Non Schengen States Delta Life Insurance Co. Ltd.

Effective date : 01-04-2016

Overeseas Mediclaim Policy
PLAN - A (For visiting countries excluding USA & Canada)
Policy Premium Rates for Different Age Groups according to Policy Duration
Duration 5 Months upto 40 Yrs. Over 40+ upto 50 Yrs. Over 50+ upto 55 Yrs. Over 55+ upto 59 Yrs Over 59+ upto 65 Yrs Over 65+ upto 70 Yrs Over 70+ upto 75 Yrs Over 75+ upto 79 Yrs
In Days Premium VAT Total Premium VAT Total Premium VAT Total Premium VAT Total Premium VAT Total Premium VAT Total Premium VAT Total Premium VAT Total
1-14 1,115 167.25 1,282.25 1,674 251.10 1,925.10 2,249 337.35 2,586.35 2,249 337.35 2,586.35 2,249 337.35 2,586.35 7,318 1,097.70 8,415.70 12,807 1,921.05 14,728.05 25,614 3,842.10 29,456.10
15-21 1,162 174.30 1,336.30 1,785 267.75 2,052.75 2,398 359.70 2,757.70 2,398 359.70 2,757.70 2,398 359.70 2,757.70 7,801 1,170.15 8,971.15 13,652 2,047.80 15,699.80 27,304 4,095.60 31,399.60
22-28 1,301 195.15 1,496.15 1,992 298.80 2,290.80 2,678 401.70 3,079.70 2,678 401.70 3,079.70 2,678 401.70 3,079.70 8,710 1,306.50 10,016.50 15,243 2,286.45 17,529.45 30,486 4,572.90 35,058.90
29-35 1,605 240.75 1,845.75 2,406 360.90 2,766.90 3,233 484.95 3,717.95 3,233 484.95 3,717.95 3,233 484.95 3,717.95 10,523 1,578.45 12,101.45 18,416 2,762.40 21,178.40 36,832 5,524.80 42,356.80
36-47 1,838 275.70 2,113.70 2,757 413.55 3,170.55 3,707 556.05 4,263.05 3,707 556.05 4,263.05 3,707 556.05 4,263.05 12,062 1,809.30 13,871.30 21,109 3,166.35 24,275.35 42,217 6,332.55 48,549.55
48-60 2,162 324.30 2,486.30 3,266 489.90 3,755.90 4,391 658.65 5,049.65 4,391 658.65 5,049.65 4,391 658.65 5,049.65 14,286 2,142.90 16,428.90 25,001 3,750.15 28,751.15 50,002 7,500.30 57,502.30
61-75 2,673 400.95 3,073.95 4,032 604.80 4,636.80 5,420 813.00 6,233.00 5,420 813.00 6,233.00 5,420 813.00 6,233.00 17,638 2,645.70 20,283.70 30,867 4,630.05 35,497.05 61,733 9,259.95 70,992.95
76-90 3,195 479.25 3,674.25 4,780 717.00 5,497.00 6,426 963.90 7,389.90 6,426 963.90 7,389.90 6,426 963.90 7,389.90 20,909 3,136.35 24,045.35 36,591 5,488.65 42,079.65 73,181 10,977.15 84,158.15
91-120 5,403 810.45 6,213.45 8,157 1,223.55 9,380.55 10,966 1,644.90 12,610.90 10,966 1,644.90 12,610.90 10,966 1,644.90 12,610.90 No Cover No Cover No Cover
121-147 6,507 976.05 7,483.05 9,782 1,467.30 11,249.30 13,152 1,972.80 15,124.80 13,152 1,972.80 15,124.80 13,152 1,972.80 15,124.80 No Cover No Cover No Cover
148-180 9,041 1,356.15 10,397.15 13,493 2,023.95 15,516.95 18,293 2,743.95 21,036.95 18,293 2,743.95 21,036.95 18,293 2,743.95 21,036.95 No Cover No Cover No Cover

PLAN -B (For visiting countries including USA & Canada)

Policy Premium Rates for Different Age Groups according to Policy Duration
+
Duration 5 Months upto 40 Yrs. Over 40 upto 50 Yrs. Over 50+ upto 55 Yrs. Over 55+ upto 59 Yrs Over 59+ upto 65 Yrs Over 65+ upto 70 Yrs Over 70+ upto 75 Yrs Over 75+ upto 79 Yrs
In Days Premium VAT Total Premium VAT Total Premium VAT Total Premium VAT Total Premium VAT Total Premium VAT Total Premium VAT Total Premium VAT Total
1-14 2,042 306.30 2,348.30 3,780 567.00 4,347.00 4,798 719.70 5,517.70 4,798 719.70 5,517.70 4,798 719.70 5,517.70 15,614 2,342.10 17,956.10 27,324 4,098.60 31,422.60 54,648 8,197.20 62,845.20
15-21 2,170 325.50 2,495.50 4,049 607.35 4,656.35 5,141 771.15 5,912.15 5,141 771.15 5,912.15 5,141 771.15 5,912.15 16,728 2,509.20 19,237.20 29,273 4,390.95 33,663.95 58,547 8,782.05 67,329.05
22-28 2,452 367.80 2,819.80 4,691 703.65 5,394.65 5,956 893.40 6,849.40 5,956 893.40 6,849.40 5,956 893.40 6,849.40 19,378 2,906.70 22,284.70 33,911 5,086.65 38,997.65 67,822 10,173.30 77,995.30
29-35 2,944 441.60 3,385.60 5,534 830.10 6,364.10 7,027 1,054.05 8,081.05 7,027 1,054.05 8,081.05 7,027 1,054.05 8,081.05 22,862 3,429.30 26,291.30 40,009 6,001.35 46,010.35 80,019 12,002.85 92,021.85
36-47 3,511 526.65 4,037.65 6,747 1,012.05 7,759.05 8,568 1,285.20 9,853.20 8,568 1,285.20 9,853.20 8,568 1,285.20 9,853.20 27,879 4,181.85 32,060.85 48,789 7,318.35 56,107.35 97,578 14,636.70 112,214.70
48-60 5,656 848.40 6,504.40 10,964 1,644.60 12,608.60 13,923 2,088.45 16,011.45 13,923 2,088.45 16,011.45 13,923 2,088.45 16,011.45 45,305 6,795.75 52,100.75 79,284 11,892.60 91,176.60 158,568 23,785.20 182,353.20
61-75 8,133 1,219.95 9,352.95 16,119 2,417.85 18,536.85 20,135 3,020.25 23,155.25 20,135 3,020.25 23,155.25 20,135 3,020.25 23,155.25 65,516 9,827.40 75,343.40 114,653 17,197.95 131,850.95 229,306 34,395.90 263,701.90
76-90 9,787 1,468.05 11,255.05 19,060 2,859.00 21,919.00 24,205 3,630.75 27,835.75 24,205 3,630.75 27,835.75 24,205 3,630.75 27,835.75 78,760 11,814.00 90,574.00 137,831 20,674.65 158,505.65 275,662 41,349.30 317,011.30
91-120 13,788 2,068.20 15,856.20 26,989 4,048.35 31,037.35 34,272 5,140.80 39,412.80 34,272 5,140.80 39,412.80 34,272 5,140.80 39,412.80 No Cover No Cover No Cover
121-147 18,307 2,746.05 21,053.05 35,929 5,389.35 41,318.35 45,625 6,843.75 52,468.75 45,625 6,843.75 52,468.75 45,625 6,843.75 52,468.75 No Cover No Cover No Cover
148-180 24,245 3,636.75 27,881.75 47,705 7,155.75 54,860.75 60,577 9,086.55 69,663.55 60,577 9,086.55 69,663.55 60,577 9,086.55 69,663.55 No Cover No Cover No Cover

OMP-2012