Who can avail of this plan?
Pakistani nationals aged a minimum of eighteen (18) years and under sixty-five years (65) can avail this plan for themselves and their family.
How long does the coverage last for customers under these plans?
The coverage options include daily, monthly, and annual. For the daily plan, the customer remains covered for the duration of the day when their contribution is deducted. Similarly, for the monthly plan, coverage extends throughout the month, and for the annual plan, coverage lasts for a year.
The coverage begins as soon as the contribution amount is deducted from the customer’s account.
How can i avail the Hospital Cash Benefit?
Hospital cash is the benefit paid as a per-day allowance as per the selected variant of hospitalization due to any illness or accident.
You can avail of the benefit for yourself or the covered family members on hospitalization up to the maximum limit for the selected variant.
Who is covered under the Hospitalization benefit?
Participant his spouse & 2 children are covered under the plan. The provided limit is for the entire family, with a maximum of 4 covered members.
When does the coverage start for the member?
The moment the amount is deducted from the customer is enrolled in the plan their coverage will start.
Under Hospital Cash Benefit am I covered for Outpatient expenses?
No, under Hospital Cash Benefit minimum twenty-four (24) hours hospital confinement is mandatory.
What are the Accidental Medical Reimbursement benefits?
Reimbursement for the treatment of accidental injuries up to the annual family limit as per the variant without the condition of getting admitted into the hospital.
How many policies I can avail in a year?
You can avail Single policy per CNIC.
How many times can a participant & his family take up hospitalization?
Customers can take up hospitalization as many times as the need arises. Up to a maximum of 100 days in a year.
What does Beneficiary/Nominee mean?
Beneficiary/Nominee means a person or person(s) appointed by you to receive benefits payable under this plan.
Beneficiaries must have insurable interest (for example: Wife, Mother, Father, Brother, Sister, Son, Daughter, Grandson, and Granddaughter).
What does the elimination period mean?
An elimination period means a period of fifteen (15) days from the effective date during which claims arising other than accident will not be payable.
Not applicable on re-enrollment/renewal. m
Who can avail of EFU m-health services?
All family members including parents can use services.
Under what conditions the claim will not be paid?
- -Pre-existing conditions, Suicide and attempt to suicide, murder, self-inflicted injury, and illegal act of the covered person.
- -Failure to seek or follow medical advice, taking of alcohol or drugs.
- -Dental Treatment
- -War, invasion, act of a foreign enemy, hostilities (whether war be declared or not), armed or unarmed truce, civil war, mutiny, rebellion, revolution, insurrection by military or usurped power, riot or civil commotion, an illegal organization, or an industrial dispute.
