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BENEFITS OF THE INSURANCE COVERAGE

Every Sri Lankan employee those who get registered   with the Sri Lanka Bureau of Foreign Employment are covered in this scheme.

 In a situation where it is subject to claim under this insurance policy the beneficiary should submit a duly filled application before 6 month at time of the event occurrence.

Hence in the following circumstances, the insurance company not agreed to pay insurance compensations.

1.death due to suicide, while insane or under influence of liquor, self-inflicted injuries and drugs addictions ,aids and other sexually transmitted diseases,

2 death or accident caused in engaging unlawful activities.

3.Law invasion acts of foreign enemy hostilities (whether war declared or not )civil war, Rebellion, insurrection military or usurped power, riot or commotion

4. Any of the events described below happening the beneficiary.

a. whilst under the influence of intoxicating liquor or drugs .

b.due to physical infirmity or medical condition existed prior to the insured prior tothe insured person’s departure from Sri Lanka unless it has declared and agreed by the insurance company

c .Deterioration of eyesight due to natural causes.

d. dental care expect occasioned by an accident.

e. illness due to venereal diseases.

 
Schedule of Benefits


No

Event

Benefits

01

Death due to any cause whilst working abroad during the contract period 

Rs.600,000/-

02

Death occurred in Sri Lanka within 03 months of arrival due to a illness or accident met when working abroad during the contract period

Rs.250,000/-

03

Permanent total disability due to accident during the contract period whilst working abroad

 

 

3.1 Compensation depending on the extent of disability
(Please refer annexure 02 table of coverage)

Maximum Rs.400,000/-

 

3.2 Cost incurred in respect of return ticket of the migrant worker.  (Schedule 3 shall apply only  the receipt of the air ticket fee is not available)

Cost of economy class return air ticket including taxes according to schedule provided. However if the consultant doctor recommends a stretcher or business class ticket

 

3.3 Medical expenses incurred after returning to Sri Lanka
(Total limit under the medical cover limited up to Rs.50,000/-
per migrant worker for the contract period)

3.3.1 Medical expenses for private Hospitalization incurred after returning to Sri Lanka Rs.50,000/- Documents should be submitted within 06 months from the date of arrival to Sri Lanka
(This expenses should incurred within 30 days from the date of arrival)

 

 

3.3.2 Government hospital allowance
Government Hospital allowance Rs.700/- per day. (maximum 30 days only)

 

 

3.3.3 expenses incurred on drugs purchased
& test, scans, x-rays undergone whilst being an
inpatient in a non paying ward of a government
hospital (Subject to bills being provided) Rs.29,000/-

 

 

3.3.4 Outpatient expenses - Any expenses incurred in respect of OPD bills for drugs, tests, scan and x-rays limited  to maximum of Rs.50,000/-
(This expenses should incurred within 14 days from the date of arrival to Sri Lanka & bills should be submitted before 06 months from the date of expenses Incurred)

04

Permanent partial disability occurred while working abroad during the contract period

 

 

4.1 Compensation depending on the extent of disability (Please refer annexure 02 table of coverage) 

Maximum Rs.125,000/-

 

4.2 Cost incurred in respect of return ticket of the migrant worker.  (Schedule 3 shall apply only  the receipt of the air ticket fee is not available)

Cost of economy class return air ticket including
taxes according to schedule provided.
However if the consultant doctor recommends a stretcher or business class ticket same to be covered.

 

4.3 Medical expenses incurred after returning to Sri Lanka
(Total limit under the medical cover limited uo to Rs.50,000/-
per migrant worker for the contract period)

4.3.1 Medical expenses for private Hospitalization incurred after returning to Sri Lanka Rs.50,000/-
Documents should be submitted within 06 months from the date of arrival to Sri Lanka
(This expenses should incurred within 30 days from the date of arrival)

 

 

4.3.2 Government hospital allowance
Government Hospital allowance Rs.700/- per day. (maximum 30 days only)
4.3.3 expenses incurred on drugs purchased
& test, scans, x-rays undergone whilst being an
inpatient in a non paying ward of a government
hospital (Subject to bills being provided) Rs.29,000/-

 

 

4.3.4Outpatient expenses - Any expenses incurred in respect of OPD bills for drugs, tests, scan and x-rays limited  to maximum of Rs.50,000/- (This expenses should incurred within 30days from the date of arrival to Sri Lanka & bills should be submitted  before 06 months from the date of expenses Incurred)

05

Temporary Disability due to accidents occurred whilst working abroad  during the contract period
( Disability should be 50% or above and should be confirmed by a  specialist  consultant doctor)
(As a result of the temporary disability if this employee is not in a position to  continue his/her employment and as result return to Sri Lanka as consultant doctors recommendation only)

 

 

5.1 Compensation depending on the extent of disability (Please refer annexure 04 table of coverage)

Maximum Rs.50,000/-

 

5.2 Cost incurred in respect of return ticket of the migrant worker.  (Schedule 3 shall apply only  the receipt of the air ticket fee is not available)

Cost of economy class return air ticket including
taxes according to schedule provided.
However if the consultant doctor recommends a strectcher or business class ticket same to be covered.

 

5.3 Medical expenses incurred after returning to Sri lanka
(Total limit under the medical cover limited up to Rs.50,000/- per migrant  worker for the contract period)

5.3.1 Medical expenses for private Hospitalization incurred after returning to Sri Lanka Rs.50,000/- Documents should be submitted within 06 months from the date of arrival to Sri Lanka
(This expenses should be incurred within 30 days from the date of arrival)

 

 

5.3.2 Government hospital allowance
Government Hospital allowance Rs.700/- per day.(maximum 30 days only)

5.3.3 expenses incurred on drugs purchased
& test, scans, x-rays undergone whilst being an
inpatient in a non paying ward of a government
hospital (Subject to bills being provided) Rs.29,000/-

 

 

5.3.4 Outpatient expenses - Any expenses incurred in respect of OPD bills for drugs, tests, scan and x-rays limited  to maximum of Rs.50,000/-
(This expenses should incurred within 07 days from the date of arrival to Sri Lanka & bills should be submitted before 03 months from the date of expenses Incurred)

06

Repatriation due to harassment within 06 months of the contract period, Critical illness, accident, injury or sickness whilst working abroad during the contract period. physical harassment to be assessed by the medical practitioner of SLIC if required Complain to  embassy of Sri Lanka in overseas  in respect of  critical harassment to be submitted for the claim under the critical harassment .In respect of mental harassment continuous treatment records for 03 months should be provided.

 

 

6.1 Cost incurred in respect of return ticket of the migrant worker.  (Schedule 3 shall apply only  the receipt of the air ticket fee is not available)

Cost of economy class return air ticket including
taxes according to schedule provided.
However if the consultant doctor recommends a stretcher or business class ticket same to be covered.

 

6.2 Medical expenses incurred after returning to Sri Lanka
(Total limit under the medical cover limited up to Rs.50,000/-
per migrant  worker for the contract period)

6.2.1 Medical expenses for private Hospitalization incurred after returning to Sri Lanka Rs.50,000/-  Documents should be submitted within 06 months from the date of arrival to Sri Lanka (This expenses should incurred within 30 days from the date of arrival)

 

 

6.2.2 Government hospital allowance
Government Hospital allowance Rs.700/- per day. (maximum 30 days only)

6.2.3 expenses incurred on drugs purchased
& test, scans, x-rays undergone whilst being an
inpatient in a non paying ward of a government
hospital (Subject to bills being provided) Rs.29,000/-

 

 

6.2.4 Outpatient expenses - Any expenses incurred in respect of OPD bills for drugs, tests, scan and x-rays  limited  to maximum of Rs.50,000/-
(This expenses should incurred within 07 days (30) from the date of arrival to Sri Lanka & bills should be submitted before 03 months from the date of expenses Incurred)

07

Repatriation due to pregnancy as a result of sexual harassment by sponsor or of his family member whilst working abroad during the
contract period (Run away from sponsor excluded)

 

 

7.1 Cost incurred in respect of return ticket of the migrant worker.  (Schedule 3 shall apply only  the receipt of the air ticket fee is not available)

Cost of economy class return air ticket including
taxes according to schedule provided.
However if the consultant doctor recommends a stretcher or business class ticket same to be covered.

 

7.2 Medical expenses incurred after returning to Sri Lanka
(Total limit under the medical cover limited up to Rs.50,000/-
per migrant worker for the contract period)
(Routine clinics, check-ups, illegal abortions are excluded)

7.2.1 Medical expenses for private Hospitalization incurred after returning to Sri Lanka Rs.50,000/- Documents should be submitted within 06 months from the date of arrival to Sri Lanka (This expenses should incurred within 30 days from the date of arrival)

 

 

7.2.2 Government Hospital allowance Rs.700/- per day. (maximum 30 days only)

7.2.3 expenses incurred on drugs purchased
& test, scans, x-rays undergone whilst being an
inpatient in a non paying ward of a government
hospital (Subject to bills being provided) Rs.29,000/-

 

 

7.2.4 Outpatient expenses - Any expenses incurred in respect of OPD bills for drugs, tests, scan and x-rays limited  to maximum of Rs.50,000/-
(This expenses should incurred within 07  (30)days from the date of arrival to Sri Lanka & bills should be submitted before 03 months from the date of expenses Incurred)

08

Benefits for Dependents

 

 

8.1 Hospitalization cash grant for dependents
(Legal spouse & children below 25 years unmarried & unemployed) (maximum 02 events/persons only for a annum per family)
(If migrant employee is unmarried, dependents are not covered) (Over three days hospitalization is required to obtain this benefits)
Subject to attached list of exclusions

Rs.1,000/- per day
(maximum 14 days only)

 

8.2 Accidental death cover for dependents
(Legal spouse & children below 25 years unmarried & unemployed) (Maximum 02 events/persons only per annum per family)
(If migrant employee is unmarried, dependents are not covered)

Rs.10,000/- per person.

 

 NOTES

  1. Suicide cases are entitled to claim full death compensation.
  1. Cover entitled for the age limit 18 - 65 years.

 

  1. Beneficiaries are entitled to claim for further 03 months subsequent to the expiry of the contract period provided the employee  within being employed overseas
  1. .Claim to be intimated & document should be submitted within 06 month from the date of arrival to Sri Lanka or death.

 

 

 

5. The beneficiary engaging in hunting or mountaineering or polo or racing or any kind other      than on foot, and Hazardous Sports

6. death or disablement occurring while the beneficiary is travelling in an aircraft other than as a ticket holding passenger in an fully licensed civil  aircraft operated by a recognized airline on a regular route or operated by recognized air charter company or owned by commercial  or industrial firm and piloted by a pilot holding commercial pilot’s license.

7. The beneficiary being found guilty of violating the laws of the country in which she /he is employed.

8. Conflicts disputes or breakdown of relationship whatever between the government of Sri Lanka and respective Foreign Government of the country in which beneficiary is employed.