontinues on both cases.
How Many Times A Claimant Will Be Eligible For Claims Of Critical Illnesses?
Critical Illness coverage is for only one time in insured’s life.
Does Term Life Coverage On Insured Continue After The Payment Of Critical Illness Claim Amount?
Yes. Term Life will continue for one year only from the date of his or her individual coverage effective date.
Who Will Get The Claim Amount In Case Of Death Of Insured Account Holder?
In case of death of insured account holder, the insured amount under Term Life shall be paid in lump-sum to insured’s legal heir.
The Insured Is Out Of Country For Treatment Of Critical Illness For Long Time. Can She Or He Claim For Insurance Coverage Under This Scheme Anytime?
The valid claims per the Critical Illness definition mentioned in Policy "Definition of Critical Illness". Shall be paid if the claimant provides all documents with proof of diagnosis to the Insurance Company within one (1) year from the date of diagnosis of Critical Illness or loss of life.
If Insured Account Holder Dies During Treatment Of Critical Illness Before Critical Illness Claim Is Filed To The Insurance Company, Can Beneficiary Or Legal Heir Claim For Critical Illness And Term Life?
Critical Illness Claim is paid if the Insured account holder is diagnosed to be suffering from a critical illness listed and defined in Policy "Definition of Critical Illness", while insured is still living at the time of diagnosis, such Illness diagnosis is not within the waiting period and is not Pre-existing condition. In case of death of such insured after the diagnosis, the insured amount under Term Life shall also be paid in lump-sum to insured’s beneficiary or legal heir.
How Do I Make A Claim?
Claim process is mentioned in "Claim Requirements", Claim Form Death, Claim Form CI, Disability, Physician Statement CI, Disability Please contact our branch office for assistance.
What Are The Documents Required For Claim Filing?
The claim process and list of required documents for claim is mentioned in "Claim Requirement -HBL". Please contact our branch office for assistance.
How Long Will It Take To Receive Claim Amount?
Claim payment in normal course, except exceptions will be 10 - 15 working days for valid Death and Critical Illness claims from the date of complete claim documents receipt from the claimant.
Does Any Tax Apply To Claim Amount?
The Death claim amount is not taxable, however as per the Nepal Income Tax Act, the TDS tax 5% is applicable on Critical illness claim amount currently and such tax rate is subject to change as per amendments of such act by Nepal Government.
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