Family Tahafuz Premium

Introduction:

For the very first time JazzCash brings “Family Tahafuz Premium” – An innovative Health Insurance facility for customers and their family

It covers the financial needs to ensure health coverage for you, your spouse and children. You can purchase these insurance plans using your JazzCash Mobile Accounts instantly.

With this hassle free and simple service, customers no longer need to go through time consuming documentation processes, carry health insurance cards or seek permission before treatment.

Product Features:

Financial Protection: The product offers a financial safety net to customers against costs of hospitalisation.
smsDOC: A service to avail free telephonic consultation with a professional doctor. Registered customers can SMS their medical query on 5634. A doctor will call back within one business day to discuss the query
Simple Enrolment Process: Paperless enrolment process allows enrolment in a matter of few minutes. No medical examinations are required for enrolment.
Coverage for family: The product not only covers the customer but also his or her spouse as well as children

Product Details

1 Year Plan

JazzCash in partnership with MicroEnsure Pakistan, brings Family Tahafuz Premium providing complete freedom in managing health related risks. This exciting new product frees the customers from the hassle of finding panel hospitals. Instead, they can get treatment from hospital of their choice.

Features

Financial protection in case of hospitalization
Coverage for customer and his family (spouse and children)
Visit any facility of your choice. No condition of visiting only panel hospitals
Generous cash benefit amounts
Simple and easy to understand coverage
Fast and electronic claims processing

OneTime (Annual) Charges	4,499
Daily Hospitalisation benefit – Customer & Spouse (Rs.)	5,000
Daily Hospitalisation benefit – ICU – Customer & Spouse (Rs.)	10,000
Daily Hospitalisation benefit – Children (Rs.)	2,500
Daily Hospitalisation benefit – ICU – Children (Rs.)	5,000

Benefit of up to 30 days, payable for one admission
No limit on the number of admissions in hospital during coverage period
Maximum limit of 60 days of hospitalisation per insured person in a year

A simple sign-up process

JazzCash Mobile Account customers can subscribe to Family Tahafuz Premium —by simply dialling *786*7*3*1*5# or via JazzCash App
Customers who do not have a JazzCash Mobile Account can simply dial *786# from their biometrically verified Jazz SIM to open their Account. Once the Mobile Account is registered, they can subscribe to Family Tahafuz Premium by dialing *786*7*3*1*5# or via JazzCash App
JazzCash Mobile Account customers can also subscribe to JazzCash by simply calling 042-33339293 from Jazz mobile phone.

Terms & Conditions

Duration of the insurance is for 1 year from the date of enrolment
Age Limit: 18 – 65 years for customer and his or her spouse. Coverage will terminate on 65th birthday
Age Limit: 1 – 22 years for children of subscribed customer. Coverage will terminate on 22nd birthday
To be eligible for coverage, children should be single and economically dependent on parents
Waiting period of 15 days upon enrolment will apply for hospitalisation due to illness. Coverage for accidents will start immediately
A waiting period of thirty (30) days will apply between consecutive hospitalisations

Exclusions

Conditions in which a claim is not payable:

Pregnancy and related complications
Treatment of pre-existing condition and any disease, illness, medical condition or injury which is a complication of a pre-existing condition
Attempted suicide, self-inflicted injury whether intentional or unintentional
Consumption of narcotics, alcohol and poison
Cosmetic and dental treatment

Value Added Benefits

HealthCare Cash Back

Customers can request cash back for any healthcare expense such as doctor’s consultation fee, medicines, lab tests etc. The limits and amounts of cash back which can be availed are as follows:

Family Tahafuz Premium	Amount per cash back: Rs. 250 Maximum four (4) cash backs can be requested in a year of coverage i.e. maximum cash back of Rs. 1,000 in a year One (1) cash back can be requested in every three (3) months after registration Waiting period of fifteen (15) days applies after registration

To request a healthcare cash back please call 042-33339293. Our representative will guide you. You will be requested to provide doctor’s prescriptions, reports and expense receipts.

Important Information
MicroEnsure Pakistan (Private) Limited is providing administrative services for Family Tahafuz and Family Tahafuz Premium. Family Tahafuz and Family Tahafuz Premium are underwritten by EFU Life Assurance Limited, which is registered and supervised by Securities and Exchange Commission of Pakistan. EFU Life Assurance Limited is the insurance company of Family Tahafuz and Family Tahafuz Premium and responsible for paying claims. The address of EFU Life Assurance is:

EFU Life House, Plot No. 112, 8th East Street, Phase I, DHA, Karachi

Mobilink Microfinance Bank and JazzCash are distributors of Family Tahafuz and Family Tahafuz Premium. They are not responsible for paying claims to customers.

Monthly Plan

JazzCash in partnership with MicroEnsure Pakistan, brings Family Tahafuz Premium providing complete freedom in managing health related risks. This exciting new feature frees the customers from the hassle of paying full year’s premium upfront. Instead, they can get same financial protection by paying monthly premiums.

Features

Financial protection in case of hospitalization
Coverage for customer and his family (spouse and children)
Visit any facility of your choice. No condition of visiting only panel hospitals
Generous cash benefit amounts
Simple and easy to understand coverage
Fast and electronic claims processing

Monthly Charges (Rs.)	370
Daily Hospitalisation benefit – Customer & Spouse (Rs.)	5,000
Daily Hospitalisation benefit – ICU – Customer & Spouse (Rs.)	10,000
Daily Hospitalisation benefit – Children (Rs.)	2,500
Daily Hospitalisation benefit – ICU – Children (Rs.)	5,000

Benefit of up to 30 days, payable for one admission
No limit on the number of admissions in hospital during coverage period
Maximum limit of 60 days of hospitalisation per insured person in a year

A simple sign-up process

JazzCash Mobile Account customers can subscribe to JazzCash Family Tahafuz Premium by dialling *786*7*3*1*5# or through their JazzCash App
Alternatively, customers can also request a call back in which a representative from MicroEnsure will call them and help in sign-up process

For more information, please call MicroEnsure helpline 051 8466466.

Terms & Conditions

Duration of the insurance is for 1 month from the date of enrolment
On each monthly due date or within applicable grace period, the applicable premium will be automatically collected from customer’s JazzCash mobile account and cover will renew for next one month
A grace period of 10 days will be allowed for collection of each renewal monthly premium. Cover will be effective during grace period and in case of any claim, outstanding premium will be collected from payable claim amount
Age Limit: 18 – 65 years for customer and his or her spouse. Coverage will terminate on 65th birthday
Age Limit: 1 – 22 years for children of subscribed customer. Coverage will terminate on 22nd birthday
To be eligible for coverage, children should be single and economically dependent on parents
Waiting period of 15 days upon enrolment will apply for hospitalisation due to illness. Coverage for accidents will start immediately
A waiting period of thirty (30) days will apply between consecutive hospitalisations

Exclusions

Conditions in which a claim is not payable:

Pregnancy and related complications
Treatment of pre-existing condition and any disease, illness, medical condition or injury which is a complication of a pre-existing condition
Attempted suicide, self-inflicted injury whether intentional or unintentional
Consumption of narcotics, alcohol and poison
Cosmetic and dental treatment

Value Added Benefits

HealthCare Cash Back

Customers can request cash back for any healthcare expense such as doctor’s consultation fee, medicines, lab tests etc. The limits and amounts of cash back which can be availed are as follows:

Family Tahafuz Premium	Amount per cash back: Rs. 250 Maximum four (4) cash backs can be requested in a year of coverage i.e. maximum cash back of Rs. 1,000 in a year One (1) cash back can be requested in every three (3) months after registration Waiting period of fifteen (15) days applies after registration

To request a healthcare cash back please call 051-8466466. Our representative will guide you. You will be requested to provide doctor’s prescriptions, reports and expense receipts.

Important Information

MicroEnsure Pakistan (Private) Limited is providing administrative services for Family Tahafuz Premium. Family Tahafuz Premium is underwritten by Asia Insurance Company Limited, which is registered and supervised by Securities and Exchange Commission of Pakistan. The insurance company of Family Tahafuz Premium is responsible for paying claims. The address of the insurance company is:

19-C & D, Block L, Gulberg III, Lahore, Pakistan

Mobilink Microfinance Bank and JazzCash are distributors of Family Tahafuz Premium. They are not responsible for paying claims to customers.

FAQs

Can the customer go to any hospital?

Yes, the customer can go to any registered hospital in Pakistan. Registered hospitals means an institution:

Which is licensed as per laws of Pakistan to provide medical treatment
Which has basic facilities for diagnostic & laboratory tests, medical diagnosis & treatment, and surgery
Which provides 24 hours nursing service comprising registered graduate nurses under supervision of an in-house physician in-charge
Where medical treatment is provided under proper documented procedures
Which keeps medical record of each patient on a daily basis and allows insurance company easy access to medical record

When does the coverage start for customer?

As soon as confirmation SMS is received from JazzCash, coverage will start. However, in case of admission in hospital due to illness, a waiting period will apply. Waiting period is fifteen (15) days in annual policy and (5) five days in monthly policy.

This condition will not apply if the admission in hospital is due to accident

If customer is admitted in a clinic, will they get any benefits?

Admission in a clinic will not be considered admission in a hospital. Therefore, customers will not be able to claim benefit of admission in a hospital.

What are the charges for JazzCash Family Tahafuz Premium?

You can select any of the following payment modes to pay subscription charges:

OneTime (Annual): PKR 4,499
Monthly: PKR 370

If you choose to pay monthly charges, your subscription will automatically continue to be renewed by deduction of charges from your JazzCash mobile wallet.

What are smsDOC and Health Care Cash back?

smsDoc and HealthCare Cash Back are value added services provided by MicroEnsure Pakistan (Private) Limited and are separate from insurance benefits offered under Family Tahafuz and Family Tahafuz Premium.

Via smsDoc, all health care and medical services are performed only by the licensed physicians. The licensed physicians are solely responsible for the medical services prescribed and in compliance with any and all requirements applicable to his or her exercise of profession. JazzCash and MicroEnsure Pakistan (Private) Limited are not engaged in the practice of medicine, whether by and through smsDoc and do not provide health care or medical services. By using smsDoc, the customer unconditionally agrees to these Service Terms and Conditions. JazzCash and MicroEnsure Pakistan (Private) Limited shall not be held liable for any loss or damage arising under or in connection with advice provided through smsDoc service.

How can a claim be made for benefits?

Claim process is very easy. If a customer is admitted in hospital they should follow following instructions:

Submit claim from JazzCash App or inform about the hospitalization on claims helpline no. 051 – 8 466 466. A person accompanying the customer can inform the helpline also.
Notify the claims helpline when the customer is discharged. Our representative will help the customer in making the claim. It is important to inform within fifteen (15) days of discharge from the hospital

We request customer to provide following documents at the time of claim:

Treatment record of hospital which includes dates of admission and discharge, medical diagnosis and treatment
A copy of customer’s CNIC
A certificate issued by the doctor
Claim form with signature
Police and medico legal reports are required in case of hospitalization due to accident, violence and attempted suicide
In case of accident, receipts of treatment expenses and prescriptions issued by doctor and the hospital

Claims are settled within five (5) working days (days on which banks are open) after complete documents are received. Claim payments are made via JazzCash mobile wallet or cheque. Submission of documents within fifteen (15) days of discharge from hospital is required for claim payment.

Under what conditions will a claim not be paid?

Pregnancy and related complications
Treatment of pre-existing condition and any disease, illness, medical condition or injury which is a complication of a pre-existing condition
Attempted suicide, self-inflicted injury whether intentional or unintentional
Consumption of narcotics, alcohol and poison
Cosmetic and dental treatment

What is the Cancellation Process?

Customers paying monthly charges can cancel anytime by dialling *786*8*3*2# or via JazzCash App or calling 4444 from their mobile phone to stop future collections of charges. Refund of paid instalments is not applicable

Customers who have paid annual subscription charges can cancel anytime by dialling *786*8*3*2# or via JazzCash App or by calling 4444 from their mobile phone within fourteen (14) days to cancel annual policy and charges will be refunded immediately, if the customer has not already filed a claim. If the policy is cancelled after 14 days then the charges will not be refunded

When will a customer’s coverage under JazzCash Family Tahafuz end?

The coverage will end in any of following cases:

When the customer turns sixty five (65) years old
When the customer does not pay the charges to renew Family Tahafuz subscription
When the customer makes a fraudulent claim

If a customer discontinues the monthly premium payment?

If a customer stops monthly premium payment their coverage will lapse and will not be automatically renewed. However, any claims lodged for the time coverage was active will be processed as per product terms and conditions.

Important information:

MicroEnsure Pakistan (Pvt.) Limited is providing administrative services for JazzCash Family Tahafuz. Family Tahafuz is underwritten by EFU Life Assurance Limited (Annual Plan) and Asia insurance company (Monthly Plan), which are registered and supervised by Securities and Exchange Commission of Pakistan. Insurance company is responsible for paying claims.

Mobilink Microfinance Bank and JazzCash are distributors of for JazzCash Family Tahafuz. They are not responsible for paying claims to customers.