Tender for insurance Company

Underwriting Eligibility of ChildrenUp to 25 years old Insurability Existing PopulationNo Underwriting Insurability New AdherentsSatisfactory Medical Questionnaire to be filled by employeeContinuity (waiting period)Waiting period for pre-existing cases: 3 months. Waiting period for other cases:NIL.                     Continuity granted (SO NO WAITING PERIOD) if previously insured for at least 12 consecutive months.Pre existing cases Unknown: 3 months waiting period. After the 3 months FULLY covered so NO financial limits applicable. For previously insured NO waiting period. Known: For delcared pre-existing cases a limit of $7,500 per person per year will be grantedIN-HOSPITAL BENEFITS LimitsCoverage100% inside network (direct billing) & 100% outside network (reimbursement basis) Network of HospitalsFull NetworkLimit per person per yearUnlimitedLimit per case per yearUnlimitedLifetime limit720 days of hospitalizationMaternity BenefitsMaximum for Normal Deliverycovered (no sub-limit) Maximum for Caesareancovered (no sub-limit) Maximum for Legal abortion covered  Waiting Period Existing PopulationNO waiting periodWaiting Period New Adherents9 months.  If Continuity granted NO waiting periodInfertility Treatmentcovered up to $5,000 per person per year (IN and OUT combined)Maternity ComplicationsCovered up to $10,000 per caseIncubatorCovered up to 30 days New born baby As of day 0 & FREE of CHARGE till end contract EpiduralCoveredConsultation of Paediatrician1 consultation Circumcision (male) at deliveryCovered if during delivery confinementCongenital CasesCovered up to $15,000 per person per year and not limited to BABY LIA (persons insured since birth with LIA) Supplemental Benefits Epidemic/ Pandemic including COVID 19Covered for a maximum of $30,000 per person per year or 21 days of hospitalization.       15 days wating period for new adherents onlyOrgan Transpantation Class A: $100,000; Class B: $80,000; Class C: $60,000  Bone MarrowCovered under Organ TransplantationRenal DialysisFirst sessions following acute renal failure at 1st admission (remaining sessions on Ministry of Health)Endoscopy, Colonoscopy, Gastroscopy Covered (for members insured on co-NSSF basis the case will be treated as co-nil so no need for the insured member to pay NSSF share to hospital first and then file a reimbursement claim at NSSF) Allergy TreatmentCoveredMigraine TreatmentCovered Passive War / TerrorismPassive War and Terrorsim are both covered in Lebanon ONLY Road accidentsCovered Work related accidentsCovered Emergency coverage abroadCovered (accident & illness). Class A on Direct billing basis and Class B/C on Reimbursement basis by Arab Assist (+ free of charge worldwide travel insurance) Polysomnography and sleep disorders/sleep apneaCovered  up to $1,500 per person per yearVeneral & Sexually Transmitted Diseases Covered Breast Reconstruction (due to breast cancer)Covered up to $10,000 per personHazardous sports Covered Parkinson DiseaseCovered Internal prosthesis due to accident or illnessCovered (accident or illness)Orthesis / external prosthesisCovered up to $2,000 per caseArtificial Limbs and eyesCovered if due to accident Cosmetic and plastic surgery of any kind Covered following accidental injury Dental and gum medical or surgical treatmentCovered following accidental injury and incl. abscess prosthesis & disorders of temporomandibular joints Clinical SurgeriesCoveredNew and unconventional treatmentsCovered up to the costs of the normal procedures  Cataract, Strabismus, Vitrectomy & Retinal surgeryCovered including costs of lensParental AccomodationCovered for children below 18 yearsRental of wheelchairCoveredAmbulance CostsCoveredVaccination for kids above 2 yearsCovered up to $500 per child per yearHome Nursing / Home CareCoveredRehabilitationCoveredMorgue and Burial Expenses$3000 per personIndividual Conversion option (GR) Available free of charge  OUT-HOSPITAL BENEFITSAmbulatoryCoverage85% inside network (direct billing) and 85% outside network (reimbursement basis)Limit per person per year$5,000Physiotherapy 25 sessions per insured per year and $20 per session (inside Network NO financial limit)Diagnostic Tests (MRI, ECG, CT-scan, Stress Test, Laboratory Tests, EEG etc….)CoveredPCR Test: PCR Test pre-operationcoveredOther PCR testscovered (if result is positive) + negative repeat test Coroscan Covered (if required and following a stress test)Video Capsule Endoscopycovered uo to $1,000 per person per year Pre-marital tests covered Sexually Transmitted diseases and HIVcovered Genetic Testscovered up to $2,000 per person per yearPet Scan Covered (if requested and for cancer cases in general)VCT 64CoveredOCTCoveredOsteodensitometry testCoveredPolysomnography and sleep disordersCovered up to $1,500 per person per yearMaternity Tests (Morphological Ultrasound; Amniocentesis; Toxoplasmosis; Rubella; Triple Test, Quadruple Test)CoveredMENTAL HEALTH BENEFITSMental HealthCoverageIN-Hopsital 100% and Out-Hospital 100%Limit per person per year$10,000Hospitalizationcovered Psychiatric Consultation covered up to $50  per session Psychological Consultationcovered up to $50 per session Online Consultationcovered up to $50 per session Nervous BreakdowncoveredBurn outcoveredPsychological testing and evaluationcovered