Suwa Sampatha


The most popular Surgical and Hospitalization Insurance Scheme in Sri Lanka, which offers reimbursement of hospitalization and surgical expenses including benefits for treatment in government hospitals. Immediate cash settlements are made directly to hospitals paving the way for greater customer convenience.

01. HOSPITALIZATION BENEFITS

A1 (Rs.) Plan A (Rs.) Plan B (Rs.) Plan C (Rs.) Plan D (Rs.)
Annual Limit 150,000 100,000 85,000 55,000 35,000
Event Limit 120,000 80,000 75,000 48,000 30,000

SECTION 1

A1 (Rs.) Plan A (Rs.) Plan B (Rs.) Plan C (Rs.) Plan D (Rs.)
Total Hospital Room charges including admission fees (per event) 52,500 35,000 29,750 19,250 12,250
Maximum Room charges per day 8,000 7,000 5,000 4,000 3,000
Intensive Care Unit charges per day up to a maximum of 10 days 8,000 7,000 5,000 4,000 3,000

SECTION 2

A1 (Rs.) Plan A (Rs.) Plan B (Rs.) Plan C (Rs.) Plan D (Rs.)
Specialized Services per event 22,500 15,000 12,750 8,500 5,000 22,500 15,000 12,750 8,500 5,000

SECTION 3

A1 (Rs.) Plan A (Rs.) Plan B (Rs.) Plan C (Rs.) Plan D (Rs.)
All other expenses including surgeon’s and doctor’s charges, Operational expenses, Medical expenses and Emergency Transport per event 75,000 50,000 42,500 28,000 18,000

02. OUTPATIENT BENEFITS

A1 (Rs.) Plan A (Rs.) Plan B (Rs.) Plan C (Rs.) Plan D (Rs.)
General Practitioner’s fees 5,000 4,000 1,500 1,500 1,200
Special Consultant’s fees 5,000 4,000 1,500 1,500 1,200
Cost of Drugs prescribed by a General Practitioner and/or a Special Consultant 5,000 4,000 1,500 1,500 1,200
Specialized Services (X-rays, Scans, Lab tests) 5,000 5,000 2,500 2,500 2,000

03. CASH GRANTS

A1 (Rs.) Plan A (Rs.) Plan B (Rs.) Plan C (Rs.) Plan D (Rs.)
Birth ow Twins 10,000 10,000 10,000 10,000 10,000
Hospitalization in a non-paying ward of a Government Hospital per day 1,000 750 500 400 300
Expenses incurred on drugs purchased and tests, scans & X-rays undergone whilst being an in-patient in a non-paying ward of a Government Hospital 14,000 11,000 10,000 6,000 4,000

04. MAJOR ILLNESS COVER

A1 (Rs.) Plan A (Rs.) Plan B (Rs.) Plan C (Rs.) Plan D (Rs.)
Reimbursement for Hospitalization expenses per annum maximum up to 500,000 300,000 200,000 200,000 100,000

Subject to a waiting period of 90 days

ANNUAL PREMIUM

A1 (Rs.) Plan A (Rs.) Plan B (Rs.) Plan C (Rs.) Plan D (Rs.)
Per Individual 21.395 14,410 8,855 6,985 4,840
Per Family Unit 32,780 20,680 14,245 10,450 7,040

Premiums quoted above are excluding IRCSL Admin fees + VAT.

There will be a waiting period of (06) six months in respect of all type of surgeries except surgeries performed due to an accident.

20% excess on Doctor’s charges and Medicines under section 3.

Age Limit : Proposer – 18-50 and could be continued up to 60 years., Children – 01 to 21 years

*Terms & Conditions apply.

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