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Health Care
01.
Why should I get a Health Insurance Contract?
Health Insurance became compulsory according to the New Insurance Regulation in Saudi Arabia set by The Council of Cooperative Health Insurance (CCHI). Therefore, you will not be able to renew your Iqama unless & until you have a valid Insurance Contract with a Licensed Insurance Company.
02.
What benefit will I get if I have a Health Insurance Policy?
If you have a valid Health Insurance Policy you will not face any problem in dealing with "Jawazat" Department. Moreover, considering the high cost of medical treatment in Saudi Arabia it's very risky to stay without Health Insurance Cover. Therefore, it is better for you to have a Health Insurance Contract so that the Insurance Company will carry the risk on your behalf.
03.
What is the maximum limit the insurance policy will cover?
According to the Saudi Insurance Law, The Maximum Indemnity Limit is SR.250,000 Per Person Per Annum.
04.
Do I have to apply for medical check up before having my insurance Policy?
If you're below the age of 65, all you have to do is to fill the Health Insurance Application Form. But if you are above 65 years of age you are required to fill a medical questionnaire form and have to go for medical check up for our evaluation before issuing your insurance policy.
05.
Can I insure a part of my family and leave the other part un-insured?
No, you can insure the whole family but not a part of it. Moreover, the family insurance requires an individual questionnaire to be filled by each member of your family provided that you should clearly mention all information related to the current or pre-existing and chronic conditions for each member of your family.
06.
When I was filling the medical questionnaire, I forgot to write that I had an accident two years ago and my leg was broken and had a surgery. Is it considered as false declaration?
Yes, if you hide any information about your pre-existing and/or chronic conditions, this will be considered as false declaration. Therefore, you are advised to carefully fill the questionnaire whenever it's required and don't hide any information even if you consider it as minor information.
07.
If I'm insured within a group policy which does not cover maternity. Can I get maternity coverage only for my wife?
No. To get maternity coverage for your wife your company's policy should cover maternity for all spouses in the policy otherwise your wife will not be covered for maternity.
08.
I recently joined a new company which has an insurance policy with you and this policy is including maternity coverage. My wife is pregnant and I'm diabetic. Is there any waiting period to cover maternity for my wife and my pre-existing diabetic?
No. According to the Saudi Insurance Law there is no waiting period to cover maternity or any pre-existing conditions.
09.
My wife is pregnant and she's going to have a baby soon. When I can get the baby covered under the policy?
You can get the baby covered from day one of his birth provided that your wife is covered under the same policy and notification of the new born baby is sent to us to add him/her to the policy. This notification should be sent to us within 10 days of birth.
10.
Does the insurance policy cover birth defects?
According to the Saudi Insurance law, Insurance policy covers birth defects only if it's life threatening.
11.
Are pre-existing conditions covered?
Yes, pre-existing and chronic conditions are covered provided that they don't fall under policy exclusions.
12.
What is a Deductible or Co-insurance?
A deductible or Co-insurance is the amount which is considered as your contribution in your treatment cost. You will have to pay this amount in the hospital either as a fixed amount "Deductible", or as a percentage of the out-patient treatment cost "Co-insurance".
13.
If I go to a hospital which is not included in the agreed provider's Network inside or outside Saudi Arabia. What is the procedure to get my money back from you and what are the documents required by you in this case?
If you chose to go to a hospital which is not included in the agreed hospitals Network then you have to submit the claim documents within 30 days from the date of treatment along with the following documents, detailed as follows:
Detailed Medical Report.
Original invoices.
Doctor's prescription.
Laboratory and X-ray results and all other investigations results "provided that all of those tests are required and prescribed by the treating doctor"
After receiving those documents, we will settle your claim as per policy terms & conditions, as per K.S.A. network charges.
14.
What is meant by eligible dependants?
Eligible dependants are Husband/wife and children, who are residing legally in the kingdom of Saudi Arabia including unmarried children (Male up to 25 or till accomplish their University, Female till she get marry), Widows and divorced daughters who are not working and still depending on the Head of the family member.
15.
I'm living in Saudi Arabia but my family is living abroad. Can I insure my family in spite of being non Saudi Residents?
As per Council of Cooperative Health Insurance (CCHI), cover is restricted within the Kingdom of Saudi Arabia only. However, we extend the policy to cover insured members outside KSA while they are in holidays or business trips for a maximum of 90 days per year. Reimbursement of claims in this case will be according to the customary charges of the same kind of services in Saudi Arabia. Dependants living outside KSA can not be covered under the policy.
16.
Is vaccination for children covered by the policy?
Yes, vaccination for children is covered by the policy as per Ministry of Health (MOH) regulations.
Motor Insurance
01.
What is Motor Insurance?
Motor insurance is a type of insurance contract between you and the insurance company. This contract allows you to get compensation from the insurance company for financial losses during the time period of this contract. (Mostly one year).
02.
Is it compulsory to have Motor Insurance?
Yes. According to the new Saudi Law motor insurance became compulsory. You will not be able to renew your Motor Vehicle's licence "Istemara" without having a Motor Insurance Policy covering bodily injury and properties of third party.
03.
What is a Comprehensive Motor Insurance?
Comprehensive Motor Insurance is an insurance policy which covers accidental damage to your vehicle and/or theft. It also covers any liabilities to third parties "others" which may arise by your vehicle in any accident. The comprehensive motor insurance policy can also be extended to cover personal accident benefit (PAB) "Driver and passengers".
04.
What is a Third Party Motor Insurance?
Third Party Motor Insurance covers liabilities to third parties "others" which may arise by your vehicle in any accident.
05.
Does Third Party motor Insurance covers damages to my vehicle?
No. Third Party motor insurance policy covers damages and/or bodily injuries to third party only.
06.
How can we determine motor insurance premium?
Actually there are many factors which affect your motor insurance premium such as:
* Value of your vehicle (Sum Insured).
* Make & Model of your vehicle.
* Your Loss Experience among the last couple of years.
* Amount of Deductible agreed in the policy (The higher your Deductible is, the lower your premium will be).
07.
Two years back I had a motor accident and police took me to prison till I arranged the payment to the third party. Will this happen again if I have Comprehensive Motor Insurance or Third Party Motor Insurance?
No. The insurance company will give you a Motor Insurance Certificate which will be accepted by Policy departments as a guarantee of payment for any third party liabilities. Therefore, they will not take you to prison.
08.
How can I apply for Motor Insurance?
All you have to do is to fill the attached motor insurance application form and send it to us, we will send you the quotation according to the information mentioned in your application form.
09.
What should I do if I have an accident?
You should call the police first. The police will come to survey the accident and determine the party at fault and the percentages of liability on each party. Then they will give you a police report including party at fault by which you can claim us.
