out.txt

[Document(metadata={'source': 'file'}, page_content='National Insurance'), Document(metadata={'source': 'file'}, page_content='to the enhanced sum insured in the event of granting higher sum insured subsequently. 4.4. Investigation & Evaluation (Excl 04) a) Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded. b) Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment are excluded. 4.5. Rest Cure, Rehabilitation and Respite Care (Excl 05) a) Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. This also includes: i. Custodial care either at home or in a nursing facility for personal care such as help with activities of daily living such as bathing, dressing, moving around either by skilled nurses or assistant or non-skilled persons. ii. Any services for people who are terminally ill to address physical, social, emotional and spiritual needs. 4.6. Obesity/ Weight Control (Excl 06) Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions: 1) Surgery to be conducted is upon the advice of the Doctor 2) The surgery/Procedure conducted should be supported by clinical protocols 3) The member has to be 18 years of age or older and 4) Body Mass Index (BMI): a. greater than or equal to 40, or b. greater than or equal to 35 in conjunction with any of the following severe co-morbidities following failure of less invasive methods of weight loss: i. Obesity-related cardiomyopathy ii. Coronary heart disease iii. Severe Sleep Apnea iv. Uncontrolled Type2 Diabetes 4.7. Change-of-Gender Treatments (Excl 07) Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex. 4.8. Cosmetic or Plastic Surgery (Excl 08) Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to the'), Document(metadata={'source': 'file'}, page_content='family cover), to transfer the credits gained for, Pre-Existing Diseases and Specific Waiting Periods from one insurer to another insurer. 2.46 Psychiatrist means a medical practitioner possessing a post-graduate degree or diploma in psychiatry awarded by an university recognised by the University Grants Commission established under the University Grants Commission Act, 1956, or awarded or recognised by the National Board of Examinations and included in the First Schedule to the Indian Medical Council Act, 1956, or recognised by the Medical Council of India, constituted under the Indian Medical Council Act, 1956, and includes, in relation to any State, any medical officer who having regard to his knowledge and experience in psychiatry, has been declared by the Government of that State to be a psychiatrist. 2.47 Qualified Nurse means a person who holds a valid registration from the Nursing Council of India or the Nursing Council of any state in India. 2.48 Reasonable and Customary Charges means the charges for services or supplies, which are the standard charges for the specific provider and consistent with the prevailing charges in the geographical area for identical or similar services, taking into account the nature of the disease/ injury involved. 2.49 Room Rent means the amount charged by a Hospital towards Room and boarding expenses and shall include the associated charges. 2.50 Schedule means a document forming part of the Policy, containing details including name of the insured person, age, relation of the insured person, sum insured, premium paid and the policy period. 2.51 Surgery or Surgical Procedure means manual and / or operative procedure (s) required for treatment of a disease or injury, correction of deformities and defects, diagnosis and cure of diseases, relief of suffering or prolongation of life, performed in a hospital or day care centre by a medical practitioner. 2.52 Third Party Administrator (TPA) means any entity, licenced under the IRDA'), Document(metadata={'source': 'file'}, page_content='| Out-patient Treatment (as Floater in a policy year) | Limit of cover per family - INR 2,000/ 3,000/ 4,000/ 5,000/ 10,000/ 15,000/ 20,000/ 25,000\nin addition to the SI |  |  |\n| ***Critical Illness (per insured person in a policy year) | Benefit amount - INR 2,00,000/ 3,00,000/ 5,00,000/ 10,00,000/ 15,00,000/ 20,00,000/\n25,00,000 in addition to the SI |  |  |\n| Discounts |  |  |  |\n| Online Discount | 10% discount in premium (for new and Renewal, ONLY where no intermediary is involved) |  |  |\n| Co-payment discount (optional) | •20% Co-payment, with a 25% discount in total premium.\n•10% Co-payment, with a 12.5% discount in total premium. |  |  |\n| Long Term Discount | Discount of 4% for 2 year policy and Discount of 7.5% for 3 year policy |  |  |\n| No Maternity/ Infertility Discount | Discount of 3%, above 45 years of age |  |  |\n| Add-ons (cover available on payment of additional premium) |  |  |  |\n| National Home Care Treatment Add-On | INR 10,000/ 15,000/ 20,000/ 25,000/ 30,000/ 35,000/ 40,000/ 45,000/ 50,000, subject to 10%\nof Basic SI under base Policy. |  |  |\n| National Non-Medical Expenses Add-on (available to SI 5\nlacs & above) | Up to 10% of Basic Sum Insured (excluding Cumulative Bonus, if any) of base Policy and\nshall be part of the base Policy Basic Sum Insured (excluding Cumulative Bonus, if any). |  |  |\n| Time interval | Type of vaccination | Frequency |\n| Vaccination for new born |  |  |\n| 0-3 months | BCG (From birth to 2 weeks) | 1 |\n|  | OPV (0‚6‚10 weeks) OR OPV + IPV1 (6,10\nweeks) | 3 OR 4 |\n|  | DPT (6 & 10 week) | 2 |\n|  | Hepatitis-B (0 & 6 week) | 2 |\n|  | Hib (6 & 10 week) | 2 |\n| Vaccination for first year |  |  |\n| 3-6 months | OPV (14 week) OR OPV + IPV2 | 1 OR 2 |\n|  | DPT (14 week) | 1 |\n|  | Hepatitis-B (14 week) | 1 |\n|  | Hib (14 week) | 1 |\n| 9 months | Measles (+9 months) | 1 |\n| 12 months | Chicken Pox (12 months) | 1 |\n| Vaccinations for age 1 to 12 years |  |  |\n| 1-2 years | OPV (15 &18 months) OR OPV + IPV3 | 1 OR 2 |')]