SURAKSHA INSURANCE 2024 TO 2027

TABLE OF BENEFITS

Hospitalization / Inpatient Benefits per student
(Private Hospitals and listed Ayurvedic Hospitals)		 LKR 300,000.00
per annum
Maximum limit for room charges per day is Rs.7,500/= and 24 hours is considered as one day. Within the limit
Per annum
Following expenses are covered.
  • Doctor Fees
  • Specialist Consultant Doctor Fee
  • Surgeon’s and Anesthetist Fees
  • Medical and Operational Expenses
  • Nursing Charges including use of Operating Theatre
  • Investigations and Special Treatment on the recommendation of Consultant Specialist upon hospitalization
Hospitalization in Government Hospitals or Government Ayurvedic Hospital
(Non Paying Wards) 		Rs.1,000/-
Per Day
Government Hospital / Government Ayurvedic Hospital Non-Paying Wards
  • One Night considered as a Day
  • In the event of Pandemic Rs.1,000/- Per Day
 Rs.1,000/-
Per Day
Expenses incurred on,
  • Drugs purchased
  • Test
  • Scans
  • X-Ray
undergone from outside whilst being an inpatient in a Government Hospital (Subject to bills and prescriptions being produced) for any one event / any one year 		Within the Limit
Per annum
Other Benefits Paid Within Inpatient Limit
Expenses of surgeries performed in a theater without hospitalization including,
  • Endoscopy
  • Colonoscopy
  • Sigmoidoscopy
  • Bronchoscope
 Within the Limit
Per annum
  • Expenses of Special Food Supplements recommended by Doctors for Critical Illness as listed here.
  • In the event of a hospitalization, the follow up drugs will be accommodated only for one week after discharge.
  • Cost of PET Scan would be paid within hospitalization limit.
  • Treatments obtained for COIVD -19 (Private Hospitals Only)
  • Treatments obtained overseas as per the doctor recommendation
  • Expenses of plastic surgeries to correct, marks or signs after an accident or due to an accident.
Additional benefits paid within inpatient limit Maximum Limit Rs.75,000/- Per student
Prescribed by Specialist Doctor following a Surgery - TED/stockings/air mattress/water mattress/rehabilitation accessories/ special shoes/walking aids/crutches/wheel chairs. (Prescribed by specialist doctor following a surgery)
  • TED
  • Stockings
  • Air Mattress
  • Water Mattress
  • Rehabilitation Accessories
  • Special Shoes
  • Walking Aids
  • Crutches
  • Wheel Chairs
 Within the limit Per annum
Outpatient Benefit Reimbursement Basis
Prescribed by Specialist, MBBS and DAMS doctors -
  • EEG
  • MRI
  • CT Scan
  • DMSA Scan
  • DTPA Scan
  • Ultra Sound Scan
  • X-Ray
 Maximum of
20,000/-
Dental Treatment (Filling and Extractions only)
Expenses for Ayurvedic treatments for injuries resulting from accidents. (Only for ATTACHED LIST of Ayrvedic Hospitals - Yearly Updated)
Annexure I forming part of the policy
Treatments hearing and vision correcting.
Provision of Accessories for correction of Visual Problems.
  • Maximum amount for the Spectacles is Rs.10,000/-
  • Once a years only on Reimbursement Basis
However, for students below poverty line Direct payments could be arranged.
(Recommended by a Medical Officer of Health or an Eye Surgeon)

UNAPPROVED OPTICIANS & EYE CLINICS (Effect from 2024-08-01)
Provision of Hearing Accessories.
(Recommended by an ENT Surgeon)
Expenses for Lumber Guards & Cervical Collars following an accident recommended by Specialist Doctor.
Critical or Prolonged Lines Coverage 1,500,000/-
Direct Payments(Cashless Facility)
Local Hospitals as per This List. 		1,500,000/-
Reimbursement Basis –
For Overseas Hospitals when treatment is not available locally or when immediate treatment is required and there is a waiting list
List Of Critical Illnesses -
  • Heart Surgeries
  • Cancer Treatment
  • Kidney Transplantation
  • Dialysis
  • Bone Marrow Transplantation
  • Hip, Shoulder, Knee Replacement
  • Brain Surgeries
  • Scoliosis
  • Cochlear Implantation Surgeries & Hearing Accessories
  • Spinal Cord Compression
  • Liver Transplantation
  • Eye surgery (Accidental Trauma, Corneal Surgeries, Cataract Surgeries, Tumors, Cancers and any other major surgeries)
  • Artificial Limbs
  • Thalassemia
  • Japanese Encephalitis

Permanent Total Disability Maximum per Event / Annum Rs.200,000/=
  • Loss of sight/vision in both eyes
  • Loss of 2 limbs
  • Loss of hearing of both ears
  • Loss of one eye and one limb
  • One ear and one limb
  • One eye and one ear
 200,000/-
Permanent Partial Disability 150,000/-
  • Loss of one limb
  • Loss of an eye
  • Loss of hearing of one ear
 150,000/-
Temporary Disability Up to a maximum limit of
Rs. 100,000.00 per Event/Annum<
Payment scale subject to proof documents as requested by SLIC GL.
Disability Period and applicable benefit limit -
  • Two weeks - One Month
  • One Month - Two Months
  • More than Two Months

25,000/-
50,000/-
100,000/-

Life Insurance Coverage
(Only for the parents of students who are below the *poverty line)		 Rs. 75,000/-
  • Death of a Parent -
    Payable Rs.75,000.00 per Student up to a maximum of 3 Students in the family limiting the coverage to Rs. 225,000.00 in respect of one parent
  • For Clergy Students, payments are made only for legitimate Parents.

  • Cover is extended to a Guardian in the event of non-availability of Parents.

  • If the number of children in a family exceeds three, the maximum claim amount which is Rs. 225,000 will be shared equally among the school going children of the family.

  • Maximum two deaths are covered for a year covering both parents.
 75,000/-

We shall not be liable to make any payment if hospitalization or claims are attributable to, or based on, or arise out of, or are directly or indirectly connected to any of the following:

General Exclusions – these exclusions apply throughout your Policy

  1. Hospitalization / Medical expenses not directly related to the specific illness or injury for which hospitalization took place and the expenses which are not approved by the attending doctor.

  2. Any treatment not performed by a doctor

  3. Expenses for elective surgery or treatment which is not medically necessary.

  4. Self-inflicted injuries or conditions (attempted suicide) and or the treatment directly or indirectly arising from alcoholism or drug abuse and any Illness or Physical Injury which may be suffered after consumption of intoxicating liquors or drugs. (Applicable for student only)

  5. Medical or surgical treatment for weight reduction or weight improvement unless the same is caused (directly or indirectly) by a medical condition.

  6. Circumcision unless necessary for treatment due to an accident or ailment.

  7. Any Insured Person committing or attempting to commit a criminal or illegal act.

  8. Non Medical expenses including Personal comfort and convenience such as telephone, television, personal attendant or barber or beauty services, diet charges, food, cosmetics, napkins, toiletry items, guest services and similar incidental expenses or services.

Exclusion applicable only for the section 01 of the Table of Benefits

  1. Non-allopathic methods of surgery and treatment.

  2. Hospitalization for donation of an organ unless specified otherwise and subject to terms and conditions of the policy.

  3. Any experimental or unproven procedures or treatments, devices or pharmacological regimens of any description.

  4. Stay in Hospital where no active regular treatment is given by a Medical Practitioner.

  5. Circumcision unless necessary for treatment due to an accident or ailment and subject to terms and conditions of the policy.

  6. Expenses for any routine or prescribed medical check-up or examination, external and or durable Medical / Non medical equipment of any kind used for diagnosis and/or treatment and/or monitoring and/or maintenance and/ or support including CPAP, CAPD, Infusion pump, ,ambulatory devices like, belts, caps, splints, stings, braces, gloves, hand soaps etc. of any kind, glucometer/ thermometer and similar related items and also any medical equipment, which are subsequently used at home, biomedical waste fees, medical records charges and any luxury taxes.

  7. Any kind of service charges, surcharges, taxes, etc. levied by the Hospital.

  8. Expenses incurred for procurement of a replacement organ, transportation costs of the replacement organ associated administration costs and expenses incurred by the donor.

  9. Any Insured Person committing or attempting to commit a criminal or illegal act.

Exclusions Applicable only to Section 2 & 3 of your Policy

We shall not be liable for any claims directly or indirectly caused by or arising from:

  1. You take part in flying or other aerial activities except as a fare paying passenger in a licensed passenger carrying aircraft.

  2. You taking part in any professional sports or in any sports for which you would or could earn or receive any form of pay.

  3. You taking part in any kind of a motor racing event (other than on foot/pedal cycle)

  4. You taking part in any dangerous activities including caving, potholing, rock climbing or mountaineering which involves using ropes, any underwater activities involving underwater breathing apparatus, sky diving, cliff diving, bungee jumping, BASE (building, antenna, span, earth) jumping, paragliding, hang-gliding, parachuting, white-water rafting, dragon boating, hunting, horse riding, polo, show jumping, mountain biking unless we have otherwise agreed in writing.