Medical nisurance
ServicesMedical nisurance

One of the different types of insurance coverage is complementary medical insurance. Due to the fact that human have always been subjected to the risk of different diseases, inevitably have to bear huge medical expenses, medicine, operation fee as well as hospital expenses for treatment. In order to help people who are in these situations, insurance companies have provided different and various insurance plans for diseases. Also in most of the countries the government employees or industrial units and manufacturing units use collective medical insurance plans.

Currently complimentary medical insurance is one of the most important fields of insurance in the countries of the world. This type of insurance in Iran is provide collectively.

Items under the coverage of medical insurance:

Disease in medical insurance agreements are defined as any kind of physical  complication or undesirable change and disorder in normal and natural activities of the body members which is identifiable by doctors and doesn’t haven’t anything to do with the will of the insured.

Therefore; the liabilities of the insurer are compensating all the medical and hospital expenses of each of the insured people which is compensable as per the agreement and with consideration of the agreed franchise.

In general the liabilities of the insurer are as per the following:

- Hospital expenses (general and specialized)

-Para-clinical expenses

-Labor expenses

-Lasik expenses

It should be noted that more different and various items can also be covers which should be mutually agreed between the insurer and insured.

Items outside the coverage of insurer liabilities (exceptions)

Payment of the following expenses is outside the liabilities of the insurer:

-All the expenses of cosmetic surgeries  and surgeries for removing the natural and congenital problems.

-All the expenses of treatments for sterilization

-All the expenses for abortion, except those which are performed out of necessity as per the relevant rule and regulations.

-All the medical expenses related to check ups, except in necessary cases and as per the explicit recognition  of the physician.

- All the expences related to mental diseases (except related to mental treatment)

-All the expenses resulting from war, strike and riot.

-all the expenses resulting from accident

-All the expenses for provision of corset, compression stockings, artificial limbs to compensate for congenital defects.

-All the medical expenses resulting from listening to unauthorized people for intervention in medical affairs, such as Orthopedics and ect.

It should be mentioned, though, with agreement of the insurer and payment of extra premium, some of the above can be covered and the insurer liabilities can be increased as well.