Generated Narrative: InsurancePlan

ClaimSupportingInfoRequirement

url

category

value: Proof of identity (SupportingInfo Category#POI)

url

code

value: Adhaar number (Identifier Type Code#ADN)

ClaimSupportingInfoRequirement

url

category

value: Proof of address (SupportingInfo Category#POA)

url

code

value: Passport number (identifierType#PPN)

ClaimExclusion

url

category

value: Pre-existing disease in renal transplant (SNOMED CT#277011002)

url

statement

value: Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded untit the expiry of 48 months

ClaimExclusion

url

category

value: Specified disease ()

url

statement

value: Expenses related to the treatment of a listed conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us.

url

item

value: Operation for glaucoma (SNOMED CT#86077009)

identifier: id: 761234556546

status: active

type: Hospitalisation Indemnity Policy (InsurancePlan Type#01)

name: Active Assure Silver

period: 2023-09-10 --> 2024-09-10

ownedBy: Organization/example-02 "XYZ Insurance Co. Ltd."

administeredBy: Organization/example-02 "XYZ Insurance Co. Ltd."

coverage

ClaimCondition

url

claim-condition

value: The Hospitalization is medically necessary and follows the written advice of a Medical Practitioner

type: Inpatient care management (procedure) (SNOMED CT#737481003)

benefit

type: Intensive care unit (environment) (SNOMED CT#309904001)

benefit

type: Blood (SNOMED CT#87612001)

benefit

type: Oxygen (substance) (SNOMED CT#24099007)

coverage

type: Management of health status after discharge from hospital (procedure) (SNOMED CT#710967003)

benefit

ClaimCondition

url

claim-condition

value: Medical Expenses incurred up to 90 days after discharge from the hospital

type: Management of health status after discharge from hospital (procedure) (SNOMED CT#710967003)

Limits

-	Value
*	<=90 day

coverage

type: Pre-hospital care (situation) (SNOMED CT#409972000)

benefit

type: Pre-hospital care (situation) (SNOMED CT#409972000)

Limits

-	Value
*	<=60 day

coverage

ClaimCondition

url

claim-condition

value: We have accepted a claim for In-patient Hospitalization under Section C.I.(a) above for the same Illness/ Injur

type: Ambulance, device (physical object) (SNOMED CT#49122002)

Benefits

-	Extension	Type
*		Ambulance, device (physical object) (SNOMED CT#49122002)

coverage

ClaimCondition

url

claim-condition

value: The Medical Expenses are incurred, including for any procedure which requires a period of specialized observation or care after completion of the procedure undertaken by an Insured Person as Day Care Treatment

type: Day care case management (SNOMED CT#737850002)

Benefits

-	Type
*	Day care case management (SNOMED CT#737850002)

coverage

ClaimCondition

url

claim-condition

value: The donation conforms to The Transplantation of Human Organs Act 1994 and the organ is for the use of the Insured Person

type: Organ donor (SNOMED CT#105461009)

Benefits

-	Extension	Type
*		Organ donor (SNOMED CT#105461009)

plan

identifier: id: Active Assure Silver (use: OFFICIAL)

type: Individual (Plan Type#01)

generalCost

Costs

-	Value	Currency
*	200000	INR

specificCost

category: Ambulance, device (physical object) (SNOMED CT#49122002)

benefit

type: Ambulance, device (physical object) (SNOMED CT#49122002)

Costs

-	Type	Value
*	fullcoverage ([not stated]#fullcoverage)	2000 INR

specificCost

category: Single room (environment) (SNOMED CT#224663004)

benefit

type: Single room (environment) (SNOMED CT#224663004)

Costs

-	Type	Value
*	fullcoverage ([not stated]#fullcoverage)	2000 INR

specificCost

category: Intensive care unit (environment) (SNOMED CT#309904001)

benefit

type: Intensive care unit (environment) (SNOMED CT#309904001)

Costs

-	Type	Value
*	fullcoverage ([not stated]#fullcoverage)	4000 INR

specificCost

category: Home care of patient (SNOMED CT#60689008)

benefit

type: Home care of patient (SNOMED CT#60689008)

Costs

-	Type	Value
*	fullcoverage ([not stated]#fullcoverage)	20000 INR

plan

identifier: id: Active Assure Silver (use: OFFICIAL)

type: Individual (Plan Type#01)

generalCost

Costs

-	Value	Currency
*	700000	INR

specificCost

category: Ambulance, device (physical object) (SNOMED CT#49122002)

benefit

type: Ambulance, device (physical object) (SNOMED CT#49122002)

Costs

-	Type	Value
*	fullcoverage ([not stated]#fullcoverage)	2000 INR

specificCost

category: Single room (environment) (SNOMED CT#224663004)

benefit

type: Single room (environment) (SNOMED CT#224663004)

Costs

-	Type	Value
*	fullcoverage ([not stated]#fullcoverage)	7000 INR

specificCost

category: Intensive care unit (environment) (SNOMED CT#309904001)

benefit

type: Intensive care unit (environment) (SNOMED CT#309904001)

Costs

-	Type	Value
*	fullcoverage ([not stated]#fullcoverage)	14000 INR

specificCost

category: Home care of patient (SNOMED CT#60689008)

benefit

type: Home care of patient (SNOMED CT#60689008)

Costs

-	Type	Value
*	fullcoverage ([not stated]#fullcoverage)	70000 INR