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1. Presentation of Group Insurance
Scheme for Maceton Ltd.

2. About Guardian Life
Mission: Our highest priority is to maximize financial benefits to our valued
policy holders through proper risk management and sustained long term
relationships.
Vision: To help our valued policy holders in building a better and safer
future and enjoy peace of mind through providing world-class life insurance
products and customer service experiences.

3. Group Benefits for Maceton Ltd:
1. Natural Death (Group Term Life with ADB,
PTD & PPD-1st Schedule of labor law),
2. Hospitalization (In-Patient Treatment),
3. Critical Illness(CIB-18)
4.OPD
5.OPD Dental
6.OPD Optical.

4. Natural Death (Group Term-GT)
Group Life Insurance coverage provides settlement of Death (due to any reason;
sickness) claim up to the sum assured against the Insured Employee or Group
Member. The payment will be paid in the event of death of an employee from
any cause whatsoever anywhere in the world, except-
• Attempted suicide or intentionally self inflicted injury, while sane or insane.
• “AIDS” or “AIDS” related Diseases or Complications.
Accidental Death (ADB)
If an insured employee meets with death due to an Accident, Guardian Life
subject to the provision stated in the Respective Policy, will pay a Benefit Amount
to the entitled person(s) or the employer. The Accidental Death Benefit is
payable in addition to Group Term-GT Life Insurance Amount within the policy
Maximum Limit to the beneficiary of the employee.
Group Benefits for Maceton Ltd:

5. Group Benefits for Maceton Ltd :
• Permanent Total Disability (PTD)
• Permanent Partial Disability (PPD)
In case of a Permanent Partial & Total Disablement caused directly by
an accident only, indemnity according to the terms and conditions as
per agreement shall be made by the GLIL to the Maceton Ltd as
specified in the First Schedule of the Labor Law of Bangladesh and
where applicable, only one sum namely the larger sum will be paid for
multiple injuries resulting from one accident.

6. Group Benefits for Maceton Ltd:
Critical Illness(CI-18) Coverage
Critical illness insurance provides additional coverage for few illnesses or emergencies. At least 3 (three) months waiting
period shall be applicable .
1.Cancer 10.Heart Valve Replacement
2.Heart Attack (Myocardial Infraction) 11.Surgery of Aorta
3.Stroke 12.Aplastic Anemia
4.Coronary Artery (Bypass) Surgery 13.Benign Brain Tumor
5.Kidney Failure (End Stage Renal Disease) 14.Chronic Lung Disease/End Stage Lung Disease
6.Major Organ Transplantation 15.Deafness/Loss of Hearing
7.Paralysis 16.Major Head Trauma
8.Multiple Sclerosis 17.Loss of Limbs
9.Blindness/Loss of Sight 18.Loss of speech

7. Hospitalization (In Patient Treatment):
Group Benefits for Maceton Ltd:
IPD Benefit Schedule
Coverage in BDT. –
Plan A
Coverage Per Person Per Disability 200,000
Daily Hospital Room Rent (Actual or Max.) 5,000
Total Hospital Room Rent 80,000
ICU/CCU Limit per confinement 14 days
All other In-Patient treatment expenses inclusive of surgical charges,
consultation fees, medicines and relevant Medical investigations related to
the ailment and other ancillary services (excluding Room & ICU/CCU
charges) maximum Per Disability.
120,000

8. Out Patient Treatment(OPD):
General OPD Benefit/Year Coverage
Max. Coverage Maximum Limit per Member per year 30,000
Max. Consultation Charges Limit per Member per year including Dental & Optical 9,000
Specialist visit (at actual but not more than per visit)
General Practitioner Office or Home visit (Actual or Max.)
1,500
500
Investigation Charges Limit per Member per year including Dental & Optical 12,000
Medicine Cost Limit per Member per year including Dental & Optical 9,000

9. Out-Patient Treatment Plan Dental:
Out-Patient Treatment Plan-Dental Coverage
Dental Treatment (Except Aesthetics & Denture) Maximum limit per
Member per Year
Dental coverage is limited to:
1) Amalgam, Resin Plastic & Temporary/Permanent Fillings
2) Root Canal Treatment
3) Doctor's Fee
4) X-rays / Investigations
5) Root Canal Treatment including bridging and capping
6) Extraction
7) Scaling & Polishing (Once in a year for each member)
BDT 5,000

10. Out-Patient Treatment Plan Optical:
Out-Patient Treatment Plan-Optical Coverage
Optical Treatment Maximum per Member per Year
Optical coverage is limited to:
1) Doctors Fee
2) Medication
3) Vision tests for errors of refraction
Lenses and spectacles (BDT. 2,000/-once in a year)
BDT 5,000

11. Claim Procedure
In Patient Treatment
• The Member must send ‘Claim Intimation Form’ to the company Within 48 Hours Of Any
Hospitalization.
***Prior Intimation Shall Be Waived for Medical Emergency.

12. Excess Of The
Benefit Limit
Should Be Borne By
The Member And
Settled With The
Hospital At The
Time of Discharge.
Benefit Limit
Directly To The
Hospital/Clinic Via
Gop (Guarantee Of
Payment)
GLIL Preferred
Hospital/Clinic
MEMBE
R

13. Reimburse Actual
Expense Incurred For
Hospital Treatment
Up To The Benefit
Limit Upon Receipt
Of Complete Claim
Form Along With
Supporting
Documents Within 10
Working Days
Submit Claim
Through ‘Claim Form’
Or ACPS To GLIL
Within 30
Days From Discharge.
Not Covered under
GLIL Network
MEMBE
R
**For All Medical Claim (IPD) Claim Submission Shall Be done in 60 Days.
**https://myguardianbd.com/Home/GlilPreferedHospital

14. Supporting documents (duly attested by competent authority) include the followings:
1. Consultant’s Recommendation on prescription for hospitalization,
2. Copy of Discharge Certificate,
3. Copy of Investigations Reports while taking treatments,
4. A copy of the Patient's File while taking treatments (if possible),
5. Original Money Receipts or Bill of Consultants (Physician/Surgeon) fee,
6. Original Bill relating to Room Charges, Investigations and Other Services where applicable,
7. Original Bill of Medicine/Drugs related to treatment.
8. Original Bill relating to Surgical Operation charges (operation theatre, surgical team, delivery charge,
anesthesia & other charges),
9. Original Bill relating to Ancillary Charges (e. g. Ambulance Service, Oxygen Therapy, Blood Transfusions
etc.) as per the agreement.
**Photocopy of any money receipt is unacceptable.
***Writing or Any Modification in any claim documents is strongly prohibited. It will be considered as
Unfair Means (Subject to proper inquiry and proof) and will be treated as Invalid.
Claim Procedure for Maceton Ltd(Cont’d):

15. • 10 days Pre & Post Hospitalization treatment expenses arising out of consultation, medicine costs &
investigations are covered, provided that such expenses are related to the disease for which
Hospitalization was required.
• If any Insured is also covered for similar benefits under any other insurance Contract, then payment of
the claim shall be made on pro-rata basis after taking into account the coverage under all contracts.
• Any charge for food or food supplements (Horlicks, Viva, Vitamin, Calcium, Bournvita etc.) except
vitamins as active treatment, antiseptics (Savlon, Dettol, Boroline, Povidone iodine etc), tissue/toilet
papers, cosmetic creams or oils of any nature, any medicated items that’s are Pharmacologically not
accepted as medicine even advised by physician, mineral water purifiers etc. are excluded. Telephone
charges, Rental car services, VAT or any other etc . are not included. However, antiseptic or/and any of
above mentioned items may be included subject to the consideration on the merits of sickness or
disability and relevancy of the treatment.
• The period for each Confinement shall be limited to a maximum of 30 (Thirty) days. Notwithstanding
anything contained herein this Contract, the sum of total benefit shall in no event whatsoever exceed
the maximum limit set forth in the Table of Benefits of Annexure – B (1) Changed as per your
requirement.
• Can’t be changed
• Changed as per your requirement. Service charge is payable.
Limitation

16. No benefit shall be paid under this Contract for expenses or losses resulting
from or incurred in connection with or in consequence of the followings:
• any Congenital Infirmity;
• mental, emotional or psychiatric disorders, alcoholism or any other narcotic addiction;
• circumcision, prophylactic, vaccination and immunization procedures;
• Obesity i.e., treatment for, or required as a result of obesity, any condition under evaluation;
• any procedures which is experimental or not generally accepted by the medical profession viz.
acupuncture, Alternative Medical Care (Homeopathic, Herbal, Ayurvedic) etc;
• any cosmetic skin treatment or plastic treatment/surgery, unless required as reconstructive surgery
as a consequence of an injury due to Accidents, burns;
• rest, convalescence or rejuvenation cures, thermal baths, physiotherapy, any confinement or
treatment for the purposes of slimming or beautification;
• treatment of family planning purposes including wilful termination of pregnancy, sterility or
treatment related to infertility or Assisted Reproduction Technology (ART);
Exclusions

17. • attempted suicide, violation or attempted violation of the law, injuries wilfully or intentionally self-
inflicted or due to insanity or under the influence of a drug;
• routine examination of eye and ear, fitting or replacement of eyeglasses (including Intra-ocular lens
or contact lenses) or hearing aids;
• health screening including Routine Examinations (health check-ups, investigations done by self),
radiotherapy-X-ray radium or radioactive isotopes treatment (except Hospitalization), chemotherapy
or hospitalization due to complication of chemotherapy (except Hospitalization) or any form of
treatment when not incidental or necessary to the treatment of the injury/Illness which caused the
Hospitalization;
• any dental treatment not stated in the Table of Benefits of Annexure – B (1) unless required as a
result of Hospitalization for re-constructive surgery as a consequence of an Accident;
• injury arising due to Accident while participating in any unlawful activities (e.g. driving a car without
a license);
• non-surgical care for tuberculosis, Sexually Transmitted Disease (STD);
• injury or disease directly or indirectly attributed to or caused by war, declared or undeclared, or war
like operations or as a result of direct involvement in civil commotion;
• Sleep disorders i.e., treatment for insomnia, sleep apnea, snoring, or any other sleep related
breathing problem;
• injury, destruction or damage caused by nuclear fission, nuclear fusion or irradiation;
• costs of prostheses, corrective devices and medical appliances, unless such corrective devices and/or
medical appliances are required as a part of surgical operations
Exclusions

18. Thank
You