Charges and Cover for BIMA Family

Note: Monthly Price for customer will be directly dependent on the number of recipients the Funder add to the policy and the plan opted for each child.

Prepaid:
The monthly price is charged in **installments over 30 days

**Prepaid
If the Funder pays only a partial amount of the monthly cost the Funder/recipient or their beneficiary are still eligible for partial coverage.
For details please refer to the detailed Terms & Conditions

**The monthly price for whole family is divided into 30 equal installments and is charged once per day from Funder’s account until the entire month’s price is received. If the Jazz Funder’s balance is not sufficient for payment then the whole family is not charged for that day.A proportionate reduced amount of insurance benefit will be provided even after at least one day deduction. However BIMA will not be responsible to provide cover to Funder or to recipients if Funder fail to pay a minimum one day deduction in a month.

How do I Claim:
SMS ‘CLAIM’ to 9878 or call 042-111-119-878 no later than 270 days from the first night of hospitalization and a BIMA representative will contact you with full information on how to process your claim.

Terms & Conditions

The Insurance is underwritten by IGI General Insurance and delivered by BIMA (registered as BIMA)

BIMA is the global leader in mobile-delivered health and insurance products. To date BIMA has reached over 31 million customers worldwide. BIMA operates across Asia, Africa and Latin America. BIMA is proudly underwritten by IGI General Insurance. IGI General Insurance offers first class security and service to the insuring public at an international standard. Jazz Telecom, is facilitating this offering but shall not be responsible for any grievance of the Jazz Customer relating to the Insurance Services and IGI General Insurance’s or BIMA’s performance of its obligations.

BIMA FAMILY POLICY

Whereas the Insured Person by a proposal which shall be the basis of the contract and be held as incorporated herein has applied to the Company for the insurance hereinafter contained and has paid or agreed to pay the first premium as consideration for such insurance.

Now this policy witnesses that subject to the terms conditions and exceptions contained herein or endorsed hereon, if at any time during the period of insurance, if the Insured Person shall sustain any Bodily Injury caused by Accident as defined herein the Company will pay to the Insured Person or in the event of his death, to his Beneficiary, if surviving, otherwise to the estate of the Insured Person the Benefit stated in the Policy Schedule attached hereto

DEFINITIONS

• ACCIDENT means a sudden, unexpected, unusual, specific event, which occurs at an identifiable time and place.
• ACCIDENT PROTECTION PLAN means one of the personal accident insurance covers under this Insurance Policy.
• BIMA SEHAT means monthly hospitalization insurance policy with Tele-Health Services
• IGI refers to the COMPANY, the INSURER, or IGI General Insurance Company Limited.
• APPLICANT means the individual (can be an individual Customer, a Funder or a Recipient) who applies for an Accident Protection or BIMA SEHAT Plan under this Policy.
• FUNDER means any JAZZ CUSTOMER who pays the END USER PRICE on behalf of a Recipient
• Recipient means an applicant, who is not paying the premium for BIMA Services from his own mobile account.
• BENEFICIARY is defined as Beneficiary in the application or the person substituted as such.
• INSURANCE BENEFIT(S) are amounts payable in the event of an indemnifiable claim and as detailed in the Schedule of Insurance Benefits attached hereinafter.
• BIMA Mobile refers to BIMA Mobile PAKISTAN.
• BODILY INJURY means Bodily Injury which
• is sustained by the Insured Person during the period of insurance and;
• is caused by external, violent and visible means and;
• is solely and independently of any other cause, except illness directly resulting from, or medical or surgical treatment rendered necessary by such Bodily Injury, occasions the death or Disablement of the Insured Person within twelve calendar months from the date of the Accident by which such Bodily Injury is caused.
• The COMPANY is stated as IGI General Insurance Company Limited.
• ELIGIBLE APPLICANT means an Applicant who meets the eligibility criteria set forth in this Policy.
• END USER PRICE means the amount to be charged to the Subscriber/Funder for getting the Insurance Policy and it shall include the Premium, Jazz’s Consideration and any applicable taxes on the telco services involved in the provision of Insurance Services.
• HOSPITAL is defined as “Any institution in Pakistan that has been registered as a hospital with the local authorities and is under the supervision of a registered and qualified medical doctor.”
• HOSPITALISATION: staying minimum of one night in a facility recognized as hospital.
• INSURANCE COVER means the amount which shall be paid by IGI to the Beneficiary or to the Insured person as per the terms and conditions of the Insurance Policy.
• INSURANCE POLICY means this insurance policy setting out the terms and conditions on which insurance coverage is granted to a Subscriber, Funder or Recipient
• INSURANCE SERVICES shall mean the insurance services to be provided to Jazz Customers and to their Recipient who can be from other network.
• The INSURED or INSURED PERSON means any Jazz Telecom Subscriber/Funder and Recipient from other networks who opt to purchase policy
• The INSURER is stated as IGI General Insurance Company Limited.
• MSISDN shall mean Mobile Subscriber Integrated Services Digital Network Number.
• PERMANENT DISABLEMENT means TOTAL OR PARTIAL PERMANENT DISABLEMENT as defined hereunder
• PERMANENT PARTIAL DISABLEMENT means all those bodily injuries which result in reducing the insured person’s ability to work as defined in the Table of Insurance Benefits.
• TOTAL AND PERMANENT DISABLEMENT means the Insured Member has established to the satisfaction of Insurer that the Insured Member has been incapacitated by Injury to such an extent as to render the Insured Member unable ever to engage in or work for reward in any occupation or work (on a temporary basis, part-time basis or full-time basis) which the Insured Member is capable of performing by reason of his or her education, training or experience.
• PREMIUM means the premium payable by an Insured Member/Funder to Insurer in relation to the Insurance Policy.
• SUBSCRIBER means those Customers who subscribe for the Insurance Services to get this Insurance Policy.
• JAZZ refers to Pakistan Mobile Communications Limited, a company duly incorporated and registered under the Companies Ordinance 1984 of Pakistan, and having its registered office at 1-A, IBC Building, F-8 Markaz, Islamabad, Pakistan.
• JAZZ CUSTOMERS shall mean the customers of Jazz using Jazz’s System.
• JAZZ SYSTEMS mean Jazz’s GSM mobile cellular system.
• JAZZ PAYMENT TERMS mean Jazz’s payment terms published at jazz.com.pk , as revised from time to time.

EXCLUSIONS

Personal Accidental Insurance

Payment of claims is subject to exclusions, as outlined below. The Personal Accident Insurance Cover shall not cover any Death or Permanent Disability which is caused by, or resulting, directly or indirectly, wholly or partly, from any of the following factors:

• Suicide or any attempt thereat (sane or insane).
• Kidnapping for ransom.
• To any death or injury sustained whilst the Insured is under the influence (temporarily or otherwise) of intoxicants, alcohol or drugs.
• War, strikes, riots, civil commotion and any natural or man-made perils (including chemical, nuclear, biological, and radiological) that results in the declaration of a state of emergency on a local or national level

BIMA Sehat

BIMA SEHAT plan shall not cover any hospitalization claim which is caused by, or resulting, directly or indirectly, wholly or partly, from any of the following factors:

• intentional self-inflicted injury, suicide attempt, or arising out of non-adherence to medical advice;
• elective treatment, such as cosmetic surgery; and pregnancy and any complications arising from pregnancy during the first nine (9) months from the Subscription

GENERAL PROVISIONS

Eligibility & Enrolment

Applicants are eligible to apply for an Accident Protection and BIMA SEHAT Insurance Plan under the Policy if Applicants meet ALL the criteria set out below:

• Eligible Applicants shall include individual pre-paid and post-paid Jazz Customers or a recipient of any other network when subscriber opts as depended. It is understood and agreed between the Parties that only one (1) person shall be insured per pre-paid or post-paid telecommunication connection.
• All Eligible Applicants shall be natural persons. Corporations, partnerships and businesses shall not be eligible for coverage under the Personal Accidental or BIMA SEHAT Policy.
• All Eligible Applicants shall be a minimum of eighteen (18) years of age and a maximum of sixty four (64) years of age at the time of registration.
• If the Applicant wishes to apply for and subscribe to an Accident Protection or BIMA SEHAT Plan under this Insurance Policy, the Applicant will be required during the registration process to:
• Acknowledge that the Applicant has read and understood the terms of the Policy and the Jazz Payment Terms;
• Confirm that the Applicant meets the eligibility criteria set out in General Provision 1 of the policy;
• Confirm the Accident Protection or BIMA SEHAT Plan that the Applicant wishes to apply for;
• Authorize Jazz to make 30 daily deductions each month from the prepaid account and

• The Insurance Benefits payable are subject to the Applicant’s confirmations being true and correct; and
• If the Applicant’s confirmation is untrue or incorrect, no Insurance Benefits will be payable and the End User Price the Subscriber/Funder paid will not be refunded.

Mistake in Age

The Company shall only pay Insurance Benefits based on the disclosed age of the Insured. With the onus on the customer for incorrect disclosure the Company shall not be liable to pay any benefit under this Policy in that particular case.

Intentional False Statements of The Insured
In the event of any concealment or misrepresentation the Personal Accident and BIMA SEHAT Policy shall become null and void with respect to the relevant Insured.

Notice of Claims

The Company shall be notified of the hospitalization and occurrence of Death of the Insured or the Permanent Disablement of the Insured or in case of hospitalization as soon as possible, but not later than 270 (two hundred & seventy days) days from the date of incident or from the first night of hospitalization after which it shall be treated as time barred and the Company shall not be bound to pay the Claim.

(1)For each Claim reported, the Company shall obtain:

From the Claimant:

In case of Hospitalization

CNIC; final hospital invoice or discharge report which states date of admission and discharge.
Insurer may require any other document if reasonably deems necessary before approving a claim under the Policy.

In case of Accidental Death:

A notice of death, which could be a legal death certificate, a certificate of attending physician, containing his registration number and mentioning actual cause of death, and proof of the personal identity of the Insured, which could be the official personal identity data.

In case of Permanent Disablement:

Medical report containing the degree of Disablement certified by the surgeon.
In case of Permanent Disablement, unnatural or unusual death, Insurer may require any other document it reasonably deems necessary before approving a claim under the Policy.

(3) The Company” shall process and pay genuine and approved claims on receipt of required documents from the Claimant within three (3) working days.

(4) If there is a dispute, suspected fraudulent activity on the claim or a unique situation which requires further clarification, the payment period can be extended but shall not exceed ten (10) working days, or as long as the dispute takes to resolve in the legal system.

Termination of Individual Insurance

The insurance of an Insured shall automatically terminate at the earliest time below:

• Upon payment on Death or
• Upon settlement of the Insured of the amount of insurance, including in the event of early termination of such relationship; or
• Upon cancellation or withdrawal of subscription by Jazz of the contract/relationship with the Insured, whatever the reason may be, or
• In case of non-payment of the individual End User Price for the Insurance Policy.
• In case of non-payment of End User Price by the Funder for the Insurance Policy., Policy of Funder and Recipient will be terminated

Participation Requirement/Process

Interested customers shall participate through an electronic enrolment process, assisted by a call center agent, or by submitting information electronically via their handset, in two phases:

1st Phase:
Name of the Customer:
Age or CNIC Number:
Name of the Beneficiary:
Relationship to Customer:

Insurance Benefits selected by Customer:

2nd phase:
Once the customer has answered the questions in the 1st Phase, the customer shall receive an SMS on for or on behalf of the Company and shall be asked to dial a short code, or send an SMS to a particular number to confirm registration. Alternatively, the Customer may offer his verbal consent over an official recorded channel managed by MILVIK to a MILVIK agent. This confirmation serves as digital signature for the BIMA SEHAT/Personal Accidental Insurance Cover. After receiving positive response, the customer shall be enrolled under the BIMA SEHAT/Personal Policy.
Arbitrations
All differences arising out of this policy shall be referred to the decision of an arbitrator to be appointed in writing by the parties in difference or if they cannot agree upon a single arbitrator to the decision of two arbitrators one to be appointed in writing by each of the parties within one calendar month after having been required in writing so to do by either of parties or incase the arbitrators do not agree of an umpire appointed in writing by the arbitrators before entering upon the reference. The umpire shall sit with the arbitrators and preside at their meetings and the making of an award shall be a condition precedent to any right of action against the Company. If the Company shall disclaim liability to the Insured Person for any claim hereunder and such claim shall not within twelve calendar months from the date of such disclaimer have been referred to arbitrator under the provisions herein contained then the claim shall for all purposes be deemed to have been abandoned and shall not thereafter be recoverable hereunder. Notwithstanding stated above, dispute resolution forums given under the Insurance Ordinance, 2000, such as the Insurance Ombudsman, Small Disputes Resolution Committee and the Insurance Tribunals, shall prevail in the order of precedence, and over the seat of Arbitration.
Compliance with Policy Provisions
Failure to comply with any of the provisions contained in the policy shall invalidate all claims hereunder.

Insurance Benefits

The Company hereby agrees to pay the following benefit subject to the terms and conditions provided under the Personal Accident/BIMA SEHAT Policy as defined hereunder.
If an Insured dies or is permanently disabled due to an Accident hospitalized due to any reason(with the exception of exclusions), on a twenty four (24)-hour worldwide basis, the Company will, upon receipt of due proof in writing of the Hospitalization/ Death or Permanent Disablement of the insured, pay the Insured or Beneficiary as the case may be the sum assured, according to their Insurance Cover level as described in this Insurance Benefits Section of the Policy Wording

Benefit:

The amount of benefit received by the Insured or the Beneficiary in the event of the Hospitalization from the first night of hospitalization or accidental Death or Total and Permanent Disablement of the Insured will be according to the amount of premium paid and subject to the terms and conditions of the product.

Terms and conditions of this cover are as follows:

• One (1) Personal Accidental and One (1) BIMA Sehat policy per applicant (individual applicant, Funder or customer)
• A Claim must be intimated to the Company within two hundred & seventy (270) days from the date of first night of hospitalization or from the date of occurrence of Death or Permanent Disablement
• Payment of claims is subject to exclusions, as outlined in the Exclusions section of this contract

In the event of partial pay-out following Permanent Disablement due to Accident, the Company shall permit renewal of the insurance offer on a case-by case basis, and inform the registered subscriber accordingly.
The following actions shall be taken depending on the decision of renewal or non-renewal:

• On non-renewal: The insurance policy shall be terminated, and all airtime deduction or billing shall be discontinued; any amount deducted or billed after the cancellation of the service is nonrefundable.
• On renewal: the insurance policy shall continue on auto-renewal, and all airtime deduction or billing will continue to apply in subsequent calendar month

Each Applicant can select the level of maximum insurance benefit at the point of Enrolment.
The Subscriber has the option to choose between four (4) cover levels, at four (4) corresponding End User Price points, as given below.

Cover levels of BIMA SEHAT

Unlimited M‑health is included for all four (4)

For More Details please visit https://www.jazz.com.pk/prepaid/bima-insurance/

Cover levels of Personal Accident

For More Details please visit https://www.jazz.com.pk/prepaid/bima/

Q: Can a Jazz Prepaid Customer become Funder?

Yes, a Jazz prepaid customer can become a Funder for BIMA Service.

Q: Can a Jazz Funder add recipient from another network?

Yes, a Funder can add user of any other network as a recipient for BIMA Service.

Q: Which products Funder can opt for recipients?

A Funder can opt for two policies (BIMA Accidental Protection & BIMA SEHAT) for each recipient.

Q: Can a Funder choose single product for Recipient?

Yes, he can.

Q: How many Recipients can a Funder add?

A Funder can add up to 10 Recipients.

Q: Does Recipient have to pay separately for BIMA Service?

No, recipient will not be charged for BIMA Services, Funder will pay from his own account for the recipient.

Q: How Recipient from other network will pay for BIMA Service?

Recipients don’t have to worry about the payment as Jazz Funder will pay for BIMA service on behalf of them.

Q: Can a Recipient request to change his/her cover level by himself?

No, Recipient can’t request to change cover level. Only Funder can request such changes.

Q: Can a Recipient claim without informing funder?

Yes, Recipient can claim directly for BIMA Services.

Q: How a Recipient can contact BIMA?

Customer can send SMS at 9878 or call at our 24/7 helpline 042-111-119-878 or dial 042-32534444

Q: Can a Funder get claim on behalf of Recipient?

If Funder is added as a beneficiary, then he can claim.

Q: Does Funder have the option to change his/her Recipient at any time?

Yes, Funder can process Recipient change request at any time. Both Funder and Recipient will receive an SMS on service de-registration.