WELCOME TO SEVAK HEALTH CARE SERVICES PRIVATE LIMITED

3. Marriage aid – for marriage of one daughter within the remaining period of Membership of the deceased – produce proof of marriage.

C. Long-term income earning opportunity (Refer details under "Business Plan")

A. Mediclaim / Accident Insurance Policy (Insurance can be provided to depended children of the member aged from 5 years and above up to25 years )

C. Long-term income earning opportunity (Refer details under "Business Plan")

MEMBERSHIP BENEFITS
A. Mediclaim / Accident Insurance Policy (Insurance can be provided to depended children of the member aged from 5 years and above up to 25 years )

B. Financial aid from relief fund
- Refer details furnished above under MEMBERSHIP SCHEME TYPE -A
C. Long-term income earning opportunity (Refer details under "Business Plan")
D. World Wide membership sponsoring opportunity.
E. Personal Web Page.
F. Opportunities to participate in social service activities.
G. Opportunities to participate in "Personality Development Seminars".
H. Membership in Blood Donation Forms.
I. Membership in Eye Donation Forums .

A. Mediclaim / Accident Insurance Policy (Insurance can be provided to depended children of the member aged from 5 years and above up to 25 years )

B. Financial aid from relief fund
- Refer details furnished above under MEMBERSHIP SCHEME TYPE -A
C. Long-term income earning opportunity (Refer details under "Business Plan")
D. World Wide membership sponsoring opportunity
E. Personal Web Page
F. Opportunities to participate in social service activities
G. Opportunities to participate in "Personality Development Seminars"
H. Membership in Blood Donation Forms
I. Membership in Eye Donation Forums
VI. MEMBERSHIP SCHEME TYPE – G (Family Policy)

MEMBERSHIP BENEFITS - Refer details furnished below
A. Mediclaim / Accident Insurance Policy

B. Financial aid from relief fund
- Refer details furnished above under MEMBERSHIP SCHEME TYPE -A
C. Long-term income earning opportunity (Refer details under "Business Plan")
D. World Wide membership sponsoring opportunity
E. Personal Web Page
F. Opportunities to participate in social service activities
G. Opportunities to participate in "Personality Development Seminars"
H. Membership in Blood Donation Forms
I. Membership in Eye Donation Forums.

Insurance Period : 1 Year	Entry Age : 5 Years and above up to 55 Years
	( Renewable up to 65 years)

INSURANCE COVERAGE

SUM INSURED (MAXIMUM )

First Insured

SPOUSE

CHILD

1. MEDICLAIM
Hospitalisation expenses for illness.

Rs, 1,00,000.00

Rs. 50,000.00

Rs. 25,000.00

2. ACCIDENT MEDICLAIM
Hospitalisation expenses - caused by any accident

Rs. 50,000.00

Rs. 25,000 .00

Rs.25,000.00

3.ROAD ACCIDENT MEDICLAIM
Section 1 - Hospitalisation expenses for Road accidents Involving Registered Motor Vehicle.

Rs. 1,00,000.00

Rs. 50,000 .00

Rs.50,000.00

Section 2 - Disability compensation for loss of one arm or leg or eye due to Road accident involving Registered Motor vehicle

Rs. 50,000.00

Rs. 25,000.00

Rs.25,000.00

Section 3 - Disability compensation for loss of two arms or legs or eyes due to Road accident involving Registered Motor vehicle

Rs. 1,00,000.00

Rs.50,000.00

Section 4 - Compensation for death due to Road accident involving Registered Motor vehicle

Rs. 1,00,000.00

Rs.50,000.00

4.PERSONAL ACCIDENT
Section 1 - Disability compensation for loss of one arm or leg or eye caused by accident.

Rs. 50,000.00

Rs.25,000.00

Section 2 - Disability compensation for loss of Two arms or legs or eyes or combination thereof caused by accident.

Rs. 1,00,000.00

Rs.50,000.00

Section 3 - Compensation for Death caused by accidents

Rs. 1,00,000.00

Rs.50,000.00

SUMMARY OF INSURANCE COVER

SUM ASSURED
(Maximum)

1. MEDICLAIM - Hospitalisation expenses for illness.

Rs, 1,00,000.00

Rs. 50,000.00

Rs. 25,000.00

2. ACCIDENT MEDICLAIM Hospitalisation expenses for any accident.

Rs. 50,000.00

Rs. 25,000 .00

Rs.25,000.00

3. ROAD ACCIDENT MEDICLAIM
Section I - Hospitalisation expenses for accidents involving Registered Motor vehicles.

Rs. 1,00,000.00

Rs. 50,000 .00

Rs.50,000.00

4. ROAD ACCIDENT MEDICLAIM + PERSONAL ACCIDENT
Section I - Disability compensation for loss of one arm or leg or eye caused by accident.

Rs. 1,00,000.00

Rs. 75,000 .00

Rs.50,000.00

Section II - Disability compensation for loss of Two arms or legs or eyes or combination thereof caused by accident.

Rs.2,00,000.00

Rs. 1,50,000.00

Rs. 1,00,000.00

Section III - Compensation for Death due to accidents.

Rs.2,00,000.00

Rs. 1,50,000.00

Rs. 1,00,000.00

5. AMBULANCE CHARGE –
actual

Rs. 1,000.00

6.EDUCATION AID
On death of first insured caused by accident – Rs.1,00,000.00 for school / college going child – maximum for two children

Rs. 2,00,000.00

NIL

7. MARRIAGE AID
On death of first insured caused by accident – aid for marriage of one girl child with the Policy period

Rs.2,00,000.00

NIL

B. Financial aid from relief fund

- Refer details furnished above under MEMBERSHIP SCHEME TYPE -A

C. Long-term income earning opportunity (Refer details under "Business Plan")

D. World Wide membership sponsoring opportunity

E. Personal Web Page

F. Opportunities to participate in social service activities

G. Opportunities to participate in "Personality Development Seminars"

H. Membership in Blood Donation Forms

I. Membership in Eye Donation Forums

MEDICLAIM / ACCIDENT MEDICLAIM AND ACCIDENT INSURANCE POLICY

DEFINITIONS AND INTERPRETATIONS

1. INSURED PERSON: Means Person(s) named on the schedule of the policy.

2. ENTIRE CONTRACT: This policy / proposal and declaration given by the insured constitute the complete contract of this policy. Only Insurer may alter the terms and conditions of this policy. Any alteration that may be made by the insurer shall be evidenced only by a duly signed and sealed endorsement on the policy.

3. HOSPITAL / NURSING HOME: means any institution in India established for indoor care and treatment of sickness and injuries and which is either : a) duly licensed and registered as a Hospital or Nursing Home with the appropriate authorities and is under the supervision of a registered and qualified Medical Practitioner.

b) In areas where licensing and registration facilities with appropriate authorities are not available, the institution must be one recognised in locality as Hospital / Nursing Home and should comply with minimum criteria as under

i. It should have at least 15 in-patient medical beds in case of Metro cities, A Class cities & B class cities or 10 in- patient medical beds in case of "C class" cities. Classification of cities shall be as per Government of India Notifications issued in this respect from time to time.

ii. Fully equipped and engaged in providing Medical and Surgical facilities along with Diagnostic facilities i.e. Pathological test and X-ray, E.C.G. etc for the care and treatment of injured or sick persons as in-patient.

iii.Fully equipped operation theatre of its own, wherever surgical operations are carried out.

iv. Fully qualified nursing staff under its employment round the clock.

v. Fully qualified Doctor(s) should be physically in-charge round the clock.

The term 'Hospital/Nursing Home' shall not include an establishment which is a place of rest, a place for the aged, a place for drug addicts or a place for alcoholics, a hotel or a similar place.

4. HOSPITALISATION PERIOD: The period for which an insured person is admitted in the hospital as inpatient and stays there for the sole purpose of receiving the necessary and reasonable treatment for the disease / ailment contracted / injuries sustained during the period of policy. Expenses on Hospitalisation are admissible-only if hospitalisation is for a minimum period of 24 hours. However, this time limit will not apply to following specific treatments taken in Nursing Home where the Insured is discharged on the same day. Such treatment will be considered to be taken under Hospitalisation Benefit.

i. Haemo Dialysis, ii. Parentral Chemotherapy, iii.Radiotherapy, iv.Eye Surgery, v.Lithotripsy (kidney stone removal), vi. Tonsillectomy, vii. D&C, viii.Dental surgery following an accident, ix.Hysterectomy, x.Coronary Angioplasty, xi.Coronary Angiography, xii.Surgery of Gall bladder, Pancreas and bile duct, xiii.Surgery of Hernia, xiv.Surgery of Hydrocele. xv. Surgery of Prostrate, xvi.Gastrointestinal Surgery, xvii.Genital Surgery, xviii. Surgery of Nose, xix.Surgery of throat, xx. Surgery of Appendix, xxi. Surgery of Urinary System, xxii. Treatment of fractures / dislocation excluding hair line fracture, Contracture releases and minor reconstructive procedures of limbs which otherwise require hospitalisation. xxiii. Arthroscopic Knee surgery, xxiv. Laproscopic therapeutic surgeries, xxv. Any surgery under General Anaesthesia, xxvi. Or any such disease / procedure agreed by Company before treatment.

FURTHER, if the treatment / procedure / surgeries of above diseases are carried out, in specialised Day Care Centre which is fully equipped with advanced technology and specialised infrastructure where the insured is discharged on the same day, the requirement of minimum beds will be overlooked provided following conditions are met.

i. The operation theatre is fully equipped for the surgical operation required in respect of sickness / ailment / injury covered under the policy, ii. Day Care nursing staff is fully qualified. iii. The doctor performing the surgery or procedure as well as post operative attending doctors are also fully qualified for the specific surgery / procedure.

FURTHER, this condition of minimum 24 hours Hospitalisation will also not apply provided I) The treatment is such that it necessitates hospitalisation and the procedure involves specialised infrastructural facilities available only in hospitals, BUT II) Due to technological advances hospitalisation is required for less than 24 hours AND/OR iii) Surgical procedure involved has to be done under General Anesthesia.

5. PRE-HOSPITALISATION: Relevant medical expenses incurred during the period up to 30 days prior to hospitalisation on disease/ illness sustained will be considered as part of claim mentioned under item 1.2 above.

6. POST-HOSPITALISATION: Relevant medical expenses incurred for the period of 60 days after hospitalisation on disease / illness sustained will be considered as part of claim mentioned under item 1.2 above.

7. MEDICAL PRACTITIONER: means a person who holds a degree/diploma of a recognised institution and is registered by Medical Council of any State of India. The term Medical Practitioner would include Physician, Specialist and Surgeon.

8. QUALIFIED NURSE: means a person who holds a certificate of a recognised Nursing Council.

9. PRE EXISTING HEALTH CONDITION OR DISEASE: means any ailment / disease / injuries that the person is suffering from, (treated / untreated, declared or not declared in the proposal form) while taking a policy for the first time.Further any complications arising from pre-existing ailment / disease / injuries will be considered as a part of that pre existing health condition.

10. IN-PATIENT: An Insured person who is admitted to hospital and stays for at least 24 hours for the sole purpose of receiving the treatment for suffered ailment / illness / disease / injury / accident during the currency of the policy.

11. REASONABLE & CUSTOMARY EXPENSES: means reasonable and customary surgical medical treatment expenses within the scope to treat the condition for which the insured person was hospitalized.

12. DAY CARE PROCEDURE: means the course of Medical treatment / surgical procedure listed at 2.3 (A) carried out, in Networked specialised Day Care Centre which is fully equipped with advanced technology and specialised infrastructure where the insured is discharged on the same day, the requirement of minimum beds will be over looked provided other conditions are met.

13. LIMIT OF INDEMNITY: means the amount stated in the schedule against the name of each insured person which represents maximum liability for any and all claims made during the policy period in respect of that insured person in respect of hospitalization taking place during currency of the policy.

14. ANY ONE ILLNESS: Any one illness will be deemed to mean continuous period of illness and it includes relapse within 105 days from the date of discharge from the Hospital / nursing home from where the treatment was taken. Occurrence of the same illness after a lapse of 105 days as stated above will be considered as fresh illness for the purpose of this policy.

NOTE: PROCEDURES / TREATMENTS USUALLY DONE IN OUT PATIENT DEPARTMENT ARE NOT PAYABLE UNDER THE POLICY EVEN IF CONVERTED TO DAY CARE SURGERY / PROCEDURE OR AS IN PATIENT IN THE HOSPITAL FOR MORE THAN 24 HOURS.

MEDICLAIM / ACCIDENT MEDICLAIM POLICY

1 WHEREAS the insured named in the Schedule hereto has by a proposal and declaration dated stated in the Schedule (which shall be the basis of this Contract and is deemed to be incorporated herein) has applied to THE NATIONAL INSURANCE COMPANY LIMITED (hereinafter called the Company) for the insurance hereinafter set forth in respect of persons(s) named in the Schedule hereto (hereinafter called the INSURED PERSON (S)) and has paid premium to the Company as consideration for such insurance to be serviced by the Company.

1.1 NOW THIS POLICY WITNESSES that subject to the terms, conditions, exclusions and definitions contained herein or endorsed or otherwise expressed hereon, the Company undertakes that, if during the period stated in the Schedule, any insured Person shall contract any disease or suffer from any illness / ailment / disease (hereinafter called 'DISEASE') or sustain any bodily injury through accident (hereinafter called 'INJURY') and if such disease or injury shall require upon the advice of a duly qualified Physician / Medical Specialist/Medical Practitioner (hereinafter called MEDICAL PRACTITIONER) or of a duly qualified Surgeon (hereinafter called 'SURGEON') to incur (a) hospitalisation expenses for medical/surgical treatment at any Nursing Home/Hospital in India as herein defined (hereinafter called 'HOSPITAL') as an inpatient, the Company will pay to the Insured Person the amount of such expenses. It is a precondition that these expenses are reasonably and necessarily incurred in respect thereof by or on behalf of such insured person but not exceeding the sum insured in aggregate in any one period of insurance stated in the schedule hereto.

1.2 The policy reimburses the payment of Hospitalisation expenses only for illness / diseases contracted or injury sustained by the Insured Persons. In the event of any claim becoming admissible under this policy, the Company will reimburse to the Insured person, the amount of expenses reasonably and necessarily incurred under different heads by or on behalf of such Insured Person not exceeding the Sum Insured in aggregate in respect of Insured Person as stated in the schedule for all claims admitted during the period of insurance mentioned in the schedule.

2. EXCLUSIONS:
The Company shall not be liable to make any payment under this policy in respect of any expenses whatsoever incurred by any Insured Person in connection with or in respect of:
2.1 Pre-existing health condition or disease or ailment / injuries: Any ailment / disease / injuries / health condition which are pre-existing (treated / untreated, declared / not declared in the proposal form).
This exclusion will also apply to any complications arising from pre existing ailments / diseases / injuries. Such complications will be considered as a part of the pre existing health condition or disease. To illustrate, if a person is suffering from hypertension or diabetes or both hypertension and diabetes at the time of taking the policy, then policy shall be subject to following exclusions.

Diabetes	Hypertension	Diabetes & Hypertension
Diabetic Retinopathy	Cerebro Vascular accident	Diabetic Retinopathy
Diabetic Nephropathy	Hypertensive Nephropathy	Diabetic Nephropathy
Diabetic Foot /wound	Internal Bleed/ Hemorrhages	Diabetic Foot
Diabetic Angiopathy	Coronary Artery Disease	Diabetic Angiopathy
Diabetic Neuropathy		Diabetic Neuropathy
Hyper / Hypoglycemic shocks		Hyper / Hypoglycemic shocks
		Coronary Artery Disease
		Cerebro Vascular accident
		Hypertension Nephropathy
		InternalBleeds/ Hemorrhages

2.2 Any disease other than those stated in clause 2.1, contracted by the Insured person during the first 30 days from the commencement date of the policy except treatment for accidental external injuries.

2.3 During the period of insurance cover, the expenses on treatment of following ailment / diseases / surgeries for specified periods are not payable if contracted and / or manifested during the currency of the policy.

1.For the first one year of the policy : Benign ENT disorders and surgeries i.e. Tonsillectomy, Adenoidectomy, Mastoidectomy, Tympanoplasty etc., Polycystic ovarian diseases.

2.For the first two years of the policy ; Surgery of hernia, hydrocele, varicose veins and varicose ulcers, prolapsed inter vertebral disk unless arising from accident, gallbladder and bile duct excluding malignancy, genito urinary system excluding malignancy, benign prostatic hypertrophy Non infective Arthritis, Undescendent Testes, Cataract, Hysterectomy for menorrhagia or fibromyoma or myomectomy or prolapsed of uterus, Fissure / Fistula in anus, Piles, Sinusitis and related disorders, Pilonidal Sinus, Gout and Rheumatism, Hypertension, Diabetes, Calculus diseases, Congenital internal diseases.

3. For the first four years of the Policy : Joint Replacement due to Degenerative condition, Age related osteoarthritis and Osteoporosis.

If the continuity of the renewal is not maintained with the Insurance Company then subsequent cover will be treated as fresh policy and clauses 4.1., 4.2, 4 .3 will apply unless agreed by the Company and suitable endorsement passed on the policy.

2.4 Injury or disease directly or indirectly caused by or arising from or attributable to War, Invasion, Act of Foreign Enemy, War like operations (whether war be declared or not) or by nuclear weapons / materials.

2.5 Circumcision (unless necessary for treatment of a disease not excluded hereunder or as may be necessitated due to any accident), vaccination, inoculation or change of life or cosmetic or of aesthetic treatment of any description, plastic surgery other than as may be necessitated due to an accident or as a part of any illness.

2.6 Surgery for correction of eye sight, cost of spectacles, contact lenses, hearing aids etc.

2.7 Any dental treatment or surgery which is corrective, cosmetic or of aesthetic procedure, filling of cavity, root canal including wear and tear etc unless arising from disease or injury and which requires hospitalisation for treatment.

2.8 Convalescence, general debility, "run down" condition or rest cure, congenital external diseases or defects or anomalies, sterility, any fertility, sub-fertility or assisted conception procedure, venereal diseases, intentional self-injury/suicide, all psychiatric and psychosomatic disorders and diseases / accident due to and or use, misuse or abuse of drugs / alcohol or use of intoxicating substances or such abuse or addiction etc.

2.9 All expenses arising out of any condition directly or indirectly caused by, or associated with Human T-ceil Lymphotropic Virus Type III (HTLD - 111) or Lymohadinopathy Associated Virus (LAV) or the Mutants Derivative or Variations Deficiency Syndrome or any Syndrome or condition of similar kind commonly referred to as AIDS, HIV and its complications including sexually transmitted diseases..

2.10 Expenses incurred at Hospital or Nursing Home primarily for evaluation / diagnostic purposes which is not followed by active treatment for the ailment during the hospitalised period.

2.11 Expenses on vitamins and tonics etc unless forming part of treatment for injury or disease as certified by the attending physician.

2.12 Any Treatment arising from or traceable to pregnancy, childbirth, miscarriage, caesarean section, abortion or complications of any of these including changes in chronic condition as a result of pregnancy.

2.13 Ayurvedic / Homeopathic / Unani / Naturopathy treatment, unproven procedure or treatment, experimental or alternative medicine and related treatment including acupressure, acupuncture, magnetic and such other therapies etc.

2.14 Expenses incurred for investigation or treatment irrelevant to the diseases diagnosed during hospitalisation or primary reasons for admission. Private nursing charges, Referral fee to family doctors, Out station consultants / Surgeons fees etc,.

2.15 Genetical disorders and stem cell implantation /surgery.

2.16 External and or durable Medical / Non medical equipment of any kind used for diagnosis and or treatment including CPAP, CAPD, Infusion pump etc., Ambulatory devices i.e. walker, Crutches, Bells .Collars, Caps , splints, slings, braces .Stockings etc of any kind, Diabetic foot wear, Glucometer / Thermometer and similar related items etc and also any medical equipment which is subsequently used at home etc..

2.17 All non medical expenses including Personal comfort and convenience items or services such as telephone, television, Aya / barber or beauty services, diet charges, baby food, cosmetics, napkins , toiletry items etc, guest services and similar incidental expenses or services etc..

2.18 Change of treatment from one pathy to other pathy.

2.19 Treatment of obesity or condition arising there from (including morbid obesity) and any other weight control programme, services or supplies etc...

2.20 Any treatment required arising from Insured's participation in any hazardous activity including but not limited to scuba diving, motor racing, parachuting, hang gliding, rock or mountain climbing etc unless specifically agreed by the Insurance Company.

2.21 Any treatment received in convalescent home, convalescent hospital, health hydro, nature care clinic or similar establishments.

2.22 Any stay in the hospital for any domestic reason or where no active regular treatment is given by the specialist.

2.23 Outpatient Diagnostic, Medical or Surgical procedures or treatments, non-prescribed drugs and medical supplies, Hormone replacement therapy, Sex change or treatment which results from or is in any way related to sex change.

2.24 Massages, Steam bathing, Shirodhara and alike treatment.

2.25 Any kind of Service charges, Surcharges, Admission fees / registration charges etc levied by the hospital.

2.26 Doctor's home visit charges, Attendant / Nursing charges during pre and post hospitalisation period.

2.27 Treatment which is continued before hospitalization and continued even after discharge for an ailment / disease / injury different from the one for which hospitalization was necessary.

PERSONAL ACCIDENT POLICY

NOW THIS POLICY WITNESSETH that subject to the terms, exclusions, definitions and conditions contained herein or endorsed or otherwise expressed here on the Company will pay the insured as hereinafter mentioned.

1. If at any time during the currency of this Policy, the Insured shall sustain any bodily injury resulting solely and directly from accident caused by external violent and visible means, then the Company shall pay to the Insured or his legal personal representative(s) as the case may be, the sum or sums hereinafter set forth, that is to say:

a) If such injury shall within twelve (12) calendar months of its occurrence be the sole and direct cause of the death of the Insured, the Capital Sum Insured stated in the schedule hereto.

b) If such injury shall within twelve (12) calendar months of its occurrence be the sole and direct cause of the total and irrecoverable loss of the total and irrecoverable loss of

i) Sight of both eyes or of the actual loss by physical separation of the two entire hands or two entire feet, or of one entire hand and one entire foot, or of such loss of sight of one eye and such loss of one entire foot, the Capital Sum Insured stated in the Schedule hereto.

ii) Loss of two hands or two feet, or of one hand and one foot, or of such loss of sight of one eye and such loss of use of one hand or one foot, the Capital Sum Insured stated in the Schedule hereto:

c. If such injury shall within twelve calendar months of its occurrence be the sole and direct cause of the total and irrecoverable loss of

i) the sight of one eye, or of the actual loss by physical separation of one entire hand or of one entire foot, fifty percent (50%) of the Capital Sum Insured stated in the schedule hereto.

ii) Total and irrecoverable loss of use of a hand or a foot without physical separation, fifty percent (50%) of the Capital Sum Insured stated in the Schedule hereto.

NOTE: For the purpose of Clause (b) and clause (c) above 'physical separation of a hand or foot means

separation at or above the wrist and/or of the foot at or above the ankle respectively.'

EXPENSES FOR CARRIAGE OF DEAD BODY

In the event of death of insured person due to accident, as defined in the policy, outside his/her residence, the Company shall reimburse, in addition to the amount payable under sub clause (a) to (d) expenses incurred for transportation of Insured's dead body, to the place of residence subject to a maximum of 2% of the Capital Sum Insured or Rs. 1000/- whichever is less.

EDUCATION FUND

Insurance is extended to provide compensation towards Education Fund for the dependent children (student) of the first insured as follows in the event of death or permanent Total Disablement of the Insured due to accident.

a) If the Insured person has one dependent child (school / college going ) below the age of 25 years, an amount equal to 10% of the CSI subject to a maximum prescribed against each type of policy.

b) If the insured person has more than one dependent child ( school / college going ) below the age of 25 years, an amount equal to twice the amount specified under clause as above.

The payment as above will be made along with the CSI to the same person/s who is / are entitled to receive the CSI.

Provided that the age limit of 25 years shall apply on the date of accident and not at the beginning of the policy year.

Further provided that if there be any other subsisting PA insurance/s in the name of the Insured and benefits under this Regulation becoming payable under all such policies, the total amount so payable shall be limited to a maximum of sums under a) and b) above. The company shall not be liable to pay or contribute more than its rate able proportion of such loss or damage.

MARRIAGE AID :

Insurance is extended to provide compensation of amounts as specified in the tables above, towards MARRIAGE of one dependent girl child of the first Insured , in the event of death or permanent Total Disablement due to accident ( Provided that the marriage takes place within the Policy period.)

EXCEPTIONS

PROVIDED ALWAYS THAT:

The Company shall not be liable under this Policy for:

1. Compensation under more than one of the foregoing Sub-clauses in respect of the same period of disablement.

2. Any other payment after a claim under one of the Sub-Clause (a), (b), (c) or (d) has been admitted and became payable.

3. Any payment in case of more than one claim under the Policy during any one period of insurance by which the maximum liability of the Company in that period would exceed the sum payable under Sub-Clause (a) of this Policy.

4. Payment of compensation in respect of Death, injury or Disablement of the Insured (a) from intentional self injury, suicide or attempted suicide (b) whilst under the influence of intoxicating liquor or drugs, (c) whilst engaging in Aviation or Ballooning whilst mounting into, dismounting from or traveling in any balloon or aircraft other than as passenger (fare paying or otherwise) any duly licensed standard type of aircraft anywhere in the world, (d) directly or indirectly caused by venereal disease or insanity, (e) arising or resulting from the insured committing any breach of law with criminal intent.

5. Payment of compensation in respect of Death, Injury or Disablement of the Insured due to or arising out of or directly or indirectly connected with or traceable to: War, Invasion, Act of foreign enemy, Hostilities (whether war be declared or not), Civil War, Rebellion, Revolution, Insurrection, Mutiny, Military or Usurped Power, Seizure, Capture, Arrests Restraints and Detainment of all kings, princes and people whatever nation, condition quality whatsoever.

6. Payment of Compensation in respect of death of, or bodily injury or any disease or illness to the insured :

(a) directly or indirectly caused by or contributed to by or arising from ionizing radiations or contamination by radio activity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel. For the purpose of this exception, combustion shall include any self-sustaining process of nuclear fusion;

(b) directly or indirectly caused by or contributed to by or arising from nuclear weapon material.

Provided also that the due observance and fulfillment of the terms and conditions of this policy (which conditions and all endorsements hereon are to be read as part of this policy) shall so far as they relate to anything to be done or not to be done by the Insured be a condition precedent to any liability of the Company under this Policy.

1. Pregnancy Exclusion Clause: the insurance under this Policy shall not extend to cover death or disablement resulting directly or indirectly caused by, contributed to or aggravated or prolonged by childbirth or pregnancy or inconsequence thereof.

ROAD SAFETY POLICY

NOW THIS POLICY WITNESSETH that subject to the terms, exclusions, definitions and conditions contained herein or endorsed or otherwise expressed here on, the Company will pay the insured as hereinafter mentioned.

If at any time during the currency of this Policy, the Insured shall sustain any bodily injury resulting solely and directly from accident caused by accidents involving registered Motor vehicles as defined in the Motor Vehicles (Amendment) Act, 1944, then the Company shall pay to the Insured or his legal personal representative(s) as the case may be, the sum or sums hereinafter set forth, that is to say:

A. Death of Insured or permanent total loss of use of any two organs ( eyes or arms or legs) – maximum sum insured ( as per schedule).

B. Permanent total loss of use of any one organ (eyes or arms or legs) – 50% of the maximum sum insured (as per schedule).

C. Hospital Expences : If the insured is hospitalized for a minimum period of 24 hours for treatment of such bodily injury , the Company will reimburse admissible medical expences during hospitalisation up to the maximum sum insured as shown in the schedule.

Exclusions : 1.Intentional self injury / suicide / attempted suicide.

2.Injury/death resulting by use of intoxicating drugs/liquor.

3.Ayurvedic / Homeopathic / Unani / Naturopathy treatment, etc. 4. Pre and post hospitalisation expences.

GENERAL TERMS & CONDITIONS OF

MEDICLAIM / ACCIDENT MEDICLAIM AND ACCIDENT INSURANCE POLICY

1. ENTIRE CONTRACT: the policy, proposal form, prospectus and declaration given by the insured shall constitute the complete contract of insurance. Only insurer may alter the terms and conditions of this policy/ contract. Any alteration that may be made by the insurer shall only be evidenced by a duly signed and sealed endorsement on the policy.

2. COMMUNICATION : Every notice or communication to be given or made under this policy shall be delivered in writing at the address of the policy issuing office ..

3. PAYMENT OF PREMIUM: The due payment of premium and the observance and fulfillment of the terms, provisions, conditions and endorsements of this policy by the Insured Person in so far as they relate to anything to be done or complied with by the Insured Person shall be condition precedent to any liability of the Company to make any payment under this policy. No waiver of any terms, provisions, conditions and endorsements of this policy shall be valid, unless made in writing and signed by an authorised official of the Company.

4. NOTICE OF CLAIM: Immediate notice of claim with particulars relating to Policy Number, Name of insured person in respect of whom claim is made, Nature of disease / illness / injury and Name and Address of the attending medical practitioner / Hospital/Nursing Home etc. should be given to the Company while taking treatment in the Hospital / Nursing Home . Such notice should be given within 48 hours of admission or before discharge from Hospital / Nursing Home, unless waived in writing.

5. CLAIM DOCUMENTS: Final claim along with hospital receipted original Bills/Cash memos/reports, claim form and list of documents as listed below should be submitted to the Company within 7 days of discharge from the Hospital / Nursing Home. In case of post hospitalisation treatment all supporting claim papers / documents should also be submitted within 7 days after completion of such treatment (up to 60 days or actual period whichever is less).

a. Original bills, receipts and discharge certificate / card from the hospital.

b. Medical history of the patient recorded by the Hospital.

c. Original Cash-memo from the hospital (s) / chemist (s) supported by proper prescription.

d. Original receipt, pathological and other test reports from a pathologist / radiologist including film etc. supported by the note from attending medical practitioner / surgeon demanding such tests.

e. Attending Consultants / Anesthetists / Specialist certificates regarding diagnosis and bill / receipts etc.

f. Surgeon's original certificate stating diagnosis and nature of operation performed along with bills / receipts etc.

g. Any other information required Insurance Company. All documents must be duly attested by the insured person.

h. First Information Report (FIR) in case of Accidents – copy attested by Station-in-charge.

i. Death Certificate – in case of death caused by accident –original.

j. Post-mortem report – in case of death caused by accident – certified copy.

k. Certificate of disability caused by accidents – original.

In addition insured should also provide the Company such additional information and assistance as the Company may require in dealing with the claim.

NOTE: Waiver of the condition may be considered in extreme cases of hardship where it is proved to the satisfaction of the Company that under the circumstances in which the insured was placed it was not possible for him or any other person to give such notice or file claim within the prescribed time limit. Otherwise Company has a right to reject the claim.

6. Any medical practitioner authorised by the Company shall be allowed to examine the Insured Person in case of any alleged injury or Disease requiring Hospitalisation when and so often as the same may reasonably be required on behalf of the Company.

7. FRAUD / MISREPRESENTATION / CONCEALMENT: The Company shall not be liable to make any payment under this policy in respect of any claim if such claim be in any manner intentionally or recklessly or otherwise misrepresented or concealed or non disclosure of material facts or making false statements or submitting false bills whether by the Insured Person or Institution /Organization on his behalf. Such action shall render this policy null and void and all claims hereunder shall be forfeited. Company may take suitable legal action against the Insured Person / Institution / Organization as per Law.

8. CONTRIBUTION : If at the time when any claim arises under this policy, there is in existence any other insurance (other than Cancer insurance Policy in collaboration with Indian Cancer Society) whether it be effected by or on behalf of any Insured Person in respect of whom the claim may have arisen covering the same loss, liability, compensation, costs or expenses, the company shall not be liable to pay or contribute more than its ratable proportion of any loss, liability, compensation, costs or expenses. The benefits under this policy shall however be in excess of the benefits available under Cancer Insurance Policy.

9. PAYMENT OF CLAIM: The policy covers illness, disease or accidental bodily injury sustained by the insured person during the policy period anywhere in India and all medical / surgical treatment under this policy shall have to be taken in India and admissible claims thereof shall be payable in Indian currency.

a) The claim will be paid to the insured person by the Insurance Company.

b) REASONABLE, CUSTOMARY AND NECESSARY EXPENSES : It shall mean the cost of surgical / medical treatment that is necessary, customary and reasonable for treating the condition for which insured person was hospitalized to the extent that such cost does not exceed the reasonable and customary charges for which insured was hospitalized.

NOTE: Any expenses as mentioned above which are not covered under the policy and / or which are not reasonable, customary and necessary, the same have to be borne by the insured person himself.

FOLLOWING REASONABLE & CUSTOMARY EXPENSES ARE REIMBURSABLE UNDER THE POLICY

a. Room rent as provided by the Hospital not exceeding 1 % of the Sum Insured per day and. I.C. Unit rent not exceeding 2% of the Sum Insured subject to the maximum specified below against each type of policy (except PA cover).

	Type A	Type B	Type C	Type D	Type E	Type F	Type G	Type H
Room Rent	Rs.250	Rs.250	Rs.250	Rs.500	Rs.500	Rs.250	Rs.250	Rs.500
I.C.U Rent	Rs.500	Rs.500	Rs.500	Rs.1000	Rs.1000	Rs.500	Rs.500	Rs.1000

(Room including I.C.U. stay should not exceed total number of admission days).
c. Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees, and Nursing Expenses.

d. Anesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Dialysis, Chemotherapy, Radiotherapy, Artificial Limbs, Cost of Prosthetic devices implanted during surgical procedure like pacemaker, Relevant Laboratory / Diagnostic test, X-Ray etc..

Note: 1. Company's Liability in respect of all claims admitted during the Period of insurance shall not exceed the Sum Insured per Person mentioned in the Schedule.

2. Hospitalization expenses incurred for donating an organ by the donor (excluding cost of organ if any) to the insured person during the course of organ transplant will also be payable. However in any case the liability of the Company will be limited to over all Sum Insured of the Insured Person.

10. PERIOD OF POLICY: This insurance policy is issued for a period of one year.

11. RENEWAL OF POLICY:

a) The decision to accept or reject for coverage of any person upon renewal of this insurance shall rest solely with the Company. The company may at its discretion revise the premium rates and / or the terms & condition of the policy every year upon renewal thereof. Renewal of this policy is not automatic; premium due must be paid by the proposer to the company before the due date. b) The Company normally sends renewal notice but not sending it will not tantamount to deficiency in services. c) If the policy is to be renewed for enhanced sum insured then the restrictions as applicable to a fresh policy (will apply to additional sum insured) as if a separate policy has been issued for the difference, subject to medical checkup as per norms of the Company. The cost of Medical checkup shall be borne by the insured.

12. SUM INSURED: The Company's liability in respect of all claims admitted during the period of Insurance shall not exceed the sum insured opted by the Insured person.

13. AUTHORITY TO OBTAIN RECORDS:

a) The insured person hereby agrees to and authorises the disclosure to the insurer or any other person nominated by the insurer of any and all Medical records and information held by any Institution / Hospital or Person from which the insured person has obtained any medical or other treatment to the extent reasonably required by the insurer in connection with any claim made under this policy or the insurer's liability there under.

b) The insurer agree that they will preserve the confidentiality of any documentation and information that comes into their possession pursuant to (a) above and will only use it in connection with any claim made under this policy or the insurer's liability there under.