GoodHope Hospitalization Assurance

GoodHope Hospitalization Assurance

Features

• Co-payment/ Co-Insurance–BDT 500.00/ claim, and 20% of ancillary services cost.

  • Fixed amount/Percentage of medical expenses that are not paid by the insurance company.

• No Claim Bonus (NCB) – up to 20% Discount on Renewal Premium.

  • No Claim Bonus applies if you renew the policy after its expiry

• Pre-Existing conditions - Not Covered.

  • Coverage for pre-existing conditions/illnesses

• Waiting Period – No waiting period.

  • The period after taking an insurance policy during which you cannot make any claim

• Pre and Post Hospitalization Expenses – Not Covered

  • Coverage for medical costs incurred before or after a hospitalization

• Ambulance expenses – Covered

  • Coverage for expenses incurred against ambulance services

• Maturity Benefits/ Premium Refund – Not Available

  • Refund of premium if there is no claim during the policy period

• Maternity - Covered After 9 Months

  • Coverage for maternity/child-birth related issues

• Hospital Confinement – 21 days per Hospitalization

  • Maximum number of days covered per Hospitalization

• Cashless / Direct Payment Facility – Not Applicable

  • Settlement of hospital bill directly at the time of discharge

Description

• Major surgical operation: Actual cost (maximum BDT. 15,000 per case)

• Intermediate surgical operation: Actual cost (maximum BDT. 10,000 per case)

• Ancillary Services: 80% of the total amount (maximum BDT. 8,000 per hospitalization)

• (Ancillary Services include Labor room services, post-operative care facilities, Oxygen therapy, skilled nursing services, intensive care facility, blood transfusions, ambulance service, dressing, tests other than routine investigations, etc.)

*Where there are no claims in respect of surgical intervention, this limit is increased to BDT. 12,000

Limitations

• Policy liability for each Confinement shall be limited to a maximum of 21 days. Successive periods of hospital confinement within 90 days due to the same disability are considered a single period. But in no event shall the benefit exceed the limit set forth in the Schedule of this Policy.

• All pre-hospitalization expenses and any minor Surgical operation are excluded where confinement in the hospital is not necessary or performed as an outdoor surgery.

• If any insured is also covered for similar benefits under any other insurance Policy then payment of the claim shall be made on a pro-rata basis after taking into account the coverage under all Policies.

• Any charges for food or food supplements (Horlicks, Viva, Bourn Vita, etc.), cosmetic creams or oils of any nature, water purifiers, etc. are excluded.

• Maternal benefits for pregnancy or childbirth are covered only after 9 months from the commencement date of this Policy. Nevertheless, emergency hospitalization arising from the following complications of pregnancy is covered:

  • Hyperemesis gravid arum

  • Extras-uterine pregnancy

  • Eclipse of pregnancy

  • Intra-abdominal surgery after the termination of pregnancy

Exclusions

• Any congenital infirmity

• Any Pre-existing Conditions

• Mental, emotional, or psychiatric disorders, alcoholism, or any other narcotic addiction

• Prophylactic and immunization procedures

• Any procedure which is experimental or not generally accepted by the medical profession (i.e.; acupuncture)

• Any cosmetic or plastic treatment/surgery unless required as reconstructive surgery as a consequence of an injury due to accidents or burns

• Rest, convalescence or rejuvenation cures, thermal baths, or confinement for the purposes of slimming or beautification

• Family planning treatments including termination of pregnancy during the first twelve weeks from the date of conception, sterility

• Willful abortion or any complication and/or sequel therefrom

• Attempted suicide, violation or attempted violation of the law, injuries willfully or intentionally self-inflicted or due to insanity or under the influence of a drug

• Routine examination of eye and ear, fitting or replacement of eyeglasses (including Contract lenses), or hearing aids

• Routine physical examinations (health check-ups), radiotherapy (X-ray, radium or radioactive isotopes treatment), chemotherapy, or any form of treatment when not incidental or necessary to the treatment of the injury/illness which caused the hospitalization

• Any dental treatment

• Injury arising due to an accident while participating in any unlawful activities (e.g. driving a vehicle without a license)

• Non-surgical care for tuberculosis

• Injury or disease directly or indirectly attributed to civil commotion

• Circumcision

• Injury, destruction, or damage caused by nuclear fission, nuclear fusion, or irradiation

• Treatment of a newborn child up to the age of 3 months

• AIDS and HIV-related diseases

*Please read the policy wording document for detailed terms and conditions of this insurance policy.

Claim Processing

Claims must be submitted within 15 (fifteen) days from the date of discharge from the hospital.

Please submit your claim using the Website. Alternatively, you can submit your claim via email to: Claims@GoodHope.Com.BD by mentioning your full name and registered mobile phone number in the subject line.

Provide clear scanned copies of your treatment-related documents while submitting the claim. Please ensure all medical documents are properly dated and the Insured Person's name is mentioned on them.

List of required documents for claims

Hospitalization (IPD) Expenses Reimbursement Claim

• Doctor's advice/prescription/emergency ticket for hospital admission

• Admission form

• Discharge certificate

• Treatment sheet

• Diagnostic test reports

• All bills

• NID/Birth Certificate of the Insured Person

• Any other available documents related to the treatment