eSewa Care | Claim Process

Introduction

eSewa Care is a healthcare package tailored to offer financial security and easy access to essential health services. Developed in collaboration with Himalayan Everest Insurance (HEI) and various healthcare service providers, eSewa Care provides the coverage of 230,000 Rs at just Rs 360 a year.

Insurance Coverage

Following are the risk coverage under eSewa Care:

1. Hospital bed charge coverage up to Rs. 10,000 per day, at a rate of Rs. 1,000 per day.
2. Death & Disability up to Rs. 120,000/-
3. Accidental Medical Rs. 100,000/-

Other benefits

In addition to insurance coverage, eSewa Care purchasers can enjoy discounts of up to 30% at various healthcare service providers across the country. With collaborations with over 40 service providers, eSewa Care ensures that its customers receive added value and savings on healthcare services.

Our Clients:     

And many more….

Claim process:

• Claim segregation:

1. Accidental Treatment: Up to Rs. 100,000/-
2. Hospital Bed Charge: Up to Rs. 10,000/- (per day Rs. 1,000/- for 10 days)
3. Accidental Death: Rs. 100,000/-
4. Funeral Expenses: Rs. 10,000/-
5. Funeral Transportation: Rs. 10,000/-

Note: Claims for bill amounts of accidental insurance less than Rs. 2,500/- will be reimbursed up to Rs. 1,000/-. This is applicable to school students and teacher only.

Required Documents:
a. Claim Form:will be provide after contacting eSewa/Himalayan Everest Insurance

b. Accidental Treatment:

1. Doctor’s prescription
2. Hospital Card
3. Payment bills
4. Police report (in case of Road Accident)

c. Hospital Bed Charge:

1. Hospital admission document
2. Discharge summary
3. Payment bills

d. Accidental Death, Funeral Expenses & Funeral Transportation:

1. Death certificate
2. Police report (in case of Road Accident)
3. Payment bills

        Note: Original documents are required for the claim process.

• Terms & Conditions:

1. Only treatment carried out in hospitals will be eligible for claims.
2. Claim can be requested only after 24 hours of the purchase.
3. Notify within 35 days after paying the bills.
4. Can be purchased from Age 2 years to 60 years only.

Note: Every hospital, that are legally registered under Nepal Government will be counted for the claim.

• What is not covered in Accidental & Hospitalization Insurance?

1. Pre-existing disease treatments are not covered.
2. Complications of pregnancy, miscarriage, abortion birth control sterilization, or infertility treatment.
3. Mental or nervous breakdown, congenital or heredity defects or conditions such as HIV/AIDS or any sexually transmitted disease, alcoholism or substance abuse self-inflicted injury suicide or any attempt, and organ transplants elective surgery.
4. Prostheses cosmetic plastic or reconstructive surgery unless it results from an insured accidental injury.
5. Hospital expenses incurred outside of Nepal.
6. Routine eye tests dental treatment or other examinations and/or tests not incidental to treatment or diagnosis of an insured injury sickness or disease.
7. Hospitalization expenses incurred outside of Nepal.
8. Hospitalization expenses incurred for any person over the age of sixty (60).

• Claim Process:

1. Customer needs to contact eSewa/HEI
2. Fill up the claim form
3. Provide requested documents
4. eSewa/HEI will verify the documents
5. HEI will provide the claim amount within 10-15 working days after receiving all the requested documents.

   Enjoy Up to 35% discount

   Merchant Name	Offers	Location
   Cistron Diagnostic Reliable Lab Pvt. Ltd.	· 10% discount on all Services	Biratnagar
   Neuro Cardio & Multispecialty Hospital Pvt. Ltd.	· 10% discount on all services	Biratnagar
   Madhyapaschim Dental Lab and Clinic	· Up to 20% discounts on dental care and lab	Birendranagar
   National Path Lab	· 10% off in Lab test	Butwal
   Tilottama Physiotherapy Clinic	· 25% discount	Butwal and Tilottama
   Bharatpur Samudayik Hospital	· 10% Discount on all facilities	Chitwan
   Cassi Sports and Recreational Center Pvt. Ltd	· 10 % discount on all sports	Chitwan
   Chitwan Himal Dental Pvt. Ltd.	· 20% discount on all service	Chitwan
   Power House Gym	· 20% discount on all services	Chitwan
   Raj Barber and training center	· 20% discount on services	Chitwan
   B.R Dental Hospital	· Up to 15% discount	Dang
   Chinari Hospital Pvt. Ltd.	· Up to 10%* Discount in CT SCAN, Pharmacy and OPD	Dang
   Swostik Multispecialty Hospital Pvt. Ltd	· 15% discount on Operation Services, Diagnosis Services, LAB, X-Ray, USG, ECG, ABP, Holter, Physiotherapy & Bed Charge Services. · 5% Discount on Pharmacy.	Dhangadhi
   Farwest Fitness and Training Center	· 20% discount on all package	Dhangadi
   Dirgayu Physiotherapy Center	· Free Consultant · Up to 15% Discount on all physiotherapy services.	Ghorahi
   Janakpur Health Care and Teaching Hospital	· 10% discount on Bed Charges · 10% discount on all procedures · 10% discount in Lab	Janakpur
   Janakpur Netralaya Pvt. Ltd.	· 10% on OPD, Optical & Medicine · 15% on OT	Janakpur
   Mangalam Diagnostic Center Janakpur	20% on all Laboratory Test	Janakpur
   Rishika Health Care Pvt. Ltd.	·	Janakpur
   Malwara Polyclinic	5% to 15% Discounts on Fees	Kailali
   Civil Human Hospital	· 10% Discount in OPD Charge · 10%-15% Discount in Lab charge · 20% Discount in Service Charge · 10% Discount in Consultant charge · 5% Discount in Medicine	Kathmandu
   Aakar Dental Clinic	20% discount on all services	Kathmandu
   Vatsalya Health Care	Rs. 15,000 Discount on IVF	Kathmandu
   Sowa Health Care	30% Discount
   Mahakali Dental Hospital	25% discount on all dental services	Mahendranagar
   Pant Chasma Pasal	20% on eye checkup	Nepalgunj
   Physio Care, Pain Relief and Rehabilitation	25% off on Physio Therapy	Nepalgunj
   Pharmacy Sewa	Upto10% Discount on Pharmacy Items	Pokhara
   West Valley Medical Clinic	· Up to 20% discount on Hair transplants · Up to 30% Discount on Hair treatment, Skin procedures & Dental services	Pokhara
   Birendranagar Denteal Care Home	Up to 20% discounts on dental care	Surkhet
   Karnali care international hospital and research	5% to 35% Discount on all their services	Surkhet
   Upakar Dental Clinic	20% discount on all services	Syangja
   Waling Oral and Dental Care Clinic	10% on Dental Scaling and Dental Normal Filling	Syangja
   Sudurpaschim Dental Care Home	15% discount on all dental services	Tikapur, Kailali
   Everest Dental Clinic	5% discount on all dental services and consulting	Tikapur,Kailali
   Fit Life –The Ultimate Fitness Club	5% to 15% Discounts on Fees	Tikapur,Kailali
   Swargadwari Dental Hospital Pvt. Ltd.	Upto 10% Discount on all Dental Services.	Tulsipur
   Godawari Hospital Pvt. Ltd.	10% discount on all Services	Urlabari
   Itahari Medical & Swasthya Upachar Clinic Pvt. Ltd	10% Discount on all services	Itahari, Sunsari
   Pashupati Model Hospital Pvt. Ltd.	15% Discount on all services	Itahari, Sunsari
   Abhaya Dental Clinic	– Free OPD Services – 50% Discount on X-ray – 15% Discount on Dental Procedures	Itahari,Sunsari
   Sayapatri Dental Clinic	20% Discount on all Services