8/9/2019 Wellsurance Executive Tariff Chart

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WELLSURANCE - EXECUTIVE

Benefits Classic Supreme Elite

1Diagnosed Critical Illness ( waiting period 90 days, survival

period 30 days)i> Cancer 300000 500000 750000

ii> First eart !ttac" 300000 500000 750000

iii> #tro"e 300000 500000 750000

iv> $idney Failure 300000 500000 750000

v> Co%a 300000 500000 750000

vi> &otal 'lindness 300000 500000 750000

vii> aralysis 300000 500000 750000

viii> ultiple #clerosis 300000 500000 750000

i*> a+or 'urns 300000 500000 750000

2 Hospitalisation:

a Hospitalisation Miscellaneous

ursing services - a* upto 90 days 750 .000 ./50

ysician1s visit - a* upto 90 days 750 .000 ./50Investigation- 2I /500 3500 3500

Investigation- C& scan or Doppler study ./50 .750 .750

ysioterapy( wile ospital conined) %a* upto 30 days 750 .000 ./50

Investigation- la4 test, and or *-ray and or C6 350 500 750

4 Operation charges

!nestetists ees /500 5000 7500

c Major surgeries

. C!'6- coronary artery 4ypass grating .00000 .50000 /00000

/ !ngioplasty -&C!( percutaniuos translu%inal coronery angiop .00000 .50000 /00000

3 'rain surgery including Cranioto%y, tu%or re%oval and interc .00000 .50000 /00000

8 ost trau%atic surgery ( s"ull racture, pelvis racture, co%plic 50000 75000 .00000

  #"ull racture

  &rau%atic a%putation o upper and or lower li%4  elvis ip Fracture

  Co%pound co%%unicated racture o any part were :2IF is re;uired

5 'one %arrow transplant .00000 .50000 /00000

< a+or organ transplant ( eart, =ung, =iver, ancreas .00000 .50000 /00000

7 $nee replace%ent 75000 ./5000 .50000

  &rau%atic septic artritis

  #evere irrepara4le "nee in+ury

ip replace%ent 75000 .00000 .50000

  &rau%atic ip in+ury- 4ot partial and total

9 #pinal surgeries 80000 75000 .00000

  &rau%atic spinal in+uries

.0 nucleation 80000

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Minor Surgeries

. !ppendecto%y .0000 .0000 .5000

/ Colecystecto%y 2e%oval o 6all #tone .5000 /0000 /0000

3 2e%oval o "idney stones .0000 .0000 .5000

8 ernia repair .5000 /0000 /0000

5 ae%orroids .0000 .0000 .5000

< 'iopsy o growt .5000 /0000 /0000

$ :utpatient

ost operative ysioterapy eligi4ility in / visits 3500 5000 7000Ce%oterapy andor radiation eligi4ility in 3 visits .50000 /50000 300000

$idney Dialysis .50000 /00000 /50000

% !%4ulance Carges

wile ad%itting and wile discarging ro% te ospital /000 /000 /000

& ospital Cas ( a* 90 days ) !'er (a)# /000 3000 8000

* IC? 'eneit - a* .5 days per policy year !'er (a)# 3000 8500

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Classic Supreme Elite Classic Supreme Elite

18 - 24 2086 3341 4145 18 - 24 190 304 377

25 - 29 2499 4022 4922 25 - 29 227 366 447

30 - 34 3249 5254 6624 30 - 34 295 478 602

35 - 39 4569 7447 9195 35 - 39 415 677 836

40 - 44 7080 11642 14518 40 - 44 644 1058 1320

45 - 49 8413 13815 17473 45 - 49 765 1256 1588

50 - 54 11734 19282 24858 50 - 54 1067 1753 2260

55 - 59 15281 25312 31644 55 - 59 1389 2301 2877

60 - 65 24450 40499 50630 60 - 65 2223 3682 4603

66 - 70 36675 60748 75945 66 - 70 3334 5523 6904

71 - 75 55013 91122 113917 71 - 75 5001 8284 10356

76 - 80 82519 136683 170875 76 - 80 7502 12426 15534

Classic Supreme Elite Classic Supreme Elite

18 - 24 2,343  3,754  4,658  18 - 24 213  341  423 

25 - 29 2,808  4,519  5,531  25 - 29 255  411  503 

30 - 34 3,650  5,903  7,443  30 - 34 332  537  677 

35 - 39 5,134  8,367  10,331  35 - 39 467  761  939 

40 - 44 7,955  13,081  16,312  40 - 44 723  1,189  1,483 

45 - 49 9,453  15,522  19,632  45 - 49 859  1,411  1,785 

50 - 54 13,184  21,665  27,930  50 - 54 1,199  1,970  2,539 

55 - 59 17,170  28,440  35,555  55 - 59 1,561  2,585  3,232 

60 - 65 27,472  45,504  56,888  60 - 65 2,497  4,137  5,172 

66 - 70 41,208  68,256  85,331  66 - 70 3,746  6,205  7,757 

71 - 75 61,812  1,02,384  1,27,997  71 - 75 5,619  9,308  11,636 

76 - 80 92,718  1,53,577  1,91,996  76 - 80 8,429  13,962  17,454 

81-90 1,85,437  3,07,153  3,83,991  81-90 16,858  27,923  34,908 

>90 2,31,796  3,83,942  4,79,989  >90 21,072  34,904  43,635 

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