Life is meant to have its’ ups and downs, but having someone to be your strength can make the journey more comforting. When you choose the Industry’s Best Personal Health Insurance Cover from Fairfirst, you give your loved ones the power to face any health contingency, with true peace of mind.
Easing your burden is only the first step. We go the extra mile,just how you would, for your family.
With six comprehensive plans ranging from Rs.100,000 to Rs. 1 Million, we have made it easier to make your well-being a priority, with added benefits and true peace of mind.
| Scheme A(Rs.) | Scheme B(Rs.) | Scheme C(Rs.) | Scheme D(Rs.) | Scheme E(Rs.) | Scheme F(Rs.) | |
|---|---|---|---|---|---|---|
| A)Hospitalisation Benefit | ||||||
| A.1. Annual/event limit | 100,000 | 150,000 | 200,000 | 300,000 | 500,000 | 1,000,000 |
| A.2. Maximum room charges per day | 5,000 | 6,000 | 7,000 | 8,000 | 10,000 | 12,500 |
| A.3. Intensive care uni | Up to the limit | Up to the limit | Up to the limit | Up to the limit | Up to the limit | Up to the limit |
| A.4. Hospital and nursing home maintenance charges including admission fees. Hospital or nursing home maintenance, medical and operational expenses for special treatment and nursing provided on the recommendation of a consulting specialist and for the use of the operating theatre |
60,000 | 90,000 | 120,000 | 180,000 | 300,000 | 600,000 |
| A.5. Surgeon’s and anaesthetist’s fees, consultant’s and specialist’s fees. Specialist services including deep therapy treatment, x-rays, radiological and radium examination and treatment, electrical treatment and physiotherapy | 30,000 | 45,000 | 60,000 | 90,000 | 150,000 | 300,000 |
| A.6. Expenses incurred for travel within Sri Lanka to obtain emergency treatment (ambulance charges only) | 1,500 | 2,000 | 2,500 | 3,000 | 5,000 | 7,000 |
| A.7. Hospitalisation in a non-paying ward of a government hospital for the first 21 days (per day)- payable under indoor limit | 2,000 | 2,000 | 2,000 | 2,000 | 5,000 | 7,000 |
| A.8. Expenses incurred on drugs purchased & tests,scans and x-rays etc. undergone whilst being an inpatient in a non-paying ward (treatment is not available in a government hospital and payable under indoor limit) | 25,000 | 37,500 | 50,000 | 75,000 | 125,000 | 250,000 |
| A.9. Pre-hospitalisation expenses up to a maximum of 30 days and up to 5% of the basic sum assured | 5,000 | 7,500 | 10,000 | 15,000 | 25,000 | 50,000 |
| A.10. Post-hospitalisation expenses up to a maximum of 30 days and up to 5% of the basic sum assured | 5,000 | 7,500 | 10,000 | 15,000 | 25,000 | 50,000 |
| A.11. Birth of twins | 10,000 | 10,000 | 10,500 | 10,000 | 10,000 | 10,000 |
| A.12. Cover of day care surgeries | 10,000 | 15,000 | 30,000 | 45,000 | 75,000 | 150,000 |
| B) Out-Patient Benefit | ||||||
| B.1. Specialist consultation fees, medical expenses incurred therein and routine medical expenses including consultation fees, purchase of drugs and laboratory tests including eye treatment and dental treatment (filling & extraction only),emergency treatment unit charges | 2,000 | 2,500 | 3,500 | 5,000 | 7,000 | 15,000 |
| C)Additional OPD Limit | ||||||
| C. Additional OPD Limit | 5,000 | 5,000 | 5,000 | 5,000 | 5,000 | 5,000 |
| C.1. Additional premium excluding taxes | 3,000 | 3,000 | 3,000 | 3,000 | 3,000 | 3,000 |
| D)Optional Critical Illness Cover | ||||||
| D. Optional Critical Illness Cover | 250,000 | 500,000 | 750,000 | 1,000,000 | 1,250,000 | 1,500,000 |
| D.1. Additional premium for optional critical illness cover | 10,000 | 25,000 | 50,000 | 75,000 | 100,000 | 125,000 |
If any or more of the following events take place, we are not liable to pay expenses that arises directly or indirectly.
Pre-existing conditions.
Any treatment not performed by a Physician/Surgeon, registered with the Medical Council of Sri Lanka or any treatment performed purely on an experimental nature.
Hospitalisation due to illness/surgery within the first 30 days from the date of cover.
Self-afflicted injuries or conditions (including attempted suicide) and/or conditions/ailments arising out of the use or misuse of any drugs or alcohol.
Medical expenses relating to any hospitalisation primarily for diagnostic, x-ray or laboratory examinations.
Participation in any hazardous activity or sports including but not limited to racing, scuba diving, aerial sports, bungee jumping and mountaineering or any criminal or illegal activities.
Hospitalisation/Surgery for correction of birth defects or congenital anomalies.
Non-allopathic methods of surgery and treatment.
There should be an active line of treatment taken place during the hospital stay. Investigatory purpose admissions are not allowed.
Treatment of mental disease/illness, stress, psychiatric or psychological disorders, sleep, snoring disorders, sleep studies.
Eye laser treatment.
Six (06) months waiting period for below classified surgeries.
The waiting period for specified diseases/ailments/conditions: from the time of inception of the policy will not cover the following conditions for a duration of six months. After six months, any claim shall be payable after six months, provided the policy has been continuously renewed with the company without any break.
i. All internal and external benign tumours, cysts, polyps of any kind, including benign breast lumps
ii. Benign ear, nose including DNS, throat disorders.
iii. Benign prostate hypertrophy
iv. Cataract & age-related eye ailment
v. Gastritis/ duodenal ulcer
vi. Hernia of all types
vii. Hydrocele
viii. Hysterectomy, prolapsed uterus, dysfunctional uterine bleeding / dilatation and curettage
ix. Polycystic ovarian diseases
x. Piles /hemorrhoids’ fissure and fistula in anus
xi. Pilonidal sinus, sinusitis and related disorders
xii. Prolapsed inter vertebral disc unless arising from accident stone in gall bladder & bile duct.
xiii. Stones in urinary systems / dialysis for renal failure
xiv. Varicose veins and varicose ulcers
xv. Age related osteoarthritis & osteoporosis
xvi. Joint replacements due to degenerative conditions
xvii. Joint replacements due to degenerative conditions
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