Thursday April 02,2020

Critical Illness and Term Life Insurance Coverage FAQ

1. What are the Risks Coverage?

2. How much is the Insurance Amount?

  • Critical Illness Insurance Amount: NPR 300,000
  • Term Life Insurance Amount: NPR 75,000

3. Who will pay the Premium of Insurance?

The premium for the insurance under this scheme is borne by Bank.

4. Am I eligible for insurance?

  • All Nepali Individual Rupees Saving Account Holder of the Bank are eligible.
  • Saving Account Holder must be of 16 years to 64 years of Age on enrollment date.
  • Please see FAQ 5 & 6 for conditions on Saving Account Balance.

5. How can I avail this benefit if I don't have any Saving Account in the Bank?

  • This plan covers New Saving Account Holders who open saving account with the Bank after launch of this scheme/feature.
  • For first time coverage, such New Saving Account must have balance of NPR 25,000 or above as at Nepali month end in which the account is opened. Insurance coverage starts from Account Opening Date.
  • To continue coverage under this scheme after covered for first time, such account holders need to maintain NPR 25,000 or above balance in their saving account whole month of any Nepali month in future.

6. How can I avail this benefit if I already have a Saving Account in the Bank?

  • For first time coverage, all existing saving account holder having day end balance of NPR 25,000 on previous day of scheme/feature launch date are covered.
  • To continue coverage under this scheme after covered for first time, such account holders need to maintain NPR 25,000 or above balance in their saving account for whole month of any Nepali month in future.

7. Is Joint Saving Account Holder eligible for this benefit?

Joint account holders are not eligible for the Insurance coverage.

8. Will my family be covered under my Insurance coverage from my account?

No. For the same, you need to open separate saving account in the name of your family member and he/she needs to be eligible under this scheme.

9. What happens if my Saving Account Balance falls below NPR 25,000?

If any day end balance falls below NPR 25,000 in any month, you will not be insured for that Nepali month. You can re-enroll later on into this scheme AGAIN by maintaining NPR 25,000 or above balance in your Saving Account for whole month of any Nepali month.

10. What are the Critical Illness insured under this scheme?

The Critical Illness is a life threatening condition. The covered 13 Critical Illnesses under this plan are Major Cancers, Strokes, First Heart Attack, Serious Coronary Artery Disease, Heart Valve Surgery, Primary Pulmonary Hypertension, End Stage Lung Disease, End Stage Liver Failure, Fulminant Hepatitis, Kidney Failure, Coma, Aplastic Anemia, Major Organ/Bone Marrow Transplantation. For details Definition of Critical Illness.

11. What is Term Life Insurance?

The Term Life under this plan provides coverage at the event of the insured's death due to any cause either accident or sickness occurring anywhere in the world, except death resulting from active participation in war or warlike operations, suicide and other exclusions mentioned in Policy.
For details Summary of Insurance Coverage.

12. Will I be insured if I am already a patient of above Critical Illness?

Such Saving Account Holder are not eligible to be covered under this scheme.

13. What is Health Declaration Form?

All New Saving Account customer who opens Saving Account with the bank & willing to take insurance coverage under this scheme, needs to submit Health Declaration Form  along with Saving Account Opening Form.

14. What is Waiting Period?

The critical illness coverage for eligible new saving accountholders commences only after the 30 days from such account opening date i.e. during such period there should not be any symptom of critical illness to the account holder. This period is not applicable to existing saving account holder of the Bank mentioned in 6. above.

15. What are the documents required for Claim Processing?

Claim process & required documents are mentioned in Summary of Insurance Coverage.

a) Term Life Death Claim Form : Death Claim Form

b) Critical Illness (CI) Claim Form : Critical Illness Claim Form

c) Medical Practitioner Statement for CI : Physician Statement for Critical Illness

You can call our branch office for further assistance.

16. Where do I have to submit the documents related to my Claim?

You have to submit the required claim related documents to the nearest branch of the Bank. Bank shall initiate the claim processing with its Insurance Partner after receiving complete documents.

17. When will I receive payment If my claim is approved by Insurance Company?

Except for exceptional cases, claim payment shall be complete within 10-15 days of receipt of all required claim related documents.

18. How many times or for how many Critical illnesses, a claimant gets insurance payment?

Critical Illness coverage is for only one time in insured's life.

19. Will I continue to be eligible for Term Life Insurance once I get payment for Critical Illness claim?

Yes. Term Life insurance shall continue provided account holder continuously remains eligible under this scheme.

20. Who will get the claim amount in case of death of accountholder?

In case of death of insured accountholder, the insured amount under Term Life shall be paid in lump-sum to insured's beneficiary.

21. I was out of country for treatment of CI, it's been already more than 3 months, can I now claim for insurance?

The valid claims per the Critical Illness definition mentioned in Policy Definition of Critical Illness shall be honored if the claimant provides all documents with proof of diagnosis to the Insurance Company within one (1) year from the date of diagnosis of Critical Illness or loss of life.

22. While undergoing the treatment of Critical illness, insured accountholder dies before Critical Illness claim is made to bank. Can beneficiary apply now and how much will they get as claim amount?

If all the criteria are fulfilled, then Critical Illness Claim shall be paid if the illness is diagnosed before his/her death. In case of death of insured after the diagnosis, the insured amount of Term Life Insurance shall also be paid in lump-sum to insured’s beneficiary.

23. Are claims Taxable?

The claim for Critical Illness is subject to tax deduction of 5% of claim amount and there shall not any tax deduction for Term Life Insurance claim. The tax rate shall be subject to change as per provision of Government of Nepal.