Features
Family Hospitalization Coverage Limit Upto PKR 800,000
Additional 25% Hospitalization Coverage in case of Accident
Free PKR 100,000 accidental death coverage for account holder
Coverage of Daycare and Special Tests (MRI, CT Scan, Echo & Thallium Scan)
Pre-Existing Conditions Coverage*
*T&C Apply
Eligibility Criteria
Adult Ages: 18 – 70 years (For Self & Family**)
For Son: 2 Months onwards – 25 years
For Daughter: 2 Months onwards – Till Marriage
Maternity Eligibility: 18 – 45 years of age (Optional Rider)
Plan is only offered for Self with the option to extend coverage to family members including spouse or spouse & children.
Newborn children will be included in the plan through enrollment after 2 months
** T&C Apply
Coverage Details
The plan is offered in four distinct variants, allowing you to select a package that aligns with your preferences and needs. The coverage limit applies separately to each family member.
Hospitalization & Benefits |
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|---|---|---|---|---|
Plan Type/Variants |
Platinum |
Gold |
Silver |
Bronze |
| Coverage Per Person | ||||
H&R Limits (Per Person / Per Year) |
Rs.800,000 |
Rs.600,000 |
Rs.400,000 |
Rs.200,000 |
Room & Board (per day) |
Private |
Private |
Semi - Private |
General |
Additional Coverage (In case of hospitalization due to accident) |
200,000 |
150,000 |
100,000 |
50,000 |
Per & Post Hospitalization Sub Limit (Covering Consultation, Medicines, and lab tests ) |
30 Days |
30 Days |
30 Days |
30 Days |
Sublimit limit for Pre/Post Hospitalization Investigations, consultations and Medicines |
80,000 |
60,000 |
40,000 |
20,000 |
Intensive care Unit |
Actual |
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Special Investigations |
MRI, CT Scan Echo & Thallium Scan |
|||
Accidental death Benefit |
PKR. 100,000 |
|||
Pre-existing conditions covered |
1st year 25% of Annual Limit |
|||
Additional Benefitst |
Up to 30% off discount in selected Labs |
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Daycare Surgeries & Specialized Investigations in
Outpatient Settings Including but not limited to: |
COVERED |
COVERED |
COVERED |
COVERED |
Emergency Accidental Outpatient Expense Sub Limit (within 48 hours) |
80,000 |
60,000 |
40,000 |
20,000 |
Local Ambulance Cover (home to hospital and hospital to hospital) |
Covered |
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Maternity benefit optional coverage |
Rs. 50,000 for Normal delivery or Rs. 100,000 for Caesarean section |
|||
Emergency International Expenses |
Reimbursement only – in line with network hospital(benchmark) |
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Inadmissible conditions |
Cancer and HIV AIDS |
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Contribution Amount
Age Next Birthday |
Platinum |
Gold |
Silver |
Bronze |
|---|---|---|---|---|
2 month-17 years |
22,059 |
14,554 |
8,570 |
5,311 |
18 - 45 years |
13,248 |
12,955 |
9,136 |
5,992 |
46 - 59 years |
23,039 |
21,864 |
15,500 |
7,863 |
60-65 years |
44,577 |
31,935 |
24,833 |
15,500 |
66 - 70years |
60,316 |
43,056 |
33,359 |
20,615 |
Maternity (Optional Rider)
Contribution for Maternity Rider |
Platinum |
Gold |
Silver |
Bronze |
|---|---|---|---|---|
21,273 |
21,273 |
21,273 |
21,273 |
Claim Process
Network Hospital: Cashless
The covered member is not required to pay for covered treatments (up to the available limits) at network hospitals. They simply need to present their original health card at the admission office. The hospital will verify the validity and coverage scope of the health card from the Takaful Company. Approval will be granted according to the terms and conditions of the plan.
Please find the attached list of Network Hospitals at the link provided below
Non-Network Hospital: Reimbursement
In case of an emergency, if the covered member utilizes a non-network hospital for the covered treatment, the Participant must pay the Non-Network Hospital for the expenses incurred. They can submit their claims for reimbursement along with the supporting documents and other necessary details to Takaful Company. The Takaful Company will reimburse, on behalf of PTF, the reasonable and customary charges that would have been incurred at a comparable network for similar treatments up to the available annual limit. Claims need to be notified to Takaful Company immediately, and not later than 30 days, on below contact points:
EFU Life Assurance Ltd - Window Takaful Operations
Plot 112, 8th East Street, DHA Phase I, Karachi, Pakistan
Tel: 111-EFU-436 (111-338-436)
Call Centre: (021)111-HELP-00 (021-111-435-700)
Email: [email protected]
Website: https://www.efulife.com
Disclaimer
Faysal Bank Limited (” Bank”) is acting as a distributor of the EFU Takaful Health Plus on behalf of EFU Life Assurance Ltd – Window Takaful Operations (“Takaful Operator”), under the Banca takaful Corporate Agency Agreement and shall not be held responsible in any manner whatsoever to any person, including, but not limited to the Prospective Participant/ Participant Member or any third party. Any liability claim arising out of this EFU Takaful Health Plus shall be directly reported to EFU Life Assurance Ltd - Window Takaful Operations.
This product brochure only gives a general outline and introduction of the benefits available under the PMD. For exact terms and conditions, please refer to the PMD (“Participation Membership Document”).
Membership will be underwritten and issued by EFU Life Assurance Ltd - Window Takaful Operations, Faysal Bank Limited is acting as a distributor under the Banca takaful Corporate Agency Agreement.
The Participants application form / recorded verbal statement will act as his /her consent for enrollment under the program (if his/her account is charged under the program) and will govern the determination of the rightful beneficiary under this Takaful Coverage.
It is clarified that the Bank shall not, under any circumstances, be liable either directly or indirectly for any obligation of the Takaful Operator as the Takaful Provider.
Further, the Bank shall not be construed or deemed in any manner to be the agent or broker of the Takaful Operator in respect of any other PMD.
In addition, the Bank shall not be either directly or indirectly liable for any obligation of the Covered Participants towards Takaful Operator in respect of the business or any membership offered to the Participant Members. These memberships shall constitute as independent contracts between EFU Life - Window Takaful Operations Ltd and the Covered Participants.
For any service-related complaints, you may contact FBL Contact Centre at (021) 111 06 06 06, contact any FBL Branch or email at [email protected]
If you have any grievance regarding your Health Takaful Membership, you may contact EFU Life - Window Takaful Operations on (021) 111-338-436 or [email protected].
Frequently Asked Questions (FAQ's)
The Membership pays for expenses incurred on hospitalization due to Accident and Sickness. The maximum amount equal to the annual limit is payable to each individual covered member in case of hospitalization. The covered expenses include:
- Room & Board Charges
- Nursing Care during Hospitalization
- ICU & Operation Theatre Charges
- Physician, Surgeon & Anesthetists Fees
- Diagnosis, Treatment & Medicine Expenses during Hospitalization
- Oxygen & Blood Supplies
The Membership also covers cost of consultation fee, prescribed medicines and lab tests which, within thirty (30) days, leads to hospitalization that is covered under the Membership.
The Membership also covers cost of consultation fee, prescribed medicines and lab tests which results within thirty (30) days as a consequence of covered hospitalization.
Free Look-in Period is a 14 Day’s grace time after receiving the membership documents during which you can understand the terms and conditions of the Plan and evaluate your eligibility to continue the takaful coverage. You may apply for cancellation within the 14 day’s Free Look in Period, upon which your contribution amount will be fully refunded, provided no claim is made during the course of the Plan.
With our plan, you enjoy 25% coverage in the first year, 50% in the second year, and full 100% from the third year onward. Please note, any pre-existing conditions—such as previous illnesses or injuries known before the membership starts—should be disclosed at the time of enrollment.