Hospitalization due to Illness. In the event of hospitalization of the Insured Person due to an illness for a consecutive period of more than 2 days, a daily benefit is payable up to a maximum of 20 days during the policy period.
Hospitalization due to Accident. In the event of hospitalization arising out of an accidental injury for a consecutive period of more than 2 days, a daily benefit is payable up to a maximum of 15 days during the policy period.
Q. What does this plan cover?
A. It covers Illness-related hospitalization (including maternity) for 2–20 consecutive days and Accident-related hospitalization for 2–15 consecutive days.
Q. Is outpatient treatment or tests covered?
A. No. Only inpatient hospital is covered.
Q. Who is NOT eligible for coverage?
A. Persons over 65 years old.
Q. What medical treatments are excluded?
A. No. Exclusions include:
- Outpatient treatment or tests, routine examinations, vaccinations, inoculation or screening, dental treatment or surgery of any kind (unless requiring hospitalization).
- Pre-existing disease, illness, injury and medical condition before purchase of policy
- Injuries from racing, speed contests, or intoxication (alcohol/drug abuse).
- Specific Conditions: Psychiatric, mental or nervous conditions, insanity.
- Conditions resulting from the use of intoxicating drugs alcohol and the treatment of alcoholism, solvent abuse, drug abuse or any addiction and medical
- conditions resulting from or related to such abuse or addiction.
- Congenital and chronic illnesses (e.g., heart disease, cancer, kidney failure), common surgeries: Tonsil/adenoid surgery, hysterectomy, hernia repair, Piles, fissures, fistulas, hydrocele, Cataract, knee/hip joint replacements, tumors and growths, degenerative disorders (e.g., arthritis, hernias), Migraine headaches, Urinary/biliary stones, Gastric/duodenal ulcers and Sinusitis.
- Hospitalization arising from pregnancy during the first 9 months from the commencement date of policy.
- Family Restrictions: Treatment at non-NHIS-approved hospitals.
Q. Why are these conditions excluded?
A. These are typically pre-existing, chronic, or elective treatments that fall outside the scope of accidental or short-term illness coverage.
Q. When does the protection start and end?
A. Starts when full premium is paid. Ends: Policy expiration or premium lapse or after full claim payout.
Q. Where am i protected?
A. Anywhere in Nigeria.
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