SCHEDULE OF BENEFITS

EKIUM AMIO LTD

INSURANCE COMPANY SWAN
Renewal Terms - 2022/2023
COVERS
with Covid-19 Extension
1. IN-PATIENT COVER (Subject to Scale of Costs) Limit per illness/accident

Option 1 Option 2
Medical Treatment and Surgical Operation
50,000 125,000
Obstetric Care
Normal & Ceasarean delivery 50,000 75,000
Cash Benefit (delivery in Public Hospital) 25,000 30,000

Road Ambulance 20,000 25,000

Assisted Reproduction (Lifetime Limit) 50,000 75,000

Congenital Operation (Lifetime Limit) 50,000 100,000
Psychological Trauma 15,000 25,000

Funeral Benefit 15,000 20,000

Excess Nil

Monthly Premium per person Rs.

Adult
1,110 1,560
Child

2. OUT-PATIENT COVER
10,000 15,000 20,000 25,000 30,000 35,000 50,000
Overall Annual Limit subject to the following maxima:-
Medical Expenses 10,000 15,000 20,000 25,000 30,000 35,000 50,000
Dentistry 5,000 7,500 10,000 12,500 15,000 17,500 25,000
Optical Costs (Every 2 years) 2,000 3,000 4,000 5,000 6,000 7,000 10,000
Pre-Natal Expenses 1,000 1,500 2,000 2,500 3,000 3,500 5,000
Artificial Aids (Lifetime Limit) 10,000 15,000 20,000 25,000 30,000 35,000 50,000
Psychological Trauma 1,000 1,500 2,000 2,500 3,000 3,500 5,000

Excess 20% with a min of Rs 250.-

Monthly Premium per person Rs.

Adult
470 570 655 775 1,015 1,145 1,355
Child

3. CATASTROPHE COVER Excess Excess

Monthly Premium per person Rs 50,000 Rs 125,000
Limit - Rs. 500,000
Adult
410 N/A
Child
Limit - Rs. 1,000,000
Adult
530 N/A
Child
Limit - Rs. 2,000,000
Adult
660 605
Child
Limit - Rs. 3,000,000
Adult
890 825
Child
Limit - Rs. 5,000,000
Adult
N/A 1,395
Child
Limit - Rs. 10,000,000
Adult
2,645 2,825
Child