SAUDI PAK

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					CORPORATE MEDICAL INSURANCE




                   SAUDI PAK
                    INSURANCE
         SAUDI PAK INSURANCE COMPANY LIMITED
Why medical insurance?
“Calamities come uncalled, medical insurance saves you from unforeseen medical expenditures”.
With the ever increasing cost of medical treatments, the need to budget high frequency low-cost as well
as low frequency high-cost procedures has become dire. A hassle free, less time consuming and more
economical solution is “Saudi Pak Corporate Medical Insurance”. It not only outsources your rising
expenditures, but also relieves you mentally and economically of medical worries.

“WE DARE TO CARE”

Why select Saudi Pak Corporate Medical Insurance?

We believe solemnly in providing the maximum insurance protection at the most competitive price in a
highly efficient manner to the corporate sector.

Who can be covered?

–        Working (regular/contractual) employees, their dependent, spouses and parents up to the age of 65 years.
–        Dependent Children upto the age of 25 years.
–        Divorced/separated/wodowed daughter(s) dependent on the employee without any age limit.

What benefits we offer?

INPATIENT BENEFIT (Hospitalization and Surgical Expenses)

Any expense incurred by an insured for non-pregnancy related hospitalizaton and surgical procedures due to any sickness or accident, subject to a predetermined
limit and other terms of the policy. This is the core benefit, which includes the following expenses:

–        Hospital Room, Operation theatre and ICU / CCU;                  –           Treatment of fractures / dislocations, etc;
–        Physicians, surgeons & anaesthetist’s charges;                   –           Day care surgeries;
–        Prescribed medicines during hospitalizations;                    –           Specialized diagnostic investigative procedures in
–        Doctors’ / Surgeons’ visits;                                                 outpatient settings such as MRI, CT Scans,Endoscopy;
–        Oxygen supplies;                                                 –           Pre and post hospitalization expenses, and
–        Blood transfusions;                                              –           Patient’s meal (provided by the hospital only).




                                                                                                                                                                                                               ARD
                                                                                                                                                                      D.
MATERNITY BENEFIT (Optional cover)                                                                                                                             CO. LT
                                                                                                                                                          ANCE




                                                                                                                                                                                                           AL C
                                                                                                                                                     INSUR
Any hospitalization directly or indirectly related to pregnancy is governed                                                                    I PAK
                                                                                                                                           SAUD




                                                                                                                                                                                                       EDIC
by the maternity benefit subject to a predetermined limit and                                                                                                    NTS      LTA
                                                                                                                   K                                              ONSU
other terms of the policy. The benefit includes charges for:                                                 DI PA                                           ENT C                     52
                                                                                                          SAU   NCE                                 MAN AGEM
                                                                                                                                                                   CT O R
                                                                                                                                                                          & CE
                                                                                                                                                                               O




                                                                                                                                                                                                      M
                                                                                                                    R     A                                   DIRE
                                                                                                               INSU                                           A   GING




                                                                                                                                                                                                   AK
–        Gynaecologist fee for delivery / consultation:                                                                                              MA N                  -10101
                                                                                                                    rate                                     y No     . SP
–        Labor room / Operation theatre charges;                                                              Corpo




                                                                                                                                                                                               DI P
                                                                                                                          NA                           Polic              0.04.2
                                                                                                                                                                                 009
                                                                                                                     M RA                                                3
–        Prescribed medicines during hospitalization;                                                                               red:                       till
                                                                                                               A KRA      bers
                                                                                                                               Cove             42      Valid
                                                                                                                                                                           00001




                                                                                                                                                                                            SAU
                                                                                                                          Mem           Wife     22
–        Post natal medical expenses;                                                                           Famil
                                                                                                                      y
                                                                                                                            rveens      Son hter 17
                                                                                                                      la Pe                 ug            ID #
–        Baby nursing care;                                                                                      Ghazan Mandre l
                                                                                                                                e        Da
                                                                                                                                         Son
                                                                                                                                                  15
                                                                                                                 Adna ata Farya s
–        Licensed midwife charges, and                                                                               n
                                                                                                                  Han n Jergee
                                                                                                                  Sana
–        Circumcision of newlly born baby boy.
                                                                                                                                      RED:
                                                                                                                                 COVE enefit:         2,500
DREAD DISEASES BENEFIT (Optional cover)                                                                                     FITS       B         imit
                                                                                                                      BENE alisation        Sub-L
                                                                                                                       Hospit         Board
                                                                                                                              Ro om &
                                                                                                                        Daily
Dread disease limit will come into picture for critical ailments; the following potentially lethal diseases
are covered under this rider.

–     Myocardial infarction (Heart attack);
–     Coronary artery disease requring surgery;                               –       Organic Failure (without transplantation);
–     Stroke;                                                                 –       Liver cirrhosis;
–     Cancer;                                                                 –       Poralysis;
–     AIDS;                                                                   –       Parkinson’s Disease;
–     Major organ transplant;                                                 –       Muscular Dystrophy;
–     Renal failure;                                                          –       Alzheimer’s Disease;
–     Multiple Sclerosis (MS);                                                –       Myasthenia Gravis;
–     Hepatitis-B and C;                                                      –       Syringomyelia and any disease which comes
–     Severe Burns;                                                                   under dread diseases definition.
–     Aortic Aneurysms;
–     Rheumatic Heart diseases;                                                       Note: The age limit for Dread Diseases Benefit is up to 60 years.

OUTPATIENT BENEFITS (Optional cover)
These expenses are to meet the diagnostic and day to day medical treatment expenses that occur without the insured being hospitalized. We offer this
benefit on reimbursement basis covering:

–    General Practitioners, Homoeopathic Physician’s services or                  –     Eye testing;
     herbal medicine treatment and supplies;                                      –     Osteopathy;
–    Specialist’s consultation;                                                   –     Phsiotherapy, acupuncture and similar treatments;
–    Prescribed medicines;                                                        –     Dental treatment, and
–    Laboratory and X-ray tests;                                                  –     Pre and post-natal treatments and supplies, while not confined in hospital.
–    ECGs, EMGs and EEGs examination and other diagnostic tests;

What limits of benefits are available?

Based on experience and current market practice, we find that requested limits may fall anywhere between:
                                                                                                                                         Limits Range
    Description of Benefits
                                                                                                                                From                            To


    Hospitalization: The per ailment limit under each category/plan is automatically increased by 50%                       Rs. 200,000                     Rs. 25,000
    in case of hospitalization due to accident with NO extra cost.


    Daily room rent (sub limit)                                                                                           Rs.         6,000               Rs.          500

    Maternity: (In case of Cesarean Section the limit will automatically increased by 50%)                                Rs.        60,000               Rs.        7,500

    Dread Disease                                                                                                         Rs.       500,000               Rs.     100,000

    Out-patient                                                                                                           Rs.        50,000               Rs.        5,000


The above are mere suggestions. Actual limits can be reduced or increased as per need and budget.

What type of information is required for generating premium cost?                      What information is required before the commencement of cover?

The actual premium working will depend on a number of factors. Some of these           The names, ages, CNIC numbers of employees, marital status and medical history
factors are beyond the control of the employer whereas others can be adjusted          of the employees / dependants are required. The same are obtained through “Employee
to result in the level of premium that the employer wishes to pay.                     Enrolment Form’ to be duly filled by each employee.

Un-controllable factors:                                                               Does pre-existing conditions of an employee / dependant cover under this
                                                                                       Insurance?
–         Size of the group,
–         Ages and health status of the employees/dependants,                          Pre-existing illnesses may be covered, subject to the full disclosure and acceptance
–         Nature of work / Occupational classification / Marital status /              by the insurer.
          Number of dependants of employees.
                                                                                       Is premium a taxable amount?
Controllable factors:
                                                                                       The premium for group medical insurance is a tax deductible expense and you will
–         Selection of benefits,                                                       get tax benefit on it.
–         Maximum limits for various benefits,
–         Benefits categorization by designations / salary.                            What is the procedure for availing in-patient medical benefits?

Different combinations of these factors will result in different premium costs.        If hospitalization/surgery is advised by a qualified physician, then any of our ‘Approved
Consequently, the cost of the scheme for two groups with smaller strength of           Panel Hospitals’ can be approached for the treatment on credit basis through
employees/dependants can be different. Our proposal form covers all the basic          authority letters/medical cards issued to each insured employees in advance.
information, which is required for generation of quotation.
                                                                                       What is an approved panel hospital?
How may persons are necessary to qualify as a group for medical insurance?
                                                                                       Any hospital which is approved by and on panel of Saudi Pak Insurance Company
Under normal circumstance a minimum of 30 persons including dependants are             is to provide medical treatment to the insured person.
required. In case of only employees cover minimum 15 should be in a group.

Can someone go to non-panel hospital?                                                         x     Injury or illness due to war/civil war/commotion.

If an insured person wishes to utilize the service of non-panel hospitals, then               x     Engaging in air travel, except as a fare-paying passenger in a licensed
he/she must seek prior approval. This condition is waived in emergency cases                        aircraft being operated by a licensed airline according to published
provided the employee informs us within 24 hours of such hospitalization.                           schedules.
                                                                                              x     Hospitalization in unapproved hospital (without prior written consent of
What will be the settlement if emergency occurs outside Pakistan?
                                                                                                    Saudi Pak Insurance except in emergency situations).
In such cases, claims will be settled in Pakistan in Pakistani currency as per                x     Any increase in the expenses incurred for the tretment on account of the
policy limits, terms and conditions. Settlement of such claims shall be on the                      insured being admitted to more expensive room than allowed by his/her
basis of what it would cost for a similar procedure to be carried out in Pakistan.                  room rent.

What does not come under the ambit of this insurance?                                         x     Treatment for injuries as a result of participation in any dangerous sport,
                                                                                                    pastime or competition, including but not restricted to riding, driving in
This insurance does not cover claims arising direct or indirectly from or                           any race and engaging in professional sports.
consequent upon:
                                                                                              x     Participation in illegal acts according to the laws of Pakistan.
x     Any pre-existing condition, unless fully disclosed and coverage approved                x     Personal comfort items such as charges for telephone, meals for other
      by insurer in writing.                                                                        than the patient or other items not medically necessary.
x     Any treatment not recommended by a licensed physician.
x     Mental/Psychiatric disorders, abuse of drugs, alcoholism etc.                           x     Any charges in respect of the donor for organ transplant claims.
x     Cosmetic/plastic surgery, unless due to accidental injury.                              x     Air ambulance or evacuation or repatriation expenses.
x     Congenital defects/deformities, including physical and mental defects
      present from birth.                                                                           What are some               Following are the extra features of our product
x     Treatment of infertility, impotency, sterilization & contraception including                  other fringe                without paying any additional premium:
                                                                                                    benefits?
      any complication relating thereto.
                                                                                                                                q     Automatic reinstatment of limit.
x     Routine physical check ups, preventive services including immunization.
                                                                                                                                q     Credit arrangement from SPI’s network
x     Supply or fitting of eye glasses, hearing aids, contact lenses and any                                                          of hospitals all over the country.
      treatment that is not considered medically necessary.                                                                     q     New born babies automatically covered
x     Correction of refractive errors of the eye and procedures such as redial                                                        in the scheme from the date of their birth.
      keratotomy and excimer laser.                                                                                             q     No waiting period for maternity benefits.
x     Cost of limbs, prosthesis or any supporting equipment for revival or                                                      q     Profit sharing available from very first
      correction of the function(s) of body.                                                                                          renewal.
x     Self inflicted injuries while sane or insane.                                                                             q     24 hour medical help line.
                                                                                                                                q     Medi-card is your passport to fast and
                                                                                                                                      easy medical treatment from our panel
                                                                                                                                      hospitals.
                                       Head Office:
              2nd Floor, State Life Building No. 2-A, Wallace Road, Karachi 74000
                          UAN: (021) 111-774-111 Fax: (021) 2417885
                            E-mail: info@saudipakinsurance.com.pk
                           Website: www.saudipakinsurance.com.pk

Faisalabad Branch                 Islamabad Branch                  Rawalpindi Branch
Mr. Malik Farooq Mustafa          Mr. Choudhry Waqar Ahmed          Mr. Choudhry Waqar Ahmed
Chief Manager                     Regional Head                     Regional Head
2nd Floor, Saudi Pak
Bank Building,                    Mr. Asim Majeed                   Mr. Irfan Omer Awan
Kotwali Road, Faisalabad          Manager                           Manager
Ph      # 041-2605688             2nd Floor, Saudi Pak Tower,       3rd Floor, Usman Plaza
            041-2605788           61/A, Jinnah Avenue,              55-Haider Road
            041-2605789           Islamabad                         Rawalpindi Cantt.
Fax     # 041-2605689             Ph      # 051-111-222-003         Ph      # 051-5792006
Mob # 0300-8669975                            Ext 3081                          051-5110572
                                              051-2800351-2         Fax     # 051-5791338
Gulberg Branch, Lahore            Fax     # 051-2800203             Mob # 0308-5205875
Mr. Raza Javaid                   Mob # 0300-8504923
Deputy Chief Manager                                                Regional Office, Lahore
Office # 9, 1st Floor             M. A. Jinnah Road Branch,         Mr. Muhammad Aslam Rajput
Al-Hafeez View, Sir Syed Road     Karachi.                          Regional Head
Liberty Commercial Zone,          Mr. Muhammad Rafiq Ghoor          Office 1, 1st Floor,
Gulberg III, Lahore.              Deputy Chief Manager              Al-Hafeez View, Sir Syed Road
Ph      # 042-2404809             5th Floor, State Life Bldg. # 6   Liberty Commercial Zone,
            042-2404810           Habib Square,                     Gulberg - III, Lahore.
Fax     # 042-2404809             M. A. Jinnah Road, Karachi.       Ph      # 042-5871158
Mob # 0300-2008536                Ph      # 021-2415212                         042-5871160 - 61
                                              021-2413793           Fax     # 042-5871159
Hyderabad Branch                              021-2416918           Mob # 0300-4196147
Mr. Mohd. Anees Qureshi           Fax     # 021-2410944
Manager                           Mob # 0300-2123273                Sialkot Branch
Mezzanine Floor,                                                    27 Paris Road,
Rashida Magsi Plaza,              Multan Branch                     Sialkot.
Risala Road, Hyderabad.           Mr. Mohammad Anwar                Ph       # 052-4006281
Ph      # 022-2780603             Deputy Manager                    Fax      # 052-4595557
           022-2780770            Room # 19-21, 3rd Floor
Fax     # 022-2780765             Trust Plaza, L.M.Q. Road
Mob # 0300-3017098                Multan.
                                  Ph      # 061-4579073 - 4
I. I. Chundrigar Road Branch,     Fax     # 061-4579075
Karachi.                          Mob # 0300-8736296
Mr. Asad Nazir
Assistant General Manager         Peshawar Branch
3rd Floor, Lakhani Centre,        Mr. Mohammad Riaz
I. I. Chundrigar Road, Karachi.   Manager
Ph       # 021-2631402            1081, Saddar Road
            021-2631420           Peshawar Cantt.
            021-2631430           Ph     # 091-5277345
Fax      # 021-2631449            Fax    # 091-5277357
Mob # 0333-2150921                Mob # 0300-8584281

				
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posted:10/18/2011
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