July 14, 2023

Mr Safder
Deltacom
Karachi.

Allianz EFU Health Care Solution for Deltacom

Dear Mr. Safder ,

Allianz EFU highly appreciates Deltacom's interest in its products and services. We are convinced that Allianz
EFU can offer you a healthcare solution that provides 'peace of mind' not only to your employees but also to
Deltacom.

We are pleased to submit our comprehensive proposal for your perusal. The proposal contains the following
products and features to provide comprehensive health insurance coverage to your employees / dependents:

• Hospital Care with free pre & post hospitalization OP coverage

• No sub-limit for surgeries
• No limit on number of days of hospitalization
• Credit facilities at large number of network (panel) hospitals.
• Customer Services Hotline and 24-Hours Medical Hotline managed by competent staff and qualified doctors.
• Convenience of Health Card for each employee.
• Employee booklet containing Membership Benefits and Guidelines for each employee

We are confident that the above features will assist you in choosing Allianz EFU as your healthcare provider--a
decision which will positively impact the health of your employees in years to come.
Kindly give us an opportunity to answer any of your queries or if you wish to set up a meeting please feel free to
contact the undersigned at Tel: 021-34550995-98 or email at waqas.khan@allianz-efu.com.

We thank you and look forward to a pleasant and mutually beneficial business relationship.

Yours truly,

Waqas Khan
Assistant Manager - Corporate Sales
 ALLIANZ EFU HEALTH INSURANCE LIMITED

COMPANY PROFILE

Allianz EFU Health Insurance Limited is the first specialized health insurer in Pakistan. It was incorporated on May 15, 2000 as a
joint venture between EFU Group and Allianz SE of Germany.

Allianz Group
Allianz Group has presence in over 70 countries worldwide and is one of the largest composite insurance companies in the
world. The group operates life, health and general insurance businesses and also specializes in asset management. The gross
revenue of the group for the year 2021 was over € 148 billion with total assets under management of over € 2.6 trillion.

EFU Group
Besides Allianz-EFU, the EFU Group comprises of EFU General Insurance Limited and EFU Life Assurance Company Limited.
The gross premium revenue (including Takaful contributions) of EFU Group was over Pak Rs. 64 billion in 2021.

Industry Ranking
Allianz EFU is one of the major market players in the Health Insurance Industry based on Gross Annual Premium Revenue,
Number of Clients and Insured Lives. Allianz EFU is the first insurance company to offer comprehensive health insurance
products to individuals through bancassurance channel.
null
Allianz EFU received Consumer Choice Award for the year 2021 in the "Best Health Insurance Provider" category.

ISO Certification
Allianz EFU has achieved ISO 9001:2015 certification from United Registrar of Systems (URS), which is recognition of the
Company's Quality Management System.

Professional Management
Allianz EFU is headed by a team of professionals with extensive experience of insurance industry in Pakistan, United Kingdom
and other parts of the world. This has helped the Company in establishing a professional culture which is unique amongst the
insurance business in Pakistan.

Human Resource
The main strength of the company lies in its dedicated and skilled human capital. Allianz EFU has employed a team of 15
qualified medical doctors. The company also employs over 175 suitably skilled professionals in other areas of operations
including actuarial, marketing, sales, IT, underwriting, claims and customer relationship management.

Operations Philosophy
The company has defined its operations with a focus on customer satisfaction, efficient risk management and product
innovation. Some of the key indicators of the company's operational excellence are:

. Simplified policy issuance procedure

. Individual Health Card for each family to facilitate fast and easy access to medical facilities at network hospitals
. Credit facility at all network hospitals
. Three 24 hour medical hotlines managed by qualified staff doctors
. Preferred provider network of over 200 hospitals spread across the country
. Supervision of medical care with the help of qualified medical doctors of the company.

Performance Benchmarks
Some of the current benchmarks of the company include, but are not limited to, issuance of initial set of health cards within 10
working days of the confirmation and payment, settlement of claims within 15 working days after receiving the complete claim
documents and issuance of health cards for any new entrant within 5 working days.
24 Hours Medical Hotline
In case of a medical emergency, our team of qualified medical doctors is accessible, as a friendly and knowledgeable resource, 24
hours a day through our medical hotlines.

Dedicated Customer Service Hotline

The company has established a specialized Call Center that ensures timely response to all customer enquiries. The Call Center is
available during office hours. The company also has a dedicated customer service hotline, available after office hours, to cater to
the needs of the customers.

Preferred Provider Network

Allianz EFU has developed close business relationships with a network of medical service providers. Today, the company
enjoys strong professional association with a network of over 260 carefully selected hospitals spread throughout the country.

Supervised Care
In cases involving hospitalization at our network hospital, one of our doctors regularly visits the patient to ensure that the
patient is getting appropriate treatment at the hospital.

IT Infrastructure and MIS

Allianz EFU has developed and implemented an Enterprise Resource Planning (ERP) system. All the development work for this
system has been done in-house by the company's highly skilled team of IT professionals.

This specialized in-house system has provided the Company with a unique edge over its competitors. The Company is now
maintaining a comprehensive health database which is one of a kind in Pakistan. This also provides the Company an
opportunity to quickly price various innovative health benefits.

Clientele
Allianz EFU clientele includes reputable organizations from various sectors of the economy including Banks, Multinational
Companies, Pharmaceuticals, Telecommunication, Media, Educational Institutions & Public sector organizations etc.

Website
Allianz EFU maintains an informative and comprehensive website www.allianzefu.com which provides information about the
Company, its products, and new developments.
 Option 1

Health Insurance Proposal for Deltacom

NUMBER OF INSURED MEMBERS

Plans--> A Total
Number of Employees 16 16
Total 16 16

STRUCTURE OF MEDICAL BENEFITS

Plans-> A
Benefits | PKR
HOSPITAL CARE:
. Total Hospitalization Limit Per Annum Per Insured --> 400,000
Daily Room And Board Sublimit * --> 12,000
. Pre-Hospitalization Diagonostic Tests, Consultations and Medicines up to 30 days
before Hospital Confinement
. Post-Hospitalization Diagonostic Tests, Consultations and Medicines up to 30 days
after Hospital Confinement
. Day Care Surgeries/ Procedures (e.g. Endoscopy, Angiography, Dialysis etc.)
. Specialized Investigations (MRI, CT Scan, PET Scan, Thallium Scan, EEG, EMG,
ETT, Echocardiography/Stress Echo, Mammography, OCT, FFA, Bone Scan, Renal COVERED
Scan, Thyroid Scan, All Type Of Biopsies)
. Treatment of Fractures & Lacerated wounds
. Local Road Ambulance for Emergencies only
. Emergency Dental treatment in case of Accidental Injuries (within 48 hours for
pain relief only)
*An insured will only be entitled to obtain services at AKUH, OMI, South City Hospital, Doctors Hospital, Hameed Latif Hospital and
Shifa International Hospital, if the room limit entitlement of the insured is at least equal to the General Ward room rent applicable
at these respective hospitals

Premium Cost For 16 Employees (Total 16 Lives)

TYPE OF BENEFIT PREMIUM (PKR)
Hospital Care 119,656
Gross Premium before taxes 119,656
Admin Surcharge 2,000
1% FIF 1,217
Stamp Duty 50
Total Annual Premium** 122,923
** Any provincial sales tax on insurance applicable is not included in this proposal / Premium bill, it will be invoiced
separately.
The annual Premium is subject to change if there is any change in the tax rate/tax structure by the Federal or
Provincial Government affecting the taxes applicable during the currency of the policy.
 Deltacom
TERMS AND CONDITIONS

1. All employees are required to complete Family Health Questionnaires (FHQ).

2. Coverage for employees shall be available up to the age of 60 years.
3. Pre-existing conditions (disclosed or undisclosed) shall not be covered under Hospital Care benefit.
4. Coverage to members over 60 years of age is not available under Hospital Care benefit.
5. The annual premium is subject to change if there are any changes in the tax rate / tax structure by the Federal
and/or Provincial Government.
6 . Congenital birth defects shall be covered for all insured members under Hospital Care benefit.
7 . Medicines, consultations and investigations related to Hepatitis B & C shall be covered from Hospital Care benefit.

8 . 100% increase in Hospital Care limit incase of accidental injuries within the same policy year.
9 . Medical emergencies on reimbursement basis shall be covered subject to a sub-limit of 25% of hospitalization limit.

10 . Only Employees are covered under this policy.

Pre-existing Conditions Definition:

Pre-existing medical condition Under this health insurance coverage shall mean any sickness, illness, disease,
injury, symptom, co-morbid condition or the underlying cause, condition, sickness, illness, disease, injury or risk
factors of an illness or any disease that causes another illness due to direct or indirect impact, has been known, was
treated, is under treatment, any treatment required or has been investigated even if no medical advice or diagnosis
or treatment was sought, prior to applying for insurance.

Payment Terms:
The premium is due in advance annually.

Commencement Of Insurance Coverage:

The health insurance coverage will start after receipt of the premium payment.

Issuance Of Health Cards:

Health cards will be issued within ten (10) working days after receipt of ALL completed Family Health
Questionnaires (FHQ).

Credit Facilities At The Network Hospitals:

Credit facilities at network hospitals can be extended to the insured members only after issuance of health cards. If
an insured member requires hospitalization prior to issuance of health cards, he will have to incur the expense out-
of-pocket and then claim reimbursement as per policy terms.

Network Of Hospitals:
The existing network of Hospitals is provided with the proposal. While we continue to upgrade and expand the
network, we may not agree to add a specific hospital.

Premium Bill:
Detailed premium bill indicating the premium amounts for each insured member can only be provided once all the
Family Health Questionnaires are submitted and health cards issued. Premium Adjustment Bills for Enrollee
Movement (addition, deletion, plan upgrade of insured members etc.) will be provided quarterly.

Validity:
This proposal is valid for two (2) months from the date of issue.
 SUMMARY OF BENEFITS

HOSPITAL CARE :

This product covers eligible reasonable and customary medical expenses incurred up to the
specified limit while an insured member is hospitalized due to illness, surgery or accident. Eligible
medical expenses during hospital stay include:

• Daily room and board charges

• Intensive Care Unit (ICU) charges
• Operation theatre charges
• Surgeon's fee
• Anaesthetist's fee
• Physician's / Consultant's fees during hospitalization
• Diagnostic tests and Medicine expenses during hospitalization
• Blood and Oxygen supplies
• Day Care Surgeries/ Procedures such as Cataract, Endoscopy, Angiography, Dialysis,
Chemotherapy etc.
• Specialized Investigations (MRI, CT Scan, PET Scan, Thallium Scan)
• Traumatic injuries such as fractures and lacerated wounds
• Emergency Dental Treatment due to accidental injuries (within 48 hours for pain relief only)
• Accidental Emergency Treatment (within 48 hours)
• Miscellaneous charges (patients meals, local road ambulance charges, etc.)

In addition, following pre and post hospitalization expenses incurred outside the hospital are also
covered:

- The cost of consultation fee, prescribed medicines and lab tests conducted within thirty (30)
days before a subsequent related hospitalization which is covered and payable under the
policy. This benefit is payable on reimbursement.

- The cost of consultation fee, prescribed medicines and lab tests which result within thirty (30)
days and as a consequence of a covered hospitalization. This benefit is payable on
reimbursement.
 HOW TO AVAIL BENEFITS - INPATIENT

Credit Facility at Network Hospital:

Planned Hospitalization at a Network Hospital:

In case an insured member needs to be hospitalized for a planned treatment or surgery, he can avail the
credit facility at a Network Hospital by following a simple pre-authorization procedure. The insured member
will have to send the Pre-authorization Form filled and signed by the treating physician to Allianz EFU three
working days prior to the admission for approval.

Approval will be given if the treatment is covered as per the policy terms and conditions.

Once approval is given the insured member will have to report to the hospital on the day of admission and
show his health card and photo ID. The insured member will be hospitalized and the Network hospital will
give all the necessary treatment. The insured member does not need to pay for the covered treatment. Allianz
EFU will make payment directly to the hospital.

Emergency Hospitalization at a Network Hospital:

In case of an emergency if an insured member goes to a network hospital and is advised admission he will be
required to present his health card. The hospital will check the validity of health card and admit the patient
for treatment.

The hospital will itself notify Allianz EFU of the hospitalization within 24 hours and approval will be given
as per policy terms and conditions.

The insured member does not need to pay for the covered treatment. Allianz EFU will make payment
directly to the hospital.

Note: In case of visiting consultants Allianz EFU will pay as per agreed rates and additional charges shall be paid by
the insured member.

Claim Reimbursement - in case of Non-Network Hospital

In case an insured member utilizes a non-network hospital for a covered treatment, he can submit his claim
for reimbursement through a claim form along with the supporting documents within 30 days of the expense
incurred date or hospital discharge date. Following documents need to be submitted for claim
reimbursement:

• Completely filled claim form

• Original hospital itemized bill
• Clinical Summary/ Discharge Card
• All prescriptions for medicines used during hospitalization
• Original Receipts of medicines received
• Laboratory reports with payment receipts
• Provisional Birth Certificate (issued by the hospital) in case of child birth

Once complete documents are received, Allianz EFU will reimburse the eligible claim within 15 working
days. Allianz EFU reserves the right to evaluate these claims for coverage and reimburse the claim up to the
comparable charges at its network hospital.
 EXCLUSIONS
The following treatments, events, conditions, activities and their related or consequential expenses are excluded from the
policy, unless specifically agreed and mentioned under terms and conditions attached with this proposal:

1. Any expenses directly or indirectly incurred for the treatment of any Pre-existing Medical Conditions, except if covered
by the Company in writing.
2. Any charges in respect of the donor for organ transplant Claims.
3. Services or Treatment in any spa, hydro clinic, sanatorium, nursing home or long term-care facility that is not a Hospital.
4. Routine medical examinations or check-ups including charges arising out of any Hospital confinement or admission
primarily for diagnostic purposes unless specifically authorised by the Company, routine eye or ear examinations,
vaccinations, medical certificates, examination for employment or travel, spectacles, contact lenses, hearing aids. Cost of
correction of refractive errors of the eye and procedures such as Radial Keratotomy and Excimer Laser and any treatment
not considered medically necessary.
5. Dental treatment except if necessitated due to accident for pain relief only within 24 to 48 hours of an accident.
6. Any Outpatient Treatment other than as a result of an accident and within forty eight (48) hours of an accident.
7. In Cataract Surgeries cost of IOL shall be covered for normal foldable lens up to the maximum amount of Rs. 40,000. All
other lenses including IQ Lens/ Restore Lens shall not be covered.
8. Cosmetic or plastic surgery, unless it is re-constructive surgery necessitated by an Injury.
9. Pregnancy and complications thereof, childbirth (including surgical delivery), miscarriage, abortion and/or any related
prenatal or postnatal care unless an optional Maternity benefit is selected.
10 . Tests or Treatment relating to fertility, infertility, contraception or sterilisation.
11 . Birth defects or congenital Illness.
12 . Prostheses, corrective devices and medical appliances which are not surgically required.
13 . Psychotic, mental or nervous disorders (including any neuroses and their physiological or psychosomatic
manifestations) or sexual reassignment (whether or not for psychological reasons).
14 . Experimental Treatment and Treatment not approved by FDA - USA.
15 . Self-inflicted Injury, attempted suicide, abuse of alcohol or drug addiction.
16 . Participation in or training for any dangerous or hazardous sport, pastime or competition or riding or driving in any
form of race or competition or any professional sport.
17 . Aviation other than as a fare-paying passenger of a recognized airline or charter service.
18 . Treatment received outside Pakistan, except in case of an Emergency and provided the treatment is otherwise covered
under the policy and does not fall under any of the exclusions. The Company will reimburse such expenses in line with
the treatment cost incurred at any Network Hospital in Pakistan, subject to availability of limit.

19 . Injury or Treatment resulting from war, riots, invasion, act of foreign enemies, hostilities or warlike operations (whether
war be declared or not), civil war, mutiny, civil commotion assuming the proportions of or amounting to a popular
uprising, military uprising, insurrection, rebellion, military or usurped power or any act of any person acting on or on
behalf of or in connection with any organization actively directed towards the overthrow or to the influencing of any
government or ruling body by force, terrorism or violence.
20 . Injuries as a result of an illegal act other than a minor misdemeanour or minor delinquency by the Insured Member.
21 . Ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear waste, from the process of nuclear
fission or from any nuclear weapons material.
22 . Any increase in the expenses incurred for Treatment on account of the Insured Member being admitted to a more
expensive room than allowed by his Daily Room and Board Limit.
23 . The cost of non-medically necessary goods or services including such items as telephone, television, newspapers or
accomodation for the insured person's family members.
24 . Weight management services and treatment related to weight reduction programs including treatment of obesity.
25 . Natural catastrophes, epidemic, including, but not limited to, flood, earthquake, avalanche and cyclone.
26 . Any Disability directly or indirectly related to or resulting from HIV, AIDS or any other sexually transmitted disease.
27 . Air ambulance or evacuation or repatriation expenses.

The above details provide general outline of the product. The actual terms and conditions are given in the Policy Document.