| 7- (a) Family Floater Coverage - Apollo DKV Insurance |
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| Easy Health Individual Health Insurance Plan / Easy Health Family Floater Insurance Plan from Apollo DKV |
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e) Domiciliary Treatment
The Medical Expenses incurred by an Insured Person for medical treatment taken at his home which would otherwise have required Hospitalisation because, on the advice of the attending Medical Practitioner, the Insured Person could not be transferred to a Hospital or a Hospital bed was unavailable, and provided that: |
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- The condition for which the medical treatment is required continues for at least 3 days, in which case We will pay the reasonable cost of any necessary medical treatment for the entire period, and
- If We accept a claim under this Benefit We will not make any payment for Post-Hospitalisation expenses but We will pay Pre- hospitalisation expenses for up to 60 days in accordance with b) above, and
- No payment will be made if the condition for which the Insured Person requires medical treatment is:
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1.Asthma, Bronchitis, Tonsillitis and Upper Respiratory Tract infection including Laryngitis and Pharyngitis, Cough and Cold, Influenza, |
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2.Arthritis, Gout and Rheumatism, |
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3.Chronic Nephritis and Nephritic Syndrome, |
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4.Diarrhoea and all type of Dysenteries including Gastroenteritis, |
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5.Diabetes Mellitus and Insupidus, |
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6.Epilepsy, |
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7.Hypertension, |
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8.Psychiatric or Psychosomatic Disorders of all kinds, |
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9.Pyrexia of unknown Origin. |
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| Section. 2 Additional Benefits |
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Claims made in respect of any of the benefits below will be subject to the Sum Insured and will affect both the entitlement to a Cumulative bonus and a health check-up. |
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a) Daily Cash for choosing Shared Accommodation
A daily cash amount will be payable per day if the Insured Person is Hospitalised in Shared Accommodation in a Network Hospital for each continuous and completed period of 24 hours if the Hospitalisation exceeds 48 hours, provided that: |
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- Our maximum liability shall be restricted to the amount mentioned in the Schedule of Benefits, and
- The days of admission and discharge shall not be counted, and
- This benefit shall not apply to time spent by the Insured Person in an intensive care unit, and
- We have accepted an inpatient Hospitalisation claim under Benefit 1a).
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b) Organ Donor
The Medical Expenses for an organ donor’s treatment for the harvesting of the organ donated, provided that: |
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- The organ donor is the Insured Person’s blood relative and the organ donated is for the use of the Insured Person, and
- We will not pay the donor’s pre- and post-hospitalisation expenses or any other medical treatment for the donor consequent on the harvesting, and
- We have accepted an inpatient Hospitalisation claim under Benefit 1a).
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c) Emergency Ambulance
We will reimburse the expenses incurred on an ambulance offered by a healthcare or ambulance service provider used to transfer the Insured Person to the nearest Hospital with adequate emergency facilities for the provision of health services following an emergency (namely a sudden, urgent, unexpected occurrence or event, bodily alteration or occasion requiring immediate medical attention), provided that: |
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- Our maximum liability shall be restricted to the amount mentioned in the Schedule of Benefits, and
- We have accepted an inpatient Hospitalisation claim under Benefit 1a).
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