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Individual Medical Takaful

Standard Benefits Elite (AUH) – General Network Select (AUH) – Restricted Network Classic (AUH) – Super Restricted Network Core (AUH) – Workers Network
AGGREGATE LIMIT AED 500,000 per person per annum AED 400,000 per person per annum AED 300,000 per person per annum AED 250,000 per person per annum
LOCAL NETWORK  General Network
(Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the
existing network, The updated network list of medical providers will be sent accordingly to the policy holder.)
Restricted Network
(Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to
the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.)
Super Restricted Network
(Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes
to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.)
Workers Network
(Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.)
OUTPATIENT LIMIT  Within the aggregate Limit .  Within the aggregate Limit .  Within the aggregate Limit . Within the aggregate Limit
In compliance with HAAD Circular no (DG/32/17) dated 13/08/2017 Patients seeking a second or subsequent outpatient appointment for the same specialty within 21 days, without doctor referral,
will only be covered if the patient obtains pre-approval by calling the “Company” claims’ centre. This process excludes the following: Patient’s first visit for a
specific symptom, children (under the age of 18), patients aged 60 years and above, health screening visits, vaccination visits, and emergencies. 
 Pharmaceuticals are 80% covered with 20% copayment  Pharmaceuticals are 80% covered with 20% copayment  Pharmaceuticals are 80% covered with 20% copayment Pharmaceuticals are 70% covered with 30% copayment upto 3000 AED per person per annum
   Physician Consultation (GP):100% Covered – With Patient deductible of AED 50 per physician consultation (not applicable for follow up within 7 days)  Physician Consultation (GP):100% Covered – With Patient deductible of AED 50 per physician consultation (not applicable for follow up within 7 days)  Physician Consultation (GP):100% Covered – With Patient deductible of AED 50 per physician consultation (not applicable for follow up within 7 days) Physician Consultation (GP):100% Covered – With Patient deductible of AED 50 per physician consultation (not applicable for follow up within 7 days)
   Specialty Consultation (Specialist / Consultant):100% Covered – With Patient deductible of AED 50 per physician consultation (not applicable for follow up within 7 days)  Specialty Consultation (Specialist / Consultant):100% Covered – With Patient deductible of AED 50 per physician consultation (not applicable for follow up within 7 days)  Specialty Consultation (Specialist / Consultant):100% Covered – With Patient deductible of AED 50per physician consultation (not applicable for follow up within 7 days) Specialty Consultation (Specialist / Consultant):100% Covered – With Patient deductible of AED 50 per physician consultation (not applicable for follow up within 7 days)
   Diagnostics Services: 100% Covered for Laboratory  & Imaging Services with AED 30/- deductible per visit   Diagnostics Services: 100% Covered for Laboratory  & Imaging Services with AED 30/- deductible per visit   Diagnostics Services: 100% Covered for Laboratory  & Imaging Services with AED 30/- deductible per visit  Diagnostics Services: 100% Covered for Laboratory & Imaging Services with AED 30/- deductible per visit
   Imaging Services to cover:  Imaging Services to cover:  Imaging Services to cover: Imaging Services to cover:
    X-rays   X-rays   X-rays   X-rays
    MRI   MRI   MRI   MRI
    CT-scan,    CT-scan,    CT-scan,    CT-scan, 
    Ultra Sound   Ultra Sound   Ultra Sound   Ultra Sound
   Laboratory Services to cover:  Laboratory Services to cover:  Laboratory Services to cover:  Laboratory Services to cover:
    Biochemistry   Biochemistry   Biochemistry   Biochemistry
    Hematology   Hematology   Hematology   Hematology
    Virology   Virology   Virology   Virology
    Bacteriology   Bacteriology   Bacteriology   Bacteriology
    Pathology    Pathology    Pathology    Pathology 
OUTPATIENT APPROVAL REQUIREMENTS CT and MRI scans
Endoscopies
All additional therapies e.g. Physiotherapy, Chiropractic, etc.
Any additional benefits to HAAD Basic Product such as Optical and Dental treatment, Psychiatry,
vaccination, etc. 
CT and MRI scans
Endoscopies
All additional therapies e.g. Physiotherapy, Chiropractic, etc.
Any additional benefits to HAAD Basic Product such as Optical and Dental treatment, Psychiatry,
vaccination, etc. 
CT and MRI scans
Endoscopies
All additional therapies e.g. Physiotherapy, Chiropractic, etc.
Any additional benefits to HAAD Basic Product such as Optical and Dental treatment, Psychiatry,
vaccination, etc. 
CT and MRI scans
Endoscopies
All additional therapies e.g. Physiotherapy, Chiropractic, etc.
Any additional benefits to HAAD Basic Product such as Optical and Dental treatment, Psychiatry, vaccination, etc.
INPATIENT COVER
Subject to Prior-Approval
Within the aggregate Limit (100% Covered Except for Exclusions)
Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU).
Within the aggregate Limit (100% Covered Except for Exclusions)
Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU).
Within the aggregate Limit (100% Covered Except for Exclusions)

Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU).
Within the aggregate Limit (100% Covered Except for Exclusions)
Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU).
SETTLEMENT BASIS INSIDE NETWORK IN UAE Direct Billing Direct Billing Direct Billing Direct Billing
BASIC TERRITORY Worldwide excluding USA, Canada. Worldwide excluding USA, Canada and Europe UAE, Arab Countries, Middle East, Indian Sub-continent and South East Asia Countries UAE
TRAVEL EXTENSION
(OUTSIDE BASIC TERRITORY)
Worldwide, Applicable only in case of emergency while on vacation or business trip provided the maximum aggregate period of stay does not exceed 90 days during the Period of policy. Reimbursement
will be up to 80% of reasonable & customary charges applicable in the in the country of treatment subject to not exceeding the applicable UAE network highest tariff.
Worldwide excluding USA & Canada, Applicable only in case of emergency while on vacation or business trip provided the maximum aggregate period of stay does not exceed 60 days during the
Period of policy. Reimbursement will be up to 80% of reasonable & customary charges applicable in the in the country of treatment subject to not exceeding the applicable UAE network highest
tariff.
Not Covered Arab Countries, South East Asia, and Indian Sub-continent, Applicable only in case of emergency while on vacation or business trip provided the maximum aggregate period of stay does not exceed 60 days during the Period of policy. Reimbursement will be up to 80% of reasonable & customary charges applicable in the in the country of treatment subject to not exceeding the applicable UAE network highest tariff.
INTERNATIONAL ASSISTANCE While they are travelling abroad, insured members will be advised through our International Assistance Program (Eurocross) upon contacting the number at the back of the medical card, about a
suitable medical facility according to their medical condition.

Benefit will cover mainly : 1.  Evacuation and Repatriation 2.  Repatriation of Mortal Remains 3.  Travel Information Service 4.  Referral to Medical
Correspondents Abroad 5.  Long Distance Medical Advice 6.  Delivery of Urgent Messages 7. Transportation to Join Member 8.  Return of Dependent Children 9.  Compensation for Delay
in the Arrival of Luggage 10.  Total Loss or Disappearance of Baggage 11.  Loss of Passport, Driving License, or National Identity Card Abroad

For Full Details and list of Benefits, conditions & exclusions: please refer to the International assistance brochure.

Not Covered Not Covered Not Covered
OUT-OF-NETWORK INSIDE UAE.

Claims to be submitted within 30 days inside UAE and within 60 days outside UAE
Outpatient Treatment:

Physician Consultation (GP) covered with 20% Co-payment and applicable deductible

Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible

Pharmaceutical: are subject providing proper documentation.

Lab and Imaging Services: are subject providing proper documentation.

Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only.

Any treatment initiated outside the network will be settled as an out of Network.

Inpatient Treatment:

Treatment taken outside the Network is covered At 80% of incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basisonly.

Outpatient Treatment:

Physician Consultation (GP) covered with 20% Co-payment and applicable deductible

Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible

Pharmaceutical: are subject providing proper documentation.

Lab and Imaging Services: are subject providing proper documentation.

Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only.

Any treatment initiated outside the network will be settled as an out of Network.

Inpatient Treatment:

Treatment taken outside the Network is covered At 80% of incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basisonly.

Outpatient Treatment:

Physician Consultation (GP) covered with 20% Co-payment and applicable deductible

Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible

Pharmaceutical: are subject providing proper documentation.

Lab and Imaging Services: are subject providing proper documentation.

Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only.

Any treatment initiated outside the network will be settled as an out of Network.

Inpatient Treatment:

Treatment taken outside the Network is covered At 80% of incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basisonly.

Outpatient Treatment:

Physician Consultation (GP) covered with 20% Co-payment and applicable deductible

Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible

Pharmaceutical: are subject providing proper documentation.

Lab and Imaging Services: are subject providing proper documentation.

Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only.

Any treatment initiated outside the network will be settled as an out of Network.

Inpatient Treatment:
Treatment taken outside the Network is covered At 80% of incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only.

OUTSIDE UAE
while on vacation or business trip provided the maximum aggregate period of stay does not exceed 90 days during the Period of policy
Treatment Outside UAE inside the Basic Territory:

Covered at 80% with applicable deductible, up to reasonable and customary charges applicable in the country of treatment on reimbursement basis only subject to not exceeding the applicable
UAE network highest tariff.

Treatment Outside UAE Outside the Basic Territory:

Covered as mentioned under the clause of travel extension.
Treatment Outside UAE inside the Basic Territory:

Covered at 80% with applicable deductible, up to reasonable and customary charges applicable in the country of treatment on reimbursement basis only subject to not exceeding the applicable
UAE network highest tariff.

Treatment Outside UAE Outside the Basic Territory:

Covered as mentioned under the clause of travel extension.
Treatment Outside UAE inside the Basic Territory:

Covered at 80% with applicable deductible, up to reasonable and customary charges applicable in the country of treatment on reimbursement basis only subject to not exceeding the applicable
UAE network highest tariff.

Treatment Outside UAE Outside the Basic Territory:

Covered as mentioned under the clause of travel extension.
Treatment Outside UAE inside the Basic Territory:

N/A

Treatment Outside UAE Outside the Basic Territory:

Covered as mentioned under the clause of travel extension.
EMERGENCY & TREATMENT NOT AVAILABLE WITHIN NETWORK in UAE Covered 100% within UAE (Subject to policy terms, conditions & exclusions and applicable deductible/co-payment if any)  Covered 100% within UAE (Subject to policy terms, conditions & exclusions and applicable deductible/co-payment if any)  Covered 100% within UAE (Subject to policy terms, conditions & exclusions and applicable deductible/co-payment if any)  Covered 100% within UAE (Subject to policy terms, conditions & exclusions and applicable deductible/co-payment if any)
ROOM TYPE Private Room Private Room Private Room Semi Private Room
PARENT ACCOMMODATION  Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 300/- per night) Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 150/- per night) Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 150/- per night) Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 150/- per night)
ACCOMPANYING PERSON  Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 300/-
per night)
Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 150/-
per night)
Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 150/-
per night)
Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 150/- per night)
LOCAL AMBULANCE Transportation services  for medical emergencies inside the UAE by an authorized party is 100% covered Transportation services  for medical emergencies inside the UAE by an authorized party is 100% covered Transportation services  for medical emergencies inside the UAE by an authorized party is 100% covered Transportation services for medical emergencies inside the UAE by an authorized party is 100% covered
PHYSIOTHERAPY  100% Covered, subject to prior approval 100% Covered, subject to prior approval 100% Covered, subject to prior approval 100% Covered, subject to prior approval
MATERNITY / Obstetrical & Follow up (IP & OP) FOR MARRIED FEMALES ONLY

Waiting period of 180 days on In-Patient cases only (unless there is proof of continuity of health insurance coverage).

Subject to Prior Approval.
1. Deductible:
AED 500/- per Delivery & AED 50/- per consultation (same conditions of OP consultations will apply).

2. Inside Abu Dhabi:
Covered up to aggregate.

3. Out Side Abu Dhabi:

Covered up to AED 15,000/- for Normal Delivery and for Cesarean Section.

The antenatal care (visits, ultra sounds, etc…) is inclusive of the above limits.

Emergency inside UAE covered 100% up to the policy limit

Treatment not available within the network is covered 100% up to maternity limit within UAE.
1. Deductible:
AED 500/- per Delivery & AED 50/- per consultation (same conditions of OP consultations will apply).

2. Inside Abu Dhabi:
Covered up to aggregate.

3. Out Side Abu Dhabi:

Covered up to AED 15,000/- for Normal Delivery and for Cesarean Section.

The antenatal care (visits, ultra sounds, etc…) is inclusive of the above limits.

Emergency inside UAE covered 100% up to the policy limit

Treatment not available within the network is covered 100% up to maternity limit within UAE.
1. Deductible:
AED 500/- per Delivery & AED 50/- per consultation (same conditions of OP consultations will apply).

2. Inside Abu Dhabi:
Covered up to aggregate.

3. Out Side Abu Dhabi:

Covered up to AED 15,000/- for Normal Delivery and for Cesarean Section.

The antenatal care (visits, ultra sounds, etc…) is inclusive of the above limits.

Emergency inside UAE covered 100% up to the policy limit

Treatment not available within the network is covered 100% up to maternity limit within UAE.
1.  Deductible:
AED 500/- per Delivery & AED 50/- per consultation (same conditions of OP consultations will apply).

2.  Inside Abu Dhabi:

Covered up to aggregate.

3.  Out Side Abu Dhabi:

Covered up to AED 10,000/- for Normal Delivery and Cesarean Section.

The antenatal care (visits, ultra sounds, etc…) is inclusive of the above limits.

Emergency inside UAE covered 100% up to the policy limit

Treatment not available within the network is covered 100% up to maternity limit within UAE.
WORK RELATED ACCIDENTS
As per Federal Law No. 8 of 1980 concerning the regulation of work relation as amended and applicable laws in this regard.
Covered inside Abu Dhabi only.  Covered inside Abu Dhabi only.  Covered inside Abu Dhabi only.  Covered inside Abu Dhabi only.
OTHER BENEFITS Diagnostic and treatment services for dental and gum treatments emergency cases only.
Hearing and vision aids, and vision correction by surgeries & ophthalmology, and laser are covered
for emergency cases only.
Diagnostic and treatment services for dental and gum treatments emergency cases only.
Hearing and vision aids, and vision correction by surgeries & ophthalmology, and laser are covered
for emergency cases only.
Diagnostic and treatment services for dental and gum treatments emergency cases only.
Hearing and vision aids, and vision correction by surgeries & ophthalmology, and laser are covered
for emergency cases only.
Diagnostic and treatment services for dental and gum treatments emergency cases only.
Hearing and vision aids, and vision correction by surgeries & ophthalmology, and laser are covered for emergency cases only.
ADDITIONAL BENEFITS        
ORGAN TRANSPLANT Covered, only for Heart, Kidney and Liver up to maximum of AED 50,000/-, subject to Prior Approval.
Organ donation, expenses of the donor and acquisition of the organ are excluded.
Not Covered Not Covered Not Covered
ALTERNATIVE MEDICINE TREATMENT INCLUDING ONLY THE FOLLOWING TREATMENTS: Prescribed Herbal Medicines, Acupuncture, Chiropractic, Homeopathy, Traditional Chinese Medicine, Ayurveda, Osteopathy,
Hypnotism, Aromatherapy
Covered up to 2,500/-  With 20% Co-payment (no additional copayment outside the applicable Network)

If prescribed by a licensed specialist
subject to prior approval
Covered up to 1,500/-  With 20% Co-payment (no additional copayment outside the applicable Network)

If prescribed by a licensed specialist
subject to prior approval
Not Covered Not Covered
HOME NURSING  Covered up to maximum of 4 week with a sublimit of 5,000/- (inclusive of the Annual Limit) subject to prior approval

Under the supervision of specialist or  consultant.
On Reimbursement basis only
This benefit will be covered without limiting or affecting any minimum benefit as per health insurance
law
Covered up to maximum of 4 week with a sublimit of 2,000/- (inclusive of the Annual Limit) subject to prior approval

Under the supervision of specialist or  consultant.
On Reimbursement basis only
This benefit will be covered without limiting or affecting any minimum benefit as per health insurance
law
Covered up to maximum of 4 week with a sublimit of 2,000/- (inclusive of the Annual Limit) subject to prior approval

Under the supervision of specialist or  consultant.
On Reimbursement basis only
This benefit will be covered without limiting or affecting any minimum benefit as per health insurance
law
Not Covered
ROUTINE VACCINATIONS  Covered up to maximum of AED 1,000/- for children up to 6 yrs only
As Per DOH Guidelines (Subject To Prior Approval)
Covered up to maximum of AED 1,000/- for children up to 6 yrs only
As Per DOH Guidelines (Subject To Prior Approval)
Not Covered Not Covered
PSYCHIATRIC TREATMENTS Covered on 80% Reimbursement Basis up to 5,000 Dhs. per member per year (No additional copayment outside the applicable network)

Subject to prior-approval
Transient mental disorder or an acute reaction to stress are covered up to policy limit in UAE only
Covered on 80% Reimbursement Basis up to 3,000 Dhs. per member per year (No additional copayment outside the applicable network)

Subject to prior-approval
Transient mental disorder or an acute reaction to stress are covered up to policy limit in UAE only
Not Covered
Transient mental disorder or an acute reaction to stress are covered up to policy limit in UAE only
Not Covered
Transient mental disorder or an acute reaction to stress are covered up to policy limit in UAE only
VITAMINS Covered if prescribed by doctor as a part of treatment and not as a supplement Covered if prescribed by doctor as a part of treatment and not as a supplement Covered if prescribed by doctor as a part of treatment and not as a supplement Covered if prescribed by doctor as a part of treatment and not as a supplement
REHABILITATION IMMEDIATELY AFTER ACUTE MEDICAL TREATMENT Inside the Emirate of Abu Dhabi and Emergency cases within UAE: Covered as per DOH Regulations subject to prior approval.
Outside the Emirate of Abu Dhabi Inside UAE (Elective cases only):
Covered
subject to prior approval up to 120 days per medical condition as below:

Physical Therapy to help strength, mobility & fitness – covered
Occupational Therapy to help you with your daily activities – not covered

Speech-Language therapy to help with speaking, understanding, reading, writing and swallowing – not covered.
Inside the Emirate of Abu Dhabi and Emergency cases within UAE: Covered as per DOH Regulations subject to prior approval.

Outside the Emirate of Abu Dhabi Inside UAE (Elective cases only):

Covered subject to prior approval up to 120 days per medical condition as below:

Physical Therapy to help strength, mobility & fitness – covered

Occupational Therapy to help you with your daily activities – not covered

Speech-Language therapy to help with speaking, understanding, reading, writing and swallowing – not covered.
Inside the Emirate of Abu Dhabi and Emergency cases within UAE: Covered as per DOH Regulations subject to prior approval.

Outside the Emirate of Abu Dhabi Inside UAE (Elective cases only):

Covered subject to prior approval up to 120 days per medical condition as below:

Physical Therapy to help strength, mobility & fitness – covered

Occupational Therapy to help you with your daily activities – not covered

Speech-Language therapy to help with speaking, understanding, reading, writing and swallowing – not covered.
Inside the Emirate of Abu Dhabi and Emergency cases within UAE: Covered as per DOH Regulations subject to prior approval.

Outside the Emirate of Abu Dhabi Inside UAE (Elective cases only):

Covered subject to prior approval up to 120 days per medical condition as below:

Physical Therapy to help strength, mobility & fitness – covered

Occupational Therapy to help you with your daily activities – not covered

Speech-Language therapy to help with speaking, understanding, reading, writing and swallowing – not covered.
ROUTINE DENTAL Covered subject to prior approval up to AED 3,000/- per person per annum with 20% copayment on all procedures, the covered procedures are:

Examination
Required tooth cleaning (following treatment only) once a year
Fillings
Root Treatment
Tooth extraction

X-Ray
Local Anesthesia
Prescribed drugs
Covered subject to prior approval up to AED 2,000/- per person per annum with 20% copayment on all procedures, the covered procedures are:

Examination
Required tooth cleaning (following treatment only) once a year
Fillings
Root Treatment
Tooth extraction

X-Ray
Local Anesthesia
Prescribed drugs
Not Covered Not Covered
OPTICAL BENEFITS   Prior approval is required.
The cover is up to maximum annual limit of AED 1,000/- per member.

Direct Billing is available within the designated Optical Network.

The cover includes the following only:

1, One elective diagnostic service for correction of vision in a licensed healthcare provider in a medical center or hospital per person per annum.

2, Lenses for spectacles are covered once a year inclusive of the maximum optical limit subject to Ophthalmologist / optometrist prescription

3, Any other services related to correction of vision are not covered.
Prior approval is required.
The cover is up to maximum annual limit of AED 1,000/- per member.

Direct Billing is available within the designated Optical Network.

The cover includes the following only:

1, One elective diagnostic service for correction of vision in a licensed healthcare provider in a medical center or hospital per person per annum.

2, Lenses for spectacles are covered once a year inclusive of the maximum optical limit subject to
Ophthalmologist / optometrist prescription

3, Any other services related to correction of vision are not covered.
Not Covered Not Covered
IN HOSPITAL CASH BENEFIT Covered up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE Covered up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE Covered up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE Covered up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE
AIR TICKET FARE Air Ticket fare, will be subject to:

1. Treatment within the member’s eligible geographical area for elective treatments as per policy.

2. Inpatient treatments.

3. Cost of treatment is less than 50% of the applicable network customary tariff of the country of policy issuance (including the cost of air fare).

4. Airfare class : Economy.

5. Reimbursement for the patients airfare (no airfare for companions).

6. Reimbursement will be limited to AED 2000/- maximum for every ticket.
Air Ticket fare, will be subject to:

1. Treatment within the member’s eligible geographical area for elective treatments as per policy.

2. Inpatient treatments.

3. Cost of treatment is less than 50% of the applicable network customary tariff of the country of policy issuance (including the cost of air fare).

4. Airfare class : Economy.

5. Reimbursement for the patients airfare (no airfare for companions).

6. Reimbursement will be limited to AED 2000/- maximum for every ticket.
Air Ticket fare, will be subject to:

1. Treatment within the member’s eligible geographical area for elective treatments as per policy.

2. Inpatient treatments.

3. Cost of treatment is less than 50% of the applicable network customary tariff of the country of policy issuance (including the cost of air fare).

4. Airfare class : Economy.

5. Reimbursement for the patients airfare (no airfare for companions).

6. Reimbursement will be limited to AED 2000/- maximum for every ticket.
Not Covered
PROSTHESIS INSERTED INTO THE BODY DURING THE COURSE OF A SURGICAL PROCEDURE Covered if medically necessary and prescribed by a doctor to be integral part of the body. Covered if medically necessary and prescribed by a doctor to be integral part of the body. Covered if medically necessary and prescribed by a doctor to be integral part of the body. Covered if medically necessary and prescribed by a doctor to be integral part of the body.

Standard Benefits Elite (DXB) – General Network Select (DXB) – Restricted Network Classic (DXB) – Super Restricted Network Core (Dubai) – Workers Network
AGGREGATE LIMIT AED 500,000 per person per annum AED 400,000 per person per annum AED 300,000 per person per annum AED 150,000 per person per annum
LOCAL NETWORK  General Network
(Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the
existing network, The updated network list of medical providers will be sent accordingly to the policy holder.)
Restricted Network
(Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to
the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.)
Super Restricted Network
(Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes
to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.)
Worker Network
(Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.)
SETTLEMENT BASIS INSIDE NETWORK IN UAE Direct Billing Direct Billing Direct Billing Direct Billing
BASIC TERRITORY Worldwide excluding USA, Canada. Worldwide excluding USA, Canada and Europe UAE, Arab Countries, Middle East, Indian Sub-continent and South East Asia Countries UAE
INTERNATIONAL ASSISTANCE While they are travelling abroad, insured members will be advised through our International Assistance Program (Eurocross) upon contacting the number at the back of the medical card, about a
suitable medical facility according to their medical condition.

Benefit will cover mainly : 1.  Evacuation and Repatriation 2.  Repatriation of Mortal Remains 3.  Travel
Information Service 4.  Referral to Medical Correspondents Abroad 5.  Long Distance Medical Advice 6.  Delivery of Urgent Messages 7. Transportation to Join Member 8.
Return of Dependent Children 9.  Compensation for Delay in the Arrival of Luggage 10.  Total Loss or Disappearance of Baggage 11.  Loss of Passport, Driving License, or National Identity
Card Abroad

For Full Details and list of Benefits, conditions & exclusions: please refer to the International assistance brochure.

Not Covered Not Covered Not Covered
EMERGENCY MEDICAL TREATMENT INSIDE UAE Within all emirates of the UAE subject to policy terms and conditions Within all emirates of the UAE subject to policy terms and conditions Within all emirates of the UAE subject to policy terms and conditions Within all emirates of the UAE subject to policy terms and conditions
OUT-OF-NETWORK INSIDE UAE. Claims to be submitted within 30 days inside UAE and within 60 days outside UAE 1. Outpatient Treatment:

Physician Consultation (GP) covered  with 20% Co-payment and applicable deductible

Specialist Consultation (SP) covered  with 20% Co-payment and applicable deductible

Pharmaceutical: Covered with 20% Co-payment and applicable deductible

Lab and Imaging Services: Covered with 20% Co-payment and applicable deductible

Reimbursement At incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on 80% reimbursement basis only.

Any treatment initiated outside the network will be settled as an out of Network.

2. Inpatient Treatment:

Treatment taken outside the Network is At incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on 80% reimbursement basis only.

1. Outpatient Treatment:

Physician Consultation (GP) covered  with 20% Co-payment and applicable deductible

Specialist Consultation (SP) covered  with 20% Co-payment and applicable deductible

Pharmaceutical: Covered with 20% Co-payment and applicable deductible

Lab and Imaging Services: Covered with 20% Co-payment and applicable deductible

Reimbursement At incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on 80% reimbursement basis only.

Any treatment initiated outside the network will be settled as an out of Network.

2. Inpatient Treatment:

Treatment taken outside the Network is At incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on 80% reimbursement basis only.

1. Outpatient Treatment:

Physician Consultation (GP) covered  with 20% Co-payment and applicable deductible

Specialist Consultation (SP) covered  with 20% Co-payment and applicable deductible

Pharmaceutical: Covered with 20% Co-payment and applicable deductible

Lab and Imaging Services: Covered with 20% Co-payment and applicable deductible

Reimbursement At incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on 80% reimbursement basis only.

Any treatment initiated outside the network will be settled as an out of Network.

2. Inpatient Treatment:

Treatment taken outside the Network is At incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on 80% reimbursement basis only.

1.  Outpatient Treatment:

Physician Consultation (GP) covered with 20% Co-payment and applicable deductible

Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible

Pharmaceutical: Covered with 20% Co-payment and applicable deductible

Lab and Imaging Services: Covered with 20% Co-payment and applicable deductible

Reimbursement At incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on 80% reimbursement basis only.

Any treatment initiated outside the network will be settled as an out of Network.

2. Inpatient Treatment:

Treatment taken outside the Network is At incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on 80% reimbursement basis only.

OUTSIDE UAE
while on vacation or business trip provided the maximum aggregate period of stay does not exceed 90 days during the Period of policy
Treatment Outside UAE inside the Basic Territory:

Covered at 80% up to reasonable and customary charges applicable in the country of treatment on reimbursement basis only subject to not exceeding the applicable UAE network highest tariff.

Treatment Outside UAE Outside the Basic Territory:
Not covered.
Treatment Outside UAE inside the Basic Territory:

Covered at 80% up to reasonable and customary charges applicable in the country of treatment on reimbursement basis only subject to not exceeding the applicable UAE network highest tariff.

Treatment Outside UAE Outside the Basic Territory:
Not covered.
Treatment Outside UAE inside the Basic Territory:

Covered at 80% up to reasonable and customary charges applicable in the country of treatment on reimbursement basis only subject to not exceeding the applicable UAE network highest tariff.

Treatment Outside UAE Outside the Basic Territory:
Not covered.
Treatment Outside UAE inside the Basic Territory:

Not covered.

Treatment Outside UAE Outside the Basic Territory:

Not covered.

IN-PATIENT TREATMENT AT AUTHORIZED HOSPITALS
ü   Subject to Prior Approval.
In-patient services will be received in private room
Ground transportation services in the UAE provided by an authorized party for medical emergencies.

Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 150/- per night)

Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of
AED 100/- per night)

Prior approval is required from the insurance company (For Emergency Treatment Approval required from the insurance company within 24 hours of admission to the authorized hospital).
In-patient services will be received in private room

Ground transportation services in the UAE provided by an authorized party for medical emergencies.

Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 150/- per night)

Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of
AED 100/- per night)

Prior approval is required from the insurance company (For Emergency Treatment Approval required from the insurance company within 24 hours of admission to the authorized hospital).

In-patient services will be received in private room

Ground transportation services in the UAE provided by an authorized party for medical emergencies.

Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 150/- per night)

Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of
AED 100/- per night)

Prior approval is required from the insurance company (For Emergency Treatment Approval required from the insurance company within 24 hours of admission to the authorized hospital).

In-patient services will be received in semi private room

Ground transportation services in the UAE provided by an authorized party for medical emergencies.

Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 150/- per night)

Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 100/- per night)

Prior approval is required from the insurance company (For Emergency Treatment Approval required from the insurance company within 24 hours of admission to the authorized hospital).

MATERNITY / Obstetrical & Follow up (IP & OP) FOR MARRIED FEMALES ONLY
ü   Subject to Prior Approval.
Out-patient ante-natal services:
10% coinsurance payable by the insured

8 visits to PHC; all care provided by PHC obstetrician for low risk or specialist obstetrician for high risk referrals. Initial investigations to include: FBC and Platelets, Blood group,
Rhesus status and antibodies ,VDRL, MSU & urinalysis, Rubella serology, HIV, Hep C offered to high risk patients, GTT if high risk.

FBS , random s or A1c  for all due to high prevalence of diabetes in UAE

Visits to include reviews, checks and tests in accordance with DHA Antenatal Care Protocols

3 ante-natal ultrasound scans

In-patient maternity services:

10% coinsurance payable by the insured

Maximum benefit 15,000 AED per normal delivery, medically necessary C-section, complications and for medically necessary termination (All limits include coinsurance)

New born cover:

Cover for 30 days from birth. Coverage of a pregnant female is extended by the insurer to provide the same benefits for a new born child of that female for a period up to 30 days from
its date of birth. This cover is provided regardless of whether or not the new born is eventually enrolled as a dependent member under the insurer’s policy.

BCG, Hepatitis B and neo-natal screening tests (Phenylketonuria (PKU), Congenital Hypothyroidism, sickle cell screening, congenital adrenal hyperplasia).

Out-patient ante-natal services:
10% coinsurance payable by the insured

8 visits to PHC; all care provided by PHC obstetrician for low risk or specialist obstetrician for high risk referrals. Initial investigations to include: FBC and Platelets, Blood group,
Rhesus status and antibodies ,VDRL, MSU & urinalysis, Rubella serology, HIV, Hep C offered to high risk patients, GTT if high risk.

FBS , random s or A1c for all due to high prevalence of diabetes in UAE

Visits to include reviews, checks and tests in accordance with DHA Antenatal Care Protocols

3 ante-natal ultrasound scans

In-patient maternity services:

10% coinsurance payable by the insured

Maximum benefit 12,500 AED per normal delivery, medically necessary C-section, complications and for medically necessary termination (All limits include coinsurance)

New born cover:

Cover for 30 days from birth. Coverage of a pregnant female is extended by the insurer to provide the same benefits for a new born child of that female for a period up to 30 days from
its date of birth. This cover is provided regardless of whether or not the new born is eventually enrolled as a dependent member under the insurer’s policy.

BCG, Hepatitis B and neo-natal screening tests (Phenylketonuria (PKU), Congenital Hypothyroidism, sickle cell screening, congenital adrenal hyperplasia).

Out-patient ante-natal services:

10% coinsurance payable by the insured

8 visits to PHC; all care provided by PHC obstetrician for low risk or specialist obstetrician for high risk referrals. Initial investigations to include: FBC and Platelets, Blood group,
Rhesus status and antibodies ,VDRL, MSU & urinalysis, Rubella serology, HIV, Hep C offered to high risk patients, GTT if high risk.

FBS , random s or A1c for all due to high prevalence of diabetes in UAE

Visits to include reviews, checks and tests in accordance with DHA Antenatal Care Protocols

3 ante-natal ultrasound scans

In-patient maternity services:

10% coinsurance payable by the insured

Maximum benefit 7,000 AED per normal delivery, 10,000 AED for medically necessary C-section, complications and for medically necessary termination (All limits include coinsurance)

New born cover:

Cover for 30 days from birth. Coverage of a pregnant female is extended by the insurer to provide the same benefits for a new born child of that female for a period up to 30 days from
its date of birth. This cover is provided regardless of whether or not the new born is eventually enrolled as a dependent member under the insurer’s policy.

BCG, Hepatitis B and neo-natal screening tests (Phenylketonuria (PKU), Congenital Hypothyroidism, sickle cell screening, congenital adrenal hyperplasia).

Out-patient ante-natal services:

10% coinsurance payable by the insured

8 visits to PHC; all care provided by PHC obstetrician for low risk or specialist obstetrician for high risk referrals. Initial investigations to include: FBC and Platelets, Blood group, Rhesus status and antibodies ,VDRL, MSU & urinalysis, Rubella serology, HIV, Hep C offered to high risk patients, GTT if high risk.

FBS , random s or A1c for all due to high prevalence of diabetes in UAE

Visits to include reviews, checks and tests in accordance with DHA Antenatal Care Protocols

3 ante-natal ultrasound scans

In-patient maternity services:

10% coinsurance payable by the insured

Maximum benefit 10,000 AED per normal delivery, 10,000 AED for medically necessary C-section, complications and for medically necessary termination (All limits include coinsurance)

New born cover:

Cover for 30 days from birth. Coverage of a pregnant female is extended by the insurer to provide the same benefits for a new born child of that female for a period up to 30 days from its date of birth. This cover is provided regardless of whether or not the new born is eventually enrolled as a dependent member under the insurer’s policy.

BCG, Hepatitis B and neo-natal screening tests (Phenylketonuria (PKU), Congenital Hypothyroidism, sickle cell screening, congenital adrenal hyperplasia).

OUT-PATIENT IN AUTHORIZED OUT- PATIENT CLINICS OF HOSPITALS, CLINICS & HEALTH CENTERS Examination, diagnostic and treatment services by authorized general practitioners, specialists and consultants: 20% coinsurance payable by the insured per visit (not to exceed Dhs.50 /-)

No coinsurance if a follow-up visit made within seven days.

Laboratory test services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured

Radiology diagnostic services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured

In cases of non-medical emergencies, the insurance company’s prior approval is required for MRI, CT scans and endoscopies.

Physiotherapy treatment services:  20% coinsurance payable per session subject to Prior approval of the insurance company.

Drugs and other medicines:

20% payable by the insured in respect of each and every prescription
Examination, diagnostic and treatment services by authorized general practitioners, specialists and consultants: 20% coinsurance payable by the insured per visit (not to exceed Dhs.50 /-)

No coinsurance if a follow-up visit made within seven days.

Laboratory test services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured

Radiology diagnostic services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured

In cases of non-medical emergencies, the insurance company’s prior approval is required for MRI, CT scans and endoscopies.

Physiotherapy treatment services:  20% coinsurance payable per session subject to Prior approval of the insurance company.

Drugs and other medicines:

20% payable by the insured in respect of each and every prescription
Examination, diagnostic and treatment services by authorized general practitioners, specialists and consultants: 20% coinsurance payable by the insured per visit (not to exceed Dhs.50 /-)

No coinsurance if a follow-up visit made within seven days.

Laboratory test services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured

Radiology diagnostic services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured

In cases of non-medical emergencies, the insurance company’s prior approval is required for MRI, CT scans and endoscopies.

Physiotherapy treatment services:  20% coinsurance payable per session subject to Prior approval of the insurance company.

Drugs and other medicines:

30% payable by the insured in respect of each and every prescription
Examination, diagnostic and treatment services by authorized general practitioners, specialists and consultants: 20% coinsurance payable by the insured per visit (not to exceed Dhs.50 /-)

No coinsurance if a follow-up visit made within seven days.

Laboratory test services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured

Radiology diagnostic services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured

In cases of non-medical emergencies, the insurance company’s prior approval is required for MRI, CT scans and endoscopies.

Physiotherapy treatment services: 20% coinsurance payable per session subject to Prior approval of the insurance company.

Drugs and other medicines:

30% payable by the insured in respect of each and every prescription upto AED 3000 per person per annum

PREVENTIVE SERVICES, VACCINES AND IMMUNIZATIONS Essential vaccinations and inoculations for newborns and children as stipulated in the DHA’s policies and its updates (currently the same as Federal MOH).

Preventive services as stipulated by DHA to include initially diabetes screening

Frequency restricted to: Diabetes: Every 3 years from age 30 High risk individuals  annually from age 18 yrs.

Adult Pneumococcal Conjugate Vaccine: As per DHA Adult Pneumococcal Vaccination guidelines.

Adult Pneumococcal Conjugate Vaccine: As per DHA Adult Pneumococcal Vaccination guidelines.

Cancer Screening and treatment: To be followed as per the guidelines laid out in the Cancer support program

Essential vaccinations and inoculations for newborns and children as stipulated in the DHA’s policies and its updates (currently the same as Federal MOH).

Preventive services as stipulated by DHA to include initially diabetes screening

Frequency restricted to: Diabetes: Every 3 years from age 30 High risk individuals annually from age 18 yrs.

Adult Pneumococcal Conjugate Vaccine: As per DHA Adult Pneumococcal Vaccination guidelines.

Hepatitis C Virus Screening and treatment: To be followed as per the guidelines laid out in the Hepatitis C support program.

Cancer Screening and treatment: To be followed as per the guidelines laid out in the Cancer support program

Essential vaccinations and inoculations for newborns and children as stipulated in the DHA’s policies and its updates (currently the same as Federal MOH).

Preventive services as stipulated by DHA to include initially diabetes screening

Frequency restricted to: Diabetes: Every 3 years from age 30 High risk individuals annually from age 18 yrs.

Adult Pneumococcal Conjugate Vaccine: As per DHA Adult Pneumococcal Vaccination guidelines.

Hepatitis C Virus Screening and treatment: To be followed as per the guidelines laid out in the Hepatitis C support program.

Cancer Screening and treatment: To be followed as per the guidelines laid out in the Cancer support program

Essential vaccinations and inoculations for newborns and children as stipulated in the DHA’s policies and its updates (currently the same as Federal MOH).

Preventive services as stipulated by DHA to include initially diabetes screening

Frequency restricted to: Diabetes: Every 3 years from age 30 High risk individuals annually from age 18 yrs.

Adult Pneumococcal Conjugate Vaccine: As per DHA Adult Pneumococcal Vaccination guidelines.

Hepatitis C Virus Screening and treatment: To be followed as per the guidelines laid out in the Hepatitis C support program.

Cancer Screening and treatment: To be followed as per the guidelines laid out in the Cancer support program
EXCLUDED HEALTHCARE SERVICES EXCEPT IN CASES OF MEDICAL EMERGENCIES Diagnostic and treatment services for dental and gum treatments: Covered for Emergency cases only Subject to 20% coinsurance

Hearing and vision aids, and vision correction by surgeries and laser  : Covered for Emergency cases only Subject to 20% coinsurance

Diagnostic and treatment services for dental and gum treatments: Covered for Emergency cases only Subject to 20% coinsurance

Hearing and vision aids, and vision correction by surgeries and laser  : Covered for Emergency cases only Subject to 20% coinsurance

Diagnostic and treatment services for dental and gum treatments: Covered for Emergency cases only Subject to 20% coinsurance

Hearing and vision aids, and vision correction by surgeries and laser  : Covered for Emergency cases only Subject to 20% coinsurance

Diagnostic and treatment services for dental and gum treatments: Covered for Emergency cases only Subject to 20% coinsurance

Hearing and vision aids, and vision correction by surgeries and laser : Covered for Emergency cases only Subject to 20% coinsurance
IN HOSPITAL CASH BENEFIT Covered subject to  Prior Approval up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE Covered subject to  Prior Approval up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE Covered subject to  Prior Approval up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE Covered subject to Prior Approval up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE
ORGAN TRANSPLANT Covered, only for Heart, Kidney and Liver, excluding organ donation, expenses of the donor and acquisition of the organ up to maximum of AED 50,000/-, subject to  Prior Approval Not covered Not covered Not covered
REPATRIATION OF MORTAL REMAINS TO HOME COUNTRY  Covered, up to maximum of AED 10,000/-
On Reimbursement basis only
subject to  Prior Approval
Covered, up to maximum of AED 10,000/-
On Reimbursement basis only
subject to  Prior Approval
Covered, up to maximum of AED 10,000/-
On Reimbursement basis only
subject to  Prior Approval
Covered, up to maximum of AED 10,000/-
On Reimbursement basis only
subject to Prior Approval
EMERGENCY EVACUATION Covered  for non-availability of treatment only on reimbursement basis; subject to  Prior Approval Covered  for non-availability of treatment only on reimbursement basis; subject to  Prior Approval Covered  for non-availability of treatment only on reimbursement basis; subject to  Prior Approval Covered for non-availability of treatment only on reimbursement basis; subject to Prior Approval
ALTERNATIVE MEDICINE TREATMENT INCLUDING ONLY THE FOLLOWING TREATMENTS: Prescribed Herbal Medicines, Acupuncture, Chiropractic, Homeopathy, Traditional Chinese Medicine, Ayurveda, Osteopathy,
Hypnotism, Aromatherapy
  Covered up to 2500/- with 20% coinsurance for consultations and medications only.
If prescribed by a licensed specialist
  Covered up to 1500/- with 20% coinsurance for consultations and medications only.
If prescribed by a licensed specialist
Not covered (Homeopathy & Ayurveda) Covered up to 2500/- with 20% coinsurance for consultations and medications only.

If prescribed by a licensed specialist
HOME NURSING    Covered up to maximum of 14 days with a sub-limit of 2,500/- (inclusive of the Annual Limit)
Under the supervision of specialist or consultant.
On Reimbursement basis only
  Covered up to maximum of 14 days with a sub-limit of 2,500/- (inclusive of the Annual Limit)
Under the supervision of specialist or consultant.
On Reimbursement basis only
  Covered up to maximum of 14 days with a sub-limit of 2,500/- (inclusive of the Annual Limit)
Under the supervision of specialist or consultant.
On Reimbursement basis only
Covered up to maximum of 14 days with a sub-limit of 2,500/- (inclusive of the Annual Limit)
Under the supervision of specialist or consultant.
On Reimbursement basis only
PATIENT SUPPORT PROGRAMME (PSP) Available for all Dubai visa holder in compliance with DHA regulations.  Separate manual on the process to be provided to the policy holder Available for all Dubai visa holder in compliance with DHA regulations.  Separate manual on the process to be provided to the policy holder Available for all Dubai visa holder in compliance with DHA regulations.  Separate manual on the process to be provided to the policy holder Available for all Dubai visa holder in compliance with DHA regulations.  Separate manual on the process to be provided to the policy holder
ROUTINE DENTAL
Coverage subject to reasonable and customary charges on Reimbursement Basis as per out of network procedure in any licensed clinic (if reimbursement is allowed) or in the appropriate
dental network on Direct Billing Basis.
Covered subject to prior approval up to AED 3,000/- per person per annum with 20% copayment on all procedures, the covered procedures are:

Examination

Required tooth cleaning (following treatment only) once a year

Fillings

Root Treatment

Tooth extraction

X-Ray

Local Anesthesia

Prescribed drugs

Covered subject to prior approval up to AED 2,000/- per person per annum with 20% copayment on all procedures, the covered procedures are:

Examination

Required tooth cleaning (following treatment only) once a year

Fillings

Root Treatment

Tooth extraction

X-Ray

Local Anesthesia

Prescribed drugs

Not Covered Not Covered
PSYCHIATRIC TREATMENTS Covered on 80% Reimbursement Basis up to 5,000 Dhs. per member per year (No additional copayment outside the applicable network)

Subject to prior-approval

Transient mental disorder or an acute reaction to stress are covered up to policy limit

Covered on 80% Reimbursement Basis up to 3,000 Dhs. per member per year (No additional copayment outside the applicable network)

Subject to prior-approval

Transient mental disorder or an acute reaction to stress are covered up to policy limit

Not Covered Covered on 80% Reimbursement Basis up to 10,000 Dhs. per member per year (No additional copayment outside the applicable network)

Subject to prior-approval

Transient mental disorder or an acute reaction to stress are covered up to policy limit
OPTICAL BENEFITS Prior approval is required.

The cover is up to maximum annual limit of AED 1,000/- per member.

Direct Billing is available within the designated Optical Network.

The cover includes the following only:

1. One elective diagnostic service for correction of vision in a licensed healthcare provider in a medical center or hospital per person per annum.

2. Lenses for spectacles prescribed by an ophthalmologist are covered once inclusive of the maximum optical limit subject to
Ophthalmologist consultation prescription inclusive of the maximum optical limit

3. Any other services related to correction of vision are not covered.

Prior approval is required.

The cover is up to maximum annual limit of AED 1,000/- per member.

Direct Billing is available within the designated Optical Network.

The cover includes the following only:

1. One elective diagnostic service for correction of vision in a licensed healthcare provider in a medical center or hospital per person per annum.

2. Lenses for spectacles prescribed by an ophthalmologist are covered once inclusive of the maximum optical limit subject to
Ophthalmologist consultation prescription inclusive of the maximum optical limit

3. Any other services related to correction of vision are not covered.

Not Covered Not Covered
AIR TICKET FARE Air Ticket fare, will be subject to:

1. Treatment within the member’s eligible geographical area for elective treatments as per policy.

2. Inpatient treatments.

3. Cost of treatment is less than 70% of the applicable network customary tariff of the country of policy issuance (including the cost of air fare).

4. Airfare class : Economy.

5. Reimbursement for the patients airfare (no airfare for companions).

6. Reimbursement will be limited to AED 2000/- maximum per treatment.

Air Ticket fare, will be subject to:

1. Treatment within the member’s eligible geographical area for elective treatments as per policy.

2. Inpatient treatments.

3. Cost of treatment is less than 70% of the applicable network customary tariff of the country of policy issuance (including the cost of air fare).

4. Airfare class : Economy.

5. Reimbursement for the patients airfare (no airfare for companions).

6. Reimbursement will be limited to AED 2000/- maximum per treatment.

Air Ticket fare, will be subject to:

1. Treatment within the member’s eligible geographical area for elective treatments as per policy.

2. Inpatient treatments.

3. Cost of treatment is less than 70% of the applicable network customary tariff of the country of policy issuance (including the cost of air fare).

4. Airfare class : Economy.

5. Reimbursement for the patients airfare (no airfare for companions).

6. Reimbursement will be limited to AED 2000/- maximum per treatment.

Not Covered
PROSTHESIS INSERTED INTO THE BODY DURING THE COURSE OF A SURGICAL PROCEDURE Covered if medically necessary and prescribed by a doctor to be integral part of the body. Covered if medically necessary and prescribed by a doctor to be integral part of the body. Covered if medically necessary and prescribed by a doctor to be integral part of the body. Covered if medically necessary and prescribed by a doctor to be integral part of the body.
INFLUENZA VACCINE Once per Annum

Standard Benefits International + International
AGGREGATE LIMIT AED 1,500,000 per person per annum AED 1,000,000 per person per annum
LOCAL NETWORK  Comprehensive Network
(Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes
to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.)
Comprehensive Network
(Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes
to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.)
OUTPATIENT LIMIT
In compliance with HAAD Circular no (DG/32/17) dated 13/08/2017 Patients seeking a second or subsequent outpatient appointment for the same specialty within 21 days, without
doctor referral, will only be covered if the patient obtains pre-approval by calling the “Company” claims’ centre. This process excludes the following: Patient’s first
visit for a specific symptom, children (under the age of 18), patients aged 60 years and above, health screening visits, vaccination visits, and emergencies.
Within the aggregate Limit.
Pharmaceuticals are 80% covered

Physician Consultation (GP):AED 50 (not applicable for follow up within 7 days)

Specialty Consultation (Specialist / Consultant):AED 50 (not applicable for follow up within 7 days)

Diagnostics Services: 100% Covered for Laboratory  & Imaging Services

Imaging Services to cover:

X-rays

MRI

CT-scan

Ultra Sound

Laboratory Services to cover:

Biochemistry

Hematology

Virology

Bacteriology

Pathology
Within the aggregate Limit.
Pharmaceuticals are 80% covered

Physician Consultation (GP): 50 (not applicable for follow up within 7 days)

Specialty Consultation (Specialist / Consultant):AED 50 (not applicable for follow up within 7 days)

Diagnostics Services: 100% Covered for Laboratory  & Imaging Services

Imaging Services to cover:

X-rays

MRI

CT-scan

Ultra Sound

Laboratory Services to cover:

Biochemistry

Hematology

Virology

Bacteriology

Pathology
OUTPATIENT APPROVAL REQUIREMENTS CT and MRI scans
Endoscopies

All additional therapies e.g. Physiotherapy, Chiropractic, etc.

Any additional benefits to DOH Basic Product such as Optical and Dental treatment, Psychiatry, vaccination, etc.
CT and MRI scans
Endoscopies

All additional therapies e.g. Physiotherapy, Chiropractic, etc.

Any additional benefits to DOH Basic Product such as Optical and Dental treatment, Psychiatry, vaccination, etc. 
INPATIENT COVER Within the aggregate Limit (100% Covered Except for Exclusions)
Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU).
Within the aggregate Limit (100% Covered Except for Exclusions)
Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU).
SETTLEMENT BASIS INSIDE NETWORK IN UAE Direct Billing Direct Billing
BASIC TERRITORY Worlwide Including USA & Canada Worlwide Excluding USA & Canada
TRAVEL EXTENSION
(OUTSIDE BASIC TERRITORY)
N/A Not Covered
INTERNATIONAL ASSISTANCE While they are travelling abroad, insured members will be advised through our International Assistance Program (Eurocross / Mideast Assistance) upon contacting the number at the back of the medical
card, about a suitable medical facility according to their medical condition.

Benefit will cover mainly : 1. Evacuation and Repatriation 2. Repatriation of Mortal Remains 3. Travel Information Service 4. Referral to Medical Correspondents Abroad 5. Long Distance
Medical Advice 6. Delivery of Urgent Messages 7. Transportation to Join Member 8. Return of Dependent Children 9. Compensation for Delay in the Arrival of Luggage 10. Total Loss or Disappearance
of Baggage 11. Loss of Passport, Driving License, or National Identity Card Abroad

For Full Details and list of Benefits, conditions & exclusions: please refer to the International assistance brochure.

While they are travelling abroad, insured members will be advised through our International Assistance Program (Eurocross / Mideast Assistance) upon contacting the number at the back of the medical
card, about a suitable medical facility according to their medical condition.

Benefit will cover mainly : 1. Evacuation and Repatriation 2. Repatriation of Mortal Remains 3. Travel Information Service 4. Referral to Medical Correspondents Abroad 5. Long Distance
Medical Advice 6. Delivery of Urgent Messages 7. Transportation to Join Member 8. Return of Dependent Children 9. Compensation for Delay in the Arrival of Luggage 10. Total Loss or Disappearance
of Baggage 11. Loss of Passport, Driving License, or National Identity Card Abroad

For Full Details and list of Benefits, conditions & exclusions: please refer to the International assistance brochure.

OUT-OF-NETWORK INSIDE UAE.
Claims to be submitted within 30 days inside UAE and within 90 days outside UAE
Outpatient Treatment:

Physician Consultation (GP) covered with 20% Co-payment and applicable deductible

Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible

Pharmaceutical: covered with 20% Co-payment

Lab and Imaging Services: covered with 20% Co-payment

Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only.

Any treatment initiated outside the network will be settled as an out of Network.

Inpatient Treatment:

Treatment taken outside the Network is covered At 80% of incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only.

Outpatient Treatment:

Physician Consultation (GP) covered with 20% Co-payment and applicable deductible

Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible

Pharmaceutical: covered with 20% Co-payment

Lab and Imaging Services: covered with 20% Co-payment

Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only.

Any treatment initiated outside the network will be settled as an out of Network.

Inpatient Treatment:

Treatment taken outside the Network is covered At 80% of incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only.

OUTSIDE UAE
while on vacation or business trip provided the maximum aggregate period of stay does not exceed 90 days during the Period of policy
Treatment Outside UAE inside the Basic Territory:

Covered at 100% subject to applicable deductible up to reasonable and customary charges applicable in the country of treatment (Out-patient is covered on reimbursement basis only, while
Inpatient is covered on Direct billing where Network is available).

Treatment Outside UAE Outside the Basic Territory:

N/A

Treatment Outside UAE inside the Basic Territory:

Covered at 100% subject to applicable deductible up to reasonable and customary charges applicable in the country of treatment (Out-patient is covered on reimbursement basis only, while
Inpatient is covered on Direct billing where Network is available).

Treatment Outside UAE Outside the Basic Territory:

Not Covered

EMERGENCY & TREATMENT NOT AVAILABLE WITHIN NETWORK WITHIN UAE Covered 100% at actual cost Covered 100% at actual cost
ROOM TYPE Private Room Private Room
PARENT ACCOMMODATION  Daily benefit for one parent accompanying an insured child under 14 years of age, Full Refund Daily benefit for one parent accompanying an insured child under 14 years of age, Full Refund
ACCOMPANYING PERSON  Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 150/-
per night)
Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 150/-
per night)
LOCAL AMBULANCE Transportation services  for medical emergencies by an authorized party is 100% covered Transportation services  for medical emergencies by an authorized party is 100% covered
PHYSIOTHERAPY 100% Covered, subject to prior approval 100% Covered, subject to prior approval
MATERNITY / Obstetrical & Follow up (IP & OP) FOR MARRIED FEMALES ONLY

Waiting period of 180 days on In-Patient cases only (unless there is proof of continuity of health insurance coverage).

Subject to Prior Approval.

1. Deductible:

AED 500/- per Delivery & 20% up to AED 50/- per consultation (same conditions of OP consultations will apply).

2.  Inside Abu Dhabi:

Covered up to aggregate.

3. Out Side Abu Dhabi:

Covered up to AED 15,000/- for Normal Delivery and up to AED 25,000/- for Cesarean Section.

The antenatal care (visits, ultra sounds, etc.…) is inclusive of the above limits.

Emergency inside UAE covered 100% up to the policy limit

Treatment not available within the network is covered 100% within UAE up to maternity limit.

1. Deductible:

AED 500/- per Delivery & 20% up to AED 50/- per consultation (same conditions of OP consultations will apply).

2.  Inside Abu Dhabi:

Covered up to aggregate.

3. Out Side Abu Dhabi:

Covered up to AED 15,000/- for Normal Delivery and up to AED 25,000/- for Cesarean Section.

The antenatal care (visits, ultra sounds, etc.…) is inclusive of the above limits.

Emergency inside UAE covered 100% up to the policy limit

Treatment not available within the network is covered 100% within UAE up to maternity limit.

WORK RELATED ACCIDENTS
As per Federal Law No. 8 of 1980 concerning the regulation of work relation as amended and applicable laws in this regard.
Covered inside Abu Dhabi only.  Covered inside Abu Dhabi only. 
OTHER BENEFITS Diagnostic and treatment services for dental and gum treatments emergency cases only.

Hearing and vision aids, and vision correction by surgeries & ophthalmology, and laser are covered for emergency cases only.

Diagnostic and treatment services for dental and gum treatments emergency cases only.

Hearing and vision aids, and vision correction by surgeries & ophthalmology, and laser are covered for emergency cases only.
ADDITIONAL BENEFITS    
ORGAN TRANSPLANT Covered, Full Refund, subject to Prior Approval.
Organ donation, expenses of the donor and acquisition of the organ are excluded.
Covered,  up to maximum of AED 250,000/-, subject to Prior Approval.
Organ donation, expenses of the donor and acquisition of the organ are excluded.
RENAL DIALYSIS Full Refund Covered,  up to maximum of AED 100,000/-, subject to Prior Approval.
ALTERNATIVE MEDICINE TREATMENT INCLUDING ONLY THE FOLLOWING TREATMENTS: CHIROPRACTIC, OSTEOPATHY Prescribed Herbal Medicines, Acupuncture, Homeopathy, Traditional Chinese Medicine, Ayurveda,
Hypnotism, Aromatherapy
Covered up to 7,500/-  With 20% Co-payment (no additional copayment outside the applicable Network)

If prescribed by a licensed specialist

subject to prior approval

Covered up to 5,000/-  With 20% Co-payment (no additional copayment outside the applicable Network)

If prescribed by a licensed specialist

subject to prior approval

HOME NURSING  Covered following Inpatient or Day-patient Treatment upon the recommendation of your specialist, up to maximum of 60 Days (inclusive of the Annual Limit) subject to prior approval

Under the supervision of specialist or  consultant.

Home Visit in case of emergency (if insured member is unable to visit clinic for Out-Patient consultation due to a severe medical reason) not to exceed AED 1,000/- per
visit.

On Reimbursement basis only
Covered following Inpatient or Day-patient Treatment upon the recommendation of your specialist, up to maximum of 30 Days (inclusive of the Annual Limit) subject to prior approval

Under the supervision of specialist or  consultant.

Home Visit in case of emergency (if insured member is unable to visit clinic for Out-Patient consultation due to a severe medical reason) not to exceed AED 1,000/- per
visit.

On Reimbursement basis only
ROUTINE VACCINATIONS  Covered for children up to 6 yrs. only 
As Per DOH Guidelines (Subject To Prior Approval)
Covered for children up to 6 yrs. only
As Per DOH Guidelines (Subject To Prior Approval)
PSYCHIATRIC TREATMENTS Covered on 80% Reimbursement Basis up to 5,000 Dhs. per member per year (No additional copayment outside the applicable network)

Subject to prior-approval

Transient mental disorder or an acute reaction to stress are covered up to policy limit inside UAE only

Covered on 80% Reimbursement Basis up to 3,000 Dhs. per member per year (No additional copayment outside the applicable network)

Subject to prior-approval

Transient mental disorder or an acute reaction to stress are covered up to policy limit inside UAE only
VITAMINS Covered if prescribed by doctor as a part of treatment and not as a supplement Covered if prescribed by doctor as a part of treatment and not as a supplement
REHABILITATION IMMEDIATELY AFTER ACUTE MEDICAL TREATMENT Inside the Emirate of Abu Dhabi and Emergency cases within UAE: Covered as per DOH Regulations subject to prior approval.

Outside the Emirate of Abu Dhabi (except Emergency within UAE):

Covered subject to prior approval up to 120 days per medical condition as below:

Physical Therapy to help strength, mobility & fitness – covered

Occupational Therapy to help you with your daily activities – not covered

Speech-Language therapy to help with speaking, understanding, reading, writing and swallowing – not covered.
Inside the Emirate of Abu Dhabi and Emergency cases within UAE: Covered as per DOH Regulations subject to prior approval.

Outside the Emirate of Abu Dhabi (except Emergency within UAE):

Covered subject to prior approval up to 120 days per medical condition as below:

Physical Therapy to help strength, mobility & fitness – covered

Occupational Therapy to help you with your daily activities – not covered

Speech-Language therapy to help with speaking, understanding, reading, writing and swallowing – not covered.
Routine Dental Examination
Fillings (standard amalgam or composite)
Root Canal Treatment

Gum Treatment, excluding Flap Surgeries
Extractions
The cover is up to maximum annual limit of AED 3,500/- per member . The cover is up to maximum annual limit of AED 2,000/- per member.
OPTICAL BENEFITS
One Routine eye examination

Lenses for spectacles are covered once inclusive of the maximum optical limit subject to Ophthalmologist / optometrist prescription
The cover is up to maximum annual limit of AED 1,800/- per member. Not Covered
IN HOSPITAL CASH BENEFIT Covered up to AED 700 per night in case of free hospitalization Covered up to AED 500 per night in case of free hospitalization
ROUTINE CHECK-UP:
One check up every two years available after 12 months continuous cover
Covered up to AED 1,000/- pppa Covered up to AED 500/- pppa
PROSTHESIS INSERTED INTO THE BODY DURING THE COURSE OF A SURGICAL PROCEDURE Covered if medically necessary and prescribed by a doctor to be integral part of the body. Covered if medically necessary and prescribed by a doctor to be integral part of the body.
PASSIVE WAR RISK (detailed wordings in ‘Passive War Risk Cover’ Sheet) Passive War and/or Passive terrorism as an innocent bystander is covered. However; Passive war is excluded in Iraq, Afghanistan& Syria and any other country where war or war like operation
takes place. It is also excluded for any member who travels to any country where war has been declared or war like operations takes place and remains there for more than 28 days following
the outbreak.
Passive War and/or Passive terrorism as an innocent bystander is covered. However; Passive war is excluded in Iraq, Afghanistan& Syria and any other country where war or war like operation
takes place. It is also excluded for any member who travels to any country where war has been declared or war like operations takes place and remains there for more than 28 days following
the outbreak.

Standard Benefits International + International
AGGREGATE LIMIT AED 1,500,000 per person per annum AED 1,000,000 per person per annum
LOCAL NETWORK  Comprehensive Network

(Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network,
The updated network list of medical providers will be sent accordingly to the policy holder.)
Comprehensive Network

(Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network,
The updated network list of medical providers will be sent accordingly to the policy holder.)
SETTLEMENT BASIS INSIDE NETWORK IN UAE Direct Billing Direct Billing
BASIC TERRITORY Worlwide Including USA & Canada Worlwide Excluding USA & Canada
INTERNATIONAL ASSISTANCE While they are travelling abroad, insured members will be advised through our International Assistance Program (Eurocross / Mideast Assistance) upon contacting the number at the back of the medical
card, about a suitable medical facility according to their medical condition.

Benefit will cover mainly : 1. Evacuation and Repatriation 2. Repatriation of Mortal Remains 3. Travel Information Service 4. Referral to Medical Correspondents Abroad 5. Long Distance
Medical Advice 6. Delivery of Urgent Messages 7. Transportation to Join Member 8. Return of Dependent Children 9. Compensation for Delay in the Arrival of Luggage 10. Total Loss or Disappearance
of Baggage 11. Loss of Passport, Driving License, or National Identity Card Abroad

For Full Details and list of Benefits, conditions & exclusions: please refer to the International assistance brochure.

While they are travelling abroad, insured members will be advised through our International Assistance Program (Eurocross / Mideast Assistance) upon contacting the number at the back of the medical
card, about a suitable medical facility according to their medical condition.

Benefit will cover mainly : 1. Evacuation and Repatriation 2. Repatriation of Mortal Remains 3. Travel Information Service 4. Referral to Medical Correspondents Abroad 5. Long Distance
Medical Advice 6. Delivery of Urgent Messages 7. Transportation to Join Member 8. Return of Dependent Children 9. Compensation for Delay in the Arrival of Luggage 10. Total Loss or Disappearance
of Baggage 11. Loss of Passport, Driving License, or National Identity Card Abroad

For Full Details and list of Benefits, conditions & exclusions: please refer to the International assistance brochure.

EMERGENCY MEDICAL TREATMENT  Full Refund Full Refund
OUT-OF-NETWORK INSIDE UAE. Claims to be submitted within 30 days inside UAE and within 90 days outside UAE Outpatient Treatment:

Physician Consultation (GP) covered with 20% Co-payment and applicable deductible

Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible

Pharmaceutical: covered with 20% Co-payment

Lab and Imaging Services: covered with 20% Co-payment

Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on
reimbursement basis only.

Any treatment initiated outside the network will be settled as an out of Network.

Treatment taken outside the Network is covered At 80% of incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only.

Outpatient Treatment:

Physician Consultation (GP) covered with 20% Co-payment and applicable deductible

Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible

Pharmaceutical: covered with 20% Co-payment

Lab and Imaging Services: covered with 20% Co-payment

Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only.

Any treatment initiated outside the network will be settled as an out of Network.

Treatment taken outside the Network is covered At 80% of incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only.

OUTSIDE UAE
while on vacation or business trip provided the maximum aggregate period of stay does not exceed 90 days during the Period of policy
Treatment Outside UAE inside the Basic Territory:

Covered at 100% subject to applicable deductible up to reasonable and customary charges applicable in the country of treatment (Out-patient is covered on reimbursement basis only, while
Inpatient is covered on Direct billing where Network is available).

Treatment Outside UAE Outside the Basic Territory:

N/A
Treatment Outside UAE inside the Basic Territory:

Covered at 100% subject to applicable deductible up to reasonable and customary charges applicable in the country of treatment (Out-patient is covered on reimbursement basis only, while
Inpatient is covered on Direct billing where Network is available).

Treatment Outside UAE Outside the Basic Territory:

Not Covered
IN-PATIENT TREATMENT AT AUTHORIZED HOSPITALS
Subject to Prior Approval.
Within the aggregate Limit (100% Covered Except for Exclusions)

Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU).

Ground transportation services in the UAE provided by an authorized party for medical emergencies.

Daily benefit for one parent accompanying an insured child under 16 years of age, Full Refunf

Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of
AED 150/- per night)

Prior approval is required from the insurance company (For Emergency Treatment Approval required from the insurance company within 24 hours of admission to the authorized hospital).

Within the aggregate Limit (100% Covered Except for Exclusions)

Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU).

Ground transportation services in the UAE provided by an authorized party for medical emergencies.

Daily benefit for one parent accompanying an insured child under 16 years of age, Full Refunf

Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of
AED 150/- per night)

Prior approval is required from the insurance company (For Emergency Treatment Approval required from the insurance company within 24 hours of admission to the authorized hospital).
MATERNITY / Obstetrical & Follow up (IP & OP) FOR MARRIED FEMALES ONLY

Note: Where any condition develops which becomes life threatening to either the mother or the new born, the medically necessary expenses will be covered up to AED 150,000/-

Subject to Prior Approval.

Out-patient ante-natal services:

10% coinsurance payable by the insured

Initial investigations to include: FBC and Platelets, Blood group, Rhesus status and antibodies ,VDRL, MSU & urinalysis, Rubella serology, HIV, Hep C offered to high risk patients, GTT
if high risk.

FBS , random s or A1c for all due to high prevalence of diabetes in unable

Visits to include reviews, checks and tests in accordance with DHA Antenatal Care Protocols

ante-natal ultrasound scans

In-patient maternity services:

10% coinsurance payable by the insured

Maximum benefit 15,000 AED per normal delivery and 25,000 AED for medically necessary C-section, complications and for medically necessary termination (All limits include coinsurance)

New born cover:

Cover for 30 days from birth. Coverage of a pregnant female is extended by the insurer to provide the same benefits for a new born child of that female for a period up to 30 days from
its date of birth. This cover is provided regardless of whether or not the new born is eventually enrolled as a dependent member under the insurer’s policy.

BCG, Hepatitis B and neo-natal screening tests (Phenylketonuria (PKU), Congenital Hypothyroidism, sickle cell screening, congenital adrenal hyperplasia).

Out-patient ante-natal services:

10% coinsurance payable by the insured

Initial investigations to include: FBC and Platelets, Blood group, Rhesus status and antibodies ,VDRL, MSU & urinalysis, Rubella serology, HIV, Hep C offered to high risk patients, GTT
if high risk.

FBS , random s or A1c for all due to high prevalence of diabetes in unable

Visits to include reviews, checks and tests in accordance with DHA Antenatal Care Protocols

ante-natal ultrasound scans

In-patient maternity services:

10% coinsurance payable by the insured

Maximum benefit 15,000 AED per normal delivery and 25,000 AED for medically necessary C-section, complications and for medically necessary termination (All limits include coinsurance)

New born cover:

Cover for 30 days from birth. Coverage of a pregnant female is extended by the insurer to provide the same benefits for a new born child of that female for a period up to 30 days from
its date of birth. This cover is provided regardless of whether or not the new born is eventually enrolled as a dependent member under the insurer’s policy.

BCG, Hepatitis B and neo-natal screening tests (Phenylketonuria (PKU), Congenital Hypothyroidism, sickle cell screening, congenital adrenal hyperplasia).

OUT-PATIENT Examination, diagnostic and treatment services by authorized general practitioners, specialists and consultants: 20% coinsurance payable by the insured per visit (not to exceed Dhs.50 /-)

No coinsurance if a follow-up visit made within seven days.

Laboratory test services carried out in the authorized facility assigned to treat the insured person: Nill coinsurance payable by the insured

Radiology diagnostic services carried out in the authorized facility assigned to treat the insured person: Nill coinsurance payable by the insured

In cases of non-medical emergencies, the insurance company’s prior approval is required for MRI, CT scans and endoscopies.

Physiotherapy : full Refund (subject to Prior approval of the insurance company)

Drugs and other medicines:

1. Cost of drugs and medicines up to an annual limit

2. 20% payable by the insured in respect of each and every prescription

Examination, diagnostic and treatment services by authorized general practitioners, specialists and consultants: 20% coinsurance payable by the insured per visit (not to exceed Dhs.50 /-)

No coinsurance if a follow-up visit made within seven days.

Laboratory test services carried out in the authorized facility assigned to treat the insured person: Nill coinsurance payable by the insured

Radiology diagnostic services carried out in the authorized facility assigned to treat the insured person: Nill coinsurance payable by the insured

In cases of non-medical emergencies, the insurance company’s prior approval is required for MRI, CT scans and endoscopies.

Physiotherapy : full Refund (subject to Prior approval of the insurance company)

Drugs and other medicines:

1. Cost of drugs and medicines up to an annual limit

2. 20% payable by the insured in respect of each and every prescription

PREVENTIVE SERVICES, VACCINES AND IMMUNIZATIONS Essential vaccinations and inoculations for newborns and children as stipulated in the DHA’s policies and its updates (currently the same as Federal MOH).

Preventive services as stipulated by DHA to include initially diabetes screening

Frequency restricted to: Diabetes: Every 3 years from age 30 High risk individuals annually from age 18 yrs.

Adult Pneumococcal Conjugate Vaccine: As per DHA Adult Pneumococcal Vaccination guidelines.

Hepatitis C Virus Screening and treatment: To be followed as per the guidelines laid out in the Hepatitis C support program.

Cancer Screening and treatment: To be followed as per the guidelines laid out in the Cancer support program
Essential vaccinations and inoculations for newborns and children as stipulated in the DHA’s policies and its updates (currently the same as Federal MOH).

Preventive services as stipulated by DHA to include initially diabetes screening

Frequency restricted to: Diabetes: Every 3 years from age 30 High risk individuals annually from age 18 yrs.

Adult Pneumococcal Conjugate Vaccine: As per DHA Adult Pneumococcal Vaccination guidelines.

Hepatitis C Virus Screening and treatment: To be followed as per the guidelines laid out in the Hepatitis C support program.

Cancer Screening and treatment: To be followed as per the guidelines laid out in the Cancer support program
EXCLUDED HEALTHCARE SERVICES EXCEPT IN CASES OF MEDICAL EMERGENCIES Diagnostic and treatment services for dental and gum treatments: Covered for Emergency cases only Subject to 20% coinsurance

Hearing and vision aids, and vision correction by surgeries and laser : Covered for Emergency cases only Subject to 20% coinsurance

Diagnostic and treatment services for dental and gum treatments: Covered for Emergency cases only Subject to 20% coinsurance

Hearing and vision aids, and vision correction by surgeries and laser : Covered for Emergency cases only Subject to 20% coinsurance
IN HOSPITAL CASH BENEFIT Covered up to AED 700 per night in case of free hospitalization Covered up to AED 500 per night in case of free hospitalization
ORGAN TRANSPLANT Covered, Full Refund, subject to Prior Approval.
Organ donation, expenses of the donor and acquisition of the organ are excluded.
Covered,  up to maximum of AED 250,000/-, subject to Prior Approval.
Organ donation, expenses of the donor and acquisition of the organ are excluded.
RENAL DIALYSIS Full Refund Covered,  up to maximum of AED 100,000/-, subject to Prior Approval.
ALTERNATIVE MEDICINE TREATMENT INCLUDING ONLY THE FOLLOWING TREATMENTS: Prescribed Herbal Medicines, Acupuncture, , Homeopathy, Traditional Chinese Medicine, Ayurveda, Hypnotism, Aromatherapy,
Chiropractic, Osteopathy
Covered up to 7,500/-  With 20% Co-payment (no additional copayment outside the applicable Network)

If prescribed by a licensed specialist
subject to prior approval
Covered up to 5,000/-  With 20% Co-payment (no additional copayment outside the applicable Network)

If prescribed by a licensed specialist
subject to prior approval
REPATRIATION OF MORTAL REMAINS TO HOME COUNTRY    
EMERGENCY EVACUATION    
ALTERNATIVE MEDICINE TREATMENT    
HOME NURSING  Covered up to maximum of 60 Days (inclusive of the Annual Limit) subject to prior approval

Under the supervision of specialist or consultant.

Home Visit in case of emergency (if insured member is unable to visit clinic for Out-Patient consultation due to a severe medical reason) not to exceed AED 1,000/- per
visit.

On Reimbursement basis only
Covered up to maximum of 30 Days (inclusive of the Annual Limit) subject to prior approval

Under the supervision of specialist or consultant.

Home Visit in case of emergency (if insured member is unable to visit clinic for Out-Patient consultation due to a severe medical reason) not to exceed AED 1,000/- per
visit.

On Reimbursement basis only
PATIENT SUPPORT PROGRAMME (PSP) Available for all Dubai visa holder in compliance with DHA regulations.  Separate manual on the process to be provided to the policy holder Available for all Dubai visa holder in compliance with DHA regulations.  Separate manual on the process to be provided to the policy holder
PSYCHIATRIC TREATMENTS Covered on 80% Reimbursement Basis up to 3,500 Dhs. per member per year (No additional copayment outside the applicable network)

Subject to prior-approval

Transient mental disorder or an acute reaction to stress are covered up to policy limit inside UAE only
Outpatient Psychiatric Care: Not Covered

Transient mental disorder or an acute reaction to stress are covered up to policy limit inside UAE only
VITAMINS Covered if prescribed by doctor as a part of treatment and not as a supplement Covered if prescribed by doctor as a part of treatment and not as a supplement
Routine Dental Examination

Fillings (standard amalgam or composite)

Root Canal Treatment

Gum Treatment, excluding Flap Surgeries

Extractions
The cover is up to maximum annual limit of AED 3,500/- per member . The cover is up to maximum annual limit of AED 2,000/- per member.
OPTICAL BENEFITS
One Routine eye examination

Lenses for spectacles are covered once inclusive of the maximum optical limit subject to Ophthalmologist / optometrist prescription
The cover is up to maximum annual limit of AED 1,800/- per member. Not Covered
ROUTINE CHECK-UP:
One check up every two years available after 12 months continuous cover
Covered  up to AED 1,000/- pppa Covered  up to AED 500/- pppa
PROSTHESIS INSERTED INTO THE BODY DURING THE COURSE OF A SURGICAL PROCEDURE Covered if medically necessary and prescribed by a doctor to be integral part of the body. Covered if medically necessary and prescribed by a doctor to be integral part of the body.
PASSIVE WAR RISK (detailed wordings in ‘Passive War Risk Cover’ Sheet) Passive War and/or Passive terrorism as an innocent bystander is covered. However; Passive war is excluded in Iraq, Afghanistan& Syria and any other country where war or war like operation
takes place. It is also excluded for any member who travels to any country where war has been declared or war like operations takes place and remains there for more than 28 days following
the outbreak.
Passive War and/or Passive terrorism as an innocent bystander is covered. However; Passive war is excluded in Iraq, Afghanistan& Syria and any other country where war or war like operation
takes place. It is also excluded for any member who travels to any country where war has been declared or war like operations takes place and remains there for more than 28 days following
the outbreak.

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Claims

CLAIMS INFORMATION

Our claim settlement procedure is prompt and hassle-free. If you wish to file a claim, we are always ready to assist you!

It is advisable to consult us for detailed assistance while filing a claim.

FILE A CLAIM ONLINE:

To file your claim online, please click  on one of the following:

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Motor Claim

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Non-Motor Claim

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Medical Reimbursement Claim

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Life Claim

FILE A CLAIM THROUGH PHONE:

To file your claim through phone, please call on one of the following numbers:

Non-Motor Claims Motor Claims
Abu Dhabi

Tamouh Tower
25th Floor Marina Square
Al Reem Island
P.O. Box 35335
United Arab Emirates

+971 2 410 7700
+971 2 410 7800

Click here for Location Map

Abu Dhabi

3rd floor, Ahmad Saeed Al Houtta Al Ameri Building,
Al Nahyan Camp Area. Behind the Civil Defense HQ
P.O. Box 35335
United Arab Emirates

+971 2 419 7444
+971 2 626 0777

Click here for Location Map

Dubai

The Regal Tower, 30th floor, Business Bay
P.O. Box 53389
United Arab Emirates

+971 4 210 8700
+971 4 210 8777

Click here for Location Map

Al Ain

Emirates Islamic Bank Building, Mezzanine 1st floor, Opposite Al Ain Mall,
Al-Murabbaa District
P.O Box 64166

+971 3 716 6700
+971 3 766 0555

Click here for Location Map

Motor Claim

STEP 1: WRITTEN INTIMATION

Please download and complete the Claim Form.

A claim can be filed for benefits under the policy by submitting a written intimation from the policyholder.


STEP 2: COMPLETE THE CLAIM FORM ALONG WITH THE REQUIRED DOCUMENTS

Complete the claim form and provide all the required documents.

Always remember to mention the event date, cause of the event and the complete contact information of the claimant while intimating the claim.


STEP 3: SUBMIT THE CLAIM FORM ALONG WITH THE REQUIRED DOCUMENTS

Submit the completed claim form and provide all the required documents.

The original documents will be required by Abu Dhabi National Takaful Co. PSC during the claim assessment stage.


STEP 4: CONTACT MOTOR CLAIMS DEPARTMENT FOR VEHICLE INSPECTION

STEP 5: CLAIM ASSESSMENT AND SETTLEMENT

A claim is assessed as soon as the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.

In order for prompt settlement of the claim, kindly ensure that the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.

To file your claim through phone, please click here to contact us.

Please fill the form below

    Attach / Drop the following files here*:

  • Motor Claim Form (completed and signed).
  • Police Report (or SAAED Referral Note).
  • License for the driver at time of accident.
  • Car Registration Copy
  • UAE Identity Card Copy
  • Supported file formats: PDF, Doc, Docx, jpg.

I hereby confirm that all required documents are available with me and shall be submitted in original to Abu Dhabi National Takaful Co. PSC before the settlement of my claim. I fully understand that without providing the required documents in original my claim will be considered incomplete and no settlement will be done.

Non-Motor Claim

STEP 1: WRITTEN INTIMATION

Please download and complete the Claim Form.

A claim can be filed for benefits under the policy by submitting a written intimation from the policyholder.


STEP 2: COMPLETE THE CLAIM FORM ALONG WITH THE REQUIRED DOCUMENTS

Complete the claim form and provide all the required documents.

Always remember to mention the event date, cause of the event and the complete contact information of the claimant while intimating the claim.


STEP 3: SUBMIT THE CLAIM FORM ALONG WITH THE REQUIRED DOCUMENTS

Submit the completed claim form and provide all the required documents.

The original documents will be required by Abu Dhabi National Takaful Co. PSC during the claim assessment stage.


STEP 4: CLAIM ASSESSMENT AND SETTLEMENT

A claim is assessed as soon as the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.

In order for prompt settlement of the claim, kindly ensure that the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.

Important Note:

Please make sure that Date of Loss, Nature of loss and Cause of Loss in stated.

To file your claim through phone, please click here to contact us.

Please fill the form below

    Attach / Drop the following files here*:

  • Claim Form (completed and signed).
  • Supporting documents.
  • Supported file formats: PDF, Doc, Docx, jpg.

I hereby confirm that all required documents are available with me and shall be submitted in original to Abu Dhabi National Takaful Co. PSC before the settlement of my claim. I fully understand that without providing the required documents in original my claim will be considered incomplete and no settlement will be done.

Medical Reimbursement Claim

STEP 1: WRITTEN INTIMATION

Please click here to know about the Medical Claim Process.

Please download and complete the Claim Form.

A claim can be filed for benefits under the policy by submitting a written intimation from the policyholder.


STEP 2: COMPLETE THE CLAIM FORM ALONG WITH THE REQUIRED DOCUMENTS

Complete the claim form and provide all the required documents.

Always remember to mention the event date, cause of the event and the complete contact information of the claimant while intimating the claim.


STEP 3: SUBMIT THE CLAIM FORM ALONG WITH THE REQUIRED DOCUMENTS

Submit the completed claim form and provide all the required documents.

The original documents will be required by Abu Dhabi National Takaful Co. PSC during the claim assessment stage.


STEP 4: CLAIM ASSESSMENT AND SETTLEMENT

A claim is assessed as soon as the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.

In order for prompt settlement of the claim, kindly ensure that the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.

To file your claim through phone, please click here to contact us.

Please fill the form below

    Attach / Drop the following files here*:

  • Claim Form (completed & signed)
  • Detailed Medical Report.
  • The original itemized bill/invoice.
  • The original receipt.
  • Copy of the Doctor’s prescription.
  • Copy of the investigative tests results/reports e.g. blood tests, x-rays, ultrasound, MRI, etc.).
  • Discharge summary for Inpatient (Hospitalization Cases).
  • Police report (if the claim relates to an accident).
  • Supported file formats: PDF, Doc, Docx, jpg.
  • Other supporting documents.

I hereby confirm that all required documents are available with me and shall be submitted in original to Abu Dhabi National Takaful Co. PSC before the settlement of my claim. I fully understand that without providing the required documents in original my claim will be considered incomplete and no settlement will be done.

Life Claim

STEP 1: WRITTEN INTIMATION

Please download and complete the Claim Form.

A claim can be filed for benefits under the policy by submitting a written intimation from the policyholder.


STEP 2: COMPLETE THE CLAIM FORM ALONG WITH THE REQUIRED DOCUMENTS

Complete the claim form and provide all the required documents.

Always remember to mention the event date, cause of the event and the complete contact information of the claimant while intimating the claim.


STEP 3: SUBMIT THE CLAIM FORM ALONG WITH THE REQUIRED DOCUMENTS

Submit the completed claim form and provide all the required documents.

The original documents will be required by Abu Dhabi National Takaful Co. PSC during the claim assessment stage.


STEP 4: CLAIM ASSESSMENT AND SETTLEMENT

A claim is assessed as soon as the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.

In order for prompt settlement of the claim, kindly ensure that the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.

To file your claim through phone, please click here to contact us.

Please fill the form below

    Attach / Drop the following files here*:

  • Claim Form (completed and signed).
  • Death Certificate.
  • Medical Reports.
  • Other supporting documents.
  • Supported file formats: PDF, Doc, Docx, jpg.

I hereby confirm that all required documents are available with me and shall be submitted in original to Abu Dhabi National Takaful Co. PSC before the settlement of my claim. I fully understand that without providing the required documents in original my claim will be considered incomplete and no settlement will be done.

Feedback Form - Customer Service

Your feedback is important to us to help us improve our services.

Kindly rate the departments that you visited in terms of customer service?

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Branch Excellent Good Fair Poor

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Do our products & service match your requirements?

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How likely are you to recommend our products & services to a friend or colleagues?

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How long did you wait to get a reply from us if you filed a complaint?

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good
4 – 6 Days
good
More than 7 Days
modereate
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Contact Us

Abu Dhabi National Takaful Co. PSC,
Tamouh Tower,
25th Floor, Al Reem Island,
P.O. Box 35335, Abu Dhabi,
United Arab Emirates

Telephone: +971 2 410 7700
Fax: +971 2 410 7800
Email: info@takaful.ae

Timings:
Mondays to Thursdays from 8:00 am to 5:00 pm,
Fridays from 8:00 am to 12:00 pm

Get Direction

Have a Takaful Professional Contact You :


Contact Our Branch Network :

Head Office

Tamouh Tower, 25th Floor
Marina Square, Al Reem Island
P.O. Box 35335
Abu Dhabi
+971 2 410 7700
+971 2 410 7800

(Motor Insurance and Claims) Al Nahyan Camp Branch

Mr. Nasr K Abdul Rahman

Branch Manager – Personal Line Business & Motor Insurance
3rd floor, Ahmad Saeed Al Houtta Al Ameri Building,
Al Nahyan Camp Area. Behind the Civil Defense HQ
Google map: 53 Hameem St – Al Nahyan – E6
PO Box 35335
Abu Dhabi

+971 2 419 7400

Muroor Branch

MR. MOHAMED ADNAN ASAD
In-charge of Muroor Branch
Traffic Vehicles Inspection & Registration Centre
P.O. Box 35335
Abu Dhabi
+971 2 410 7700
+971 2 449 2506

Al-Murabbaa District

MR. SAMER AHMED HALIME
Branch Manager
Abu Dhabi National Takaful PSC., Emirates Islamic Bank Building, Mezzanine 1 Floor, Opposite Al Ain Mall, Al-Murabbaa District, P.O Box 64166, Al Ain.
+971 3 7166700
+971 3 766 0555

Muroor Branch

MR. MOHAMMAD ALBURENI
Assistant Underwriting Officer
Traffic Vehicles Inspection & Registration Centre
P.O. Box 64166
Al Ain
+971 2 449 2504
+971 3 781 1244

The Regal Tower

MR. ARJUN GC
Head of Dubai and Northern Emirates
The Regal Tower, 30th floor, Business Bay
P.O. Box 53389
Dubai
+971 4 210 8700
+971 4 210 8777




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