International Seaways Schedule of Benefits

Benefits Sum Insured / or NOT COVERED each Insured Person

Membership Eligibility 1. Employees – 18 to 65 years old
2. Spouses – 18 (or from local legal age) to 65 years
old
3. Dependent Children (over 30 days and under 22
years of age).
Maximum period of cover (per cause) 12 months
In Patient - Max Limit per Annum USD 5,000
Out Patient – Max Limit per Annum USD 500
Maternity – Max Limit per Annum USD 1,000
I. HOSPITALISATION/IN PATIENT
Hospitalisation/In-Patient
1. Room and Board according to type of Covered – Semi Private Room (flexible – common
enrolment sense interpretation)
2. Services of Physician, Surgeon and Covered
Specialist, In Patient treatment, In-
Patient Medications, Diagnostic
Procedures, Intensive Care Treatment
Maternity Covered up to USD 1000
- Delivery Covered
-Pre-Natal and Post-Natal consultation Covered
-Pre-Natal laboratory work-ups Covered
Benefit is not payable until the Insured Person has had
continuous cover under the Marine Benefits Medical
Plan for at least 365 days.

Transplants Covered

II.OUT-PATIENT BENEFIT
Out-Patient
-Consultation including specialists Covered
evaluation
-First aid treatment of injury or illness Covered
-Treatment for minor injuries such as Covered
lacerations, mild burns, sprain and strain
fractures
-Laboratory examinations and all other Covered
diagnostic procedures required
-Outpatient Medication Not covered
-Minor surgery not requiring confinement Covered
- Nursing Care – up to six months Covered
III.EMERGENCY BENEFIT
-Emergency care services Covered
-Emergency Care in Areas where there are Covered
No accredited specialists at the accredited
hospital
-Emergency Care in Areas where there are Covered
No accredited hospital, 100% coverage
-Emergency care services in Non- Covered
accredited hospitals
-Unavailability of Room during emergency Covered for board difference and incremental cost of
confinement when room category is not upgrade to next available room category.
available
-Ambulance conduction (surface) Covered
-Emergency care services in medical Not covered
facilities in foreign territories while on
official business trip
IV.SPECIAL MODALITIES OF
TREATMENTS
-Percutaneous Adrenalectomy, Covered
Laparoscopic procedures, Heart Surgery,
Angioplasty
-New Diagnostic Procedures Covered
-Speech Therapy Covered
-Dialysis Covered
-Chemotherapy Covered
-Radiotherapy Covered
-Physical Therapy Covered
-All sophisticated diagnostic modalities or Covered
methods of treatment for which there are
No comparable conventional of traditional
equivalent or counterparts.
Pre-Existing Conditions Covered for Employees. Limited coverage (USD
5,000 or 75% of cost) for dependents after 1 full
year of membership.

-Congenital illnesses Covered for employee

Vaccines
-Anti-tetanus Covered
-Anti-rabies, anti-venom vaccines Covered
-Work related illnesses/injuries Not covered

Dental Benefits Covered as listed in a)-n) below.

Dental Treatment and procedures:

a) Oral prophylaxis Once a year

b) Consultations and oral examinations Covered

c) Tooth extractions Limited to simple tooth extraction, excluding

surgery for impacted or ankylosed tooth etc.

d) Temporary fillings Covered

e) Permanent filling (lightcure filling) 1 tooth per year

f) Gum treatments for cases like inflammation Covered

or bleeding

g) Recementation of loose jackets, crowns, in- Covered

lays and on-lays

h) Treatment of mouth lesions, wounds and Covered

burns

i) Emergency out-patient dental treatment In accredited dental clinics only

j) Temporomandibular Joint (TMJ) Covered

consultations

k) Restorative and Prosthodontic consultations Covered

l) Dental Nutrition & Dietary counselling Covered

m) Dental Health Education Covered

n) Prenatal & Postnatal consultations Covered

-Mental disorders Not covered

-Congenital birth defects Not covered
-Vision Not covered