Group Health Insurance
 

New Jubilee Corporate Health Care
Our Promise Quality Health Care At An Affordable Price

NJI is the third (03) largest insurance company of Pakistan , established in 1953 with its Head Office in Karachi and branches throughout Pakistan . The Company is listed on stock exchange at Karachi & Lahore .

NJI is the only top Pakistani insurance company with the distinction of being assigned an Insurer Financial Strength (IFS) rating of “AA” by both PACRA and JCR-VIS. The fact that both independent rating companies have rated us “AA” affirms NJI's financial strength which has been steadily built over the past five (5) decades.

NJI is the pioneer of health insurance business in Pakistan . It's backed by well trained professionals, including full time doctors, experienced under writers and servicing personnel to provide efficient and personalized service to its valued customers.

New Jubilee health care policy is a unique group health insurance designed by professional for employers who wish to provide comprehensive protection to their employees and their dependents family members against medical expenses arising due to sickness and accidents.

New Jubilee health Care policy provides peace of mind to your employees and employers both when the cost of medical treatment is escalating at an alarming rate.

The medical policy can be designed to suit your needs and to provide health insurance against expenses arising from hospitalization due to sickness and accident, maternity cases and outpatient treatment.

Benefit Description

Hospitalization Expense Benefits (Core Cover)
It covers any expense incurred by an insured because of non-pregnancy related hospitalization and surgical procedure due to any sickness or accidental injuries, subject to a pre determined limit.

The flexible annual limits offered under this benefit are very useful for covering both simple as well as complicated cases with extended length of stay in the hospital or when undergoing expensive medical treatments such as:

 

•  CABG (By – Pass)
•  Cancer
•  Stroke
•  Kidney failure
•  Knee replacement
•  Major Burns
•  Multiple fractures

There is no restriction on number of days of hospitalization. It includes doctor's, surgeon's and anesthetist's fees, room-rent, operation theater charges laboratory charges, cost of medicines and related hospital supplies.

Day care surgeries and certain specialized investigation in out patient settings like MRI, CT scan, Endoscopy, Thallium Scan and Angiography are covered under the hospitalization limit.

Pre & Post hospitalization benefit is also available within the hospitalization limit for a maximum of 30 days before or after the (non-pregnancy related) hospitalization to each insured.

Pre & Post hospitalization covers expenses, which are directly related to the cause of hospitalization as under:

•  Consultants' fee.
•  Cost of medicines
•  Cost of laboratory tests
•  Dressing charges and stitch removal

Per Annum Limit
Each insured has an independent and separate annual limit of hospitalization. The annual limit is available on hospitalization due to sickness or accidental injuries, irrespective of the number of hospitalizations in a policy year.

Maternity Expense Benefits-(Optional)
Maternity expense benefit pays for medical expenses related to pregnancy and child birth. All expenses directly or indirectly related to pregnancy i.e. pre-natal & post-natal complications, cesarean section etc. are paid as per entitlement of limit.

Circumcision of baby boy is also included in the annual maternity limit.

Outpatient Expense Benefits-(Optional)
This section of the policy covers expenses arising from sickness and injuries which do not require hospitalization. Doctor fee, lab tests, x-ray and examination i.e. ECG's, ETT's, EEG's etc, cost of medicines and incidental supplies are covered.

NJI Health Insurance Plans
In view of the varying demands and requirements of our corporate clients, NJI has the ability to customize the plans with or without the optional benefits stated above.

Health Card
To provide extra peace of mind, we will issue a personalized health card and letter to each employee. In case of medical emergency, this card identifies the insured to network hospitals.

24 Hours Medical Helpline
We have established a 24 hour a day, 365 days a year, medical helpline. The medical helpline is manned by our qualified staff doctors whose primary role is to guide and assist you in case of medical emergency.

Special Features of the Jubilee Health Care Policy  

  • No Pre – Authorization (OR) Prior Approval required for medical treatment at network hospitals.
  • All employees and insured dependents enjoy full cover from day one.
  • Waiver of health questionnaire forms for larger groups*.
  • Coverage for pre existing conditions*.
  • NJI policy also covers hospitalization abroad. The hospitalization expenses are reimburses to the insured in Pakistan and in Pak rupees subject to the limits in the structure of benefits and subject to what the same treatment would cost locally in Pakistan .
  • NJI has a list of approved network hospital which provides care to all insured persons with out any deposit or advance payment. We reimburse hospital bills directly.
  • NJI's doctors and staff monitor the care and treatment of the insured patients while in hospital. They are also available for advice regarding selection of appropriate doctors and hospital for treatment of specific conditions.
  • NJI's specialized staff work closely with the employer's representative to control and prevent misuse of benefits provided by the employer.

‘*' Conditions apply .

How much would the scheme cost?

Annual Premium for your company will depend upon the total number of employees, their age profile, family details and level of benefits to be insured.

Exclusions:

There are certain expenses for which no benefits are payable under the policy. Some of the main exclusions are listed as under:

•  Any Pre-Existing conditions, unless fully disclosed prior to the date of eligibility for insurance and coverage approved by NJI in writing
•  Any Treatment not recommended by a legally licensed Physician or which is not Medically Necessary.
•  Mental illnesses, psychiatrics disorders and any sickness or condition arising from, and including drug abuse, alcoholism or an Insured's criminal act.
•  Routine physical check-ups, rest cures, services including immunization.
•  Any In-Patient dental Treatment, X-rays, extractions or fillings unless necessitated due to accidental injury occurring while the insured was covered.
•  Cost of limbs any other organ (prostheses) or any kind of supporting equipment for revival or correction of the function of body.
•  Treatment of any refractive errors of the eyes including cost of procedures such as 'Radial Keratotomy ' and ' Excimer Laser‘. Obesity, weight reduction/enhancement.
•  Cosmetic/plastic surgery, unless necessitated due to accidental injuries occurring while the Insured was covered under the scheme.
•  Self-inflicted injuries while sane or insane, including attempted suicide.
•  Treatment or surgical operation for congenital defects or deformities, including physical and mental defects present from birth.
•  Treatment of infertility, impotency, sterilization & contraception including any complication relating hereto.
•  Treatment for injuries sustained as a result of participation by the Insured in an act which is illegal according to the laws of Pakistan .

Note:

For the exact details of coverage, terms, conditions and exclusions, please refer to our policy document.

 

 
 
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